Post image for Determining medication safety in pregnancy, review of Pregnancy & Medication Safety

Most health care professionals can recall a time when a patient, family member, or friend has asked some variation of the question: “Is this drug safe in pregnancy?”  The truthful, if difficult, answer to such a question is often “maybe,” or even “we don’t know.”

Health professionals who prescribe medications to women face the challenge of an often incomplete and constantly evolving body of evidence about the safety of medications during pregnancy.  For these practitioners, and for curious consumers, enter an Android app: Pregnancy & Medication Safety, by fdable.

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Post image for NoteTaking on the iPad from a physician perspective, Penultimate app review

By: Benjamin King, MD

The form factor of tablets lends itself to illustrating procedures and anatomy to patients with interactive on-screen models or entering notes into the electronic medical record without having to break eye contact with patients.

Penultimate from Cocoa Box Design allows just that with a simple, yet elegant application that has great use in the clinical setting, especially for use for patient education.


The styling is modeled after a leather bound notebook.  When you start a new notebook the app flips open invitingly, and really looks as though you’re writing on a pad of paper.  The attention to detail on the paper itself, using shadowing and texture, results in the appearance of writing on a high quality artists’ notebook.

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Post image for The first iPad electronic health record, DrChrono, gets major update, exclusive beta review

We featured DrChrono, the first native iPad electronic health record, almost a year ago on iMedicalApps. Since then, they have made huge changes, not only with their software, but their overall business plan.  When they initially launched on the iPad, they didn’t offer a free version of their EHR, had a quirky user interface, and were betting big that physicians would embrace the iPad.

So far, they bet right. Study after study is showing how physicians are enamored with the iPad, and the number of physicians signing up for DrChrono reflects this theme.  DrChrono told iMedicalApps, they have experienced 30% growth per month, and have had 600 health care provider signups in the last 3 days alone.  In our opinion, these significant numbers can be attributed to four things: The iPad’s popularity among physicians, enhanced user interface of the DrChrono EHR, the quest to attain $44,000 in stimulus incentives, and the recent offering of a free version of the DrChrono electronic health record.

Over the last several months, the DrChrono team has been furiously working on a large upgrade, version 8.0, for the iPad.  We were the first to get our hands on the 8.0 beta upgrade, which they plan on releasing in approximately 2 weeks.

In this review, we’ll go over the main features of the DrChrono iPad electronic health record, and touch on the iPhone and Android versions of the EHR. (read more)

Like many successful companies, Clinically Relevant was founded when its founder realized he had a need that was not being met. Namely, he wanted to be able to quickly find out what the clinical evidence was for a particular diagnostic test. While the relevant papers could be found by performing a literature search, he figured there must be better way for a clinician on the move. Thus CORE or Clinical ORthopaedic Exam was born (iMedicalApps reviews: iPhone, Android ). In his regular job, Daniel Rhon, MPT, DPT, DSc is a research physical therapist at Madigan Army Medical Center in Seattle

The company went on to publish other successful apps. In addition to commercial success, the company now also garnering academic attention, with CORE being reviewed in one of the top physical therapy journals, The Journal of Orthopaedic & Sports Physical Therapy (JOSPT) (link – subscription required)

After their initial success on iOS with CORE and other titles, the company decided to port their apps to the Android platform. As one the first serious legitimate medical apps on Android, CORE was among the titles selected by Google to pre-populate the medical section of the Android Market as it initially launched in December 2010. Their most recent tile, a three app series titled Mobile OMT (Orthopedic Manipulative Therapy) has been released both on iOS and in Mac App store, providing now a unique opportunity to compare three different platforms and distribution channels.

As can be seen in the following interview, the challenges the Android Marketplace poses for the medical app developer are real, including the initially poorly implemented piracy controls, lack of promo codes and the size limits of the apps. In contrast, the more “managed” iTunes app store provided a more stable and predictable distribution channel, with less fear of piracy.

Sales were very slow at the beginning on Android, perhaps making them wonder whether the effort to port the apps could have been better invested into developing more features or apps on iOS. At least in that sense, it was heartening that the largest proportion of the required work was in curating the underlying clinical evidence, rather than in porting the coding to a second platform. Since then, however, sales on Android have steadily been picking up and the company is now even considering rebuilding their apps for the budding Android tablet market.
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Post image for Welcome to the new and improved iMedicalApps: relaunched

We want to welcome our readers to the new and improved iMedicalApps. It’s been a longtime coming. We want to also thank our readership, without your support, comments and referrals we would not have seen the 8 fold increase in traffic in just this last year alone.

Due to this increase in traffic, and the distinct types of content we produce, we knew a new site was needed that would better serve our readers and better match our unique role in the medical ecosystem. As always, we depend on and value your input. Let us know what you like and what you think could be improved.

The first thing you will notice is a much more attractive and cleaner layout. Our new design will also better delineate the three types of content on iMedicalApps: reviews, news, and commentary. The design enables the reader to focus on all three types of content individually, or as a whole.

One essential component of the new design is an improved “Review” section. On the old site, it was very difficult to parse through our reviews — they were all lumped together in one big section. With the new site, this has been completely revamped. You can now search for app and product reviews by several criteria, including device (iPhone, Android, etc), “type” of medical app, or by medical speciality . Even better, you can combine one or more of these filters — pretty neat. (read more)

Mark Cain CTO MIM Software presenting at Apple WWDC 2008One of the exciting early promises of the iPhone for doctors was its potential to present imaging studies, such as CT & MRI while on the go. Early on, many did not suspect how powerful was the “small touchscreen computer that makes phone calls”, in the words of Mark Cain. So, when OsiriX for the iPhone, the first CT/MRI (DICOM) viewer for a smart phone, was released in November 2008, it was an impressive introduction to the potential for mobile medicine.

At about the same time, a radiology software company MIM Software (previously MIM Vista), also became interested in the potential of the iPhone. The company was started in 2001 when its founder Dennis Nelson, then a biomedical engineer at Cleveland’s Case Western radiology department, noticed how difficult it was for physicians to read combined PET (positron emission tomography) & CT studies. He wrote software to “fuse” the two images into one which eventually became the company’s first and ground breaking product.

In this interview, Mark Cain, CTO of MIM Software, shares with us how they first developed an iPhone viewer for DICOM (CT & MRI) images. The software was so impressive in its early incarnations that Mark Cain was on stage (video)with Steve Jobs at the 2008 WWDC where the iPhone SDK was the main topic and it went on to win one of Apple’s coveted design awards in 2008.

He also tells the story of their submission of the software for FDA clearance in 2008 as a medical device. After four previous submissions to the FDA for various radiology imaging software, he thought he understood the process. But what ensued was an up and down 2 1/2 year journey before their mobile DICOM viewer was finally approved by the FDA in December 2010. This difficult process gives us a window into the short history of the rapidly evolving world of mobile medical software and devices. It also demonstrates how much of what doctors actually get to use is dependent on the regulatory and other non-clincal aspects of the tools.

Be sure to check out our recent review of the iPad app Mobile MIM viewer, the first FDA approved mobile DICOM viewer and their cloud-based DICOM sharing web-application MIM Cloud.
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Post image for Mobile MIM liberates doctors to view CT & MRI scans on iPads and is FDA approved [App Review]

[Ed. Check tomorrow for an interview with Mark Cain, CTO of MIM Software.]

One of the most attractive uses for an iPad in the clinical setting is the potential to view radiologic imaging at the point of care. While the graphics capabilities of even the first iPhone were enough to be able to adequately display multi-slice imaging, there were two critical pieces missing to make the iPad a viable mobile radiology workstation: FDA approval and a simple way to store and transfer images to the iPad.

MIM Software, a radiology software company, seems to have neatly solved both these problems by pairing their viewer, Mobile MIM, with MIMCloud, their cloud based radiology (DICOM) viewing and sharing web application and by obtaining the first ever FDA clearance for mobile imaging software in February 2011. The story of their FDA approval process will be highlighted in an interview with Mark Cain, CTO of MIM Software tomorrow.

MIM Mobile is a free download from the App store and runs on both iPhone and iPad. As the video portion of this review will demonstrate, the app is very well engineered with amazingly fluid navigation–even with images containing hundreds of slices. It also performs mutli-planar reconstructions out of the box, meaning that the same body part can be visualized in three planes simultaneously. These are invaluable tools for evaluating imaging abnormalities and for planning surgery. When you take into account that they were executed on a device with limited physical memory and no virtual memory , they are even more remarkable. This might be why MIM was on stage with Steve Jobs at the unveiling of the iPhone software development kit in 2008 and why MIM Viewer was one of the few non-Apple apps highlighted in the recent iPad 2 commercial, as we recently noted .

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Post image for Grand Rounds, “Dr. Watson” edition, artificial intelligence and medicine, physician perspective

This is the first time iMedicalApps is hosting Grand Rounds, and to those not familiar, Grand Rounds is weekly collection of medical blog posts with different themes — hosted by various blogs.

To be perfectly honest, I had no idea what Grand Rounds was until very recently. When I started iMedicalApps in November 2009, we were a rag tag team of physicians and medical students, and I had no experience with the “medical blogosphere” — I didn’t even know it existed, I just wanted to review medical apps and provide a quality resource for medical professionals.

But in the past year and a half, we’ve seen exponential site growth, and I’ve actually found myself reading content from extremely talented physician writers. Over that period, iMedicalApps has become more than just a review site — and I’m happy to break the news on Grand Rounds that we’ll be re-launching a completely new iMedicalApps on Thursday (We were hoping for earlier, but making a comprehensive and feature laden site takes massive hours).

With that said, in preparation for hosting grand rounds, I read through old editions, and was blown away by the sheer quality and talented writing. I’m excited that our website is hosting Grand Rounds.

In prior Grand Rounds, I’ve noticed a bevy of links, sometimes with a theme, and most of the time without. I decided to have a very focused topic — Watson and medicine — so I could aggregate physician opinion on artificial intelligence and medicine.  Unfortunately, showing my rookie status with hosting Grand Rounds, I only collected links from peers for a span of one day, instead of the usual week.  Thus, I did a miniature literature search, visited some of my favorite medical blogs, and used Google quite a bit..  The results are a collection of varying physician opinions, but many with the same underlying themes.

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Post image for The end of the pager is coming – Part II

Pagers were first introduced in the 1950′s. Interestingly enough, physicians were early adopters of this then-emerging technology, paying around $10/month for the service in NYC. And for nearly half a century, pagers came to dominate communications in healthcare settings thanks to their reliability and reach.

And while many things in medicine have changed, this part of how we communicate with each other hadn’t until recently. And as any healthcare provider can attest, this has been to the detriment of patient care. Pagers are a horribly inefficient way to communicate and have limited utility. Fortunately, in recent years, more and more companies have emerged to try to improve on this aging technology.

Voalte is one of these companies. Embracing consumer smartphones as their platform of choice, Voalte1 is an iPhone/iPod Touch and Blackberry based platform for in-hospital communications. Though it is primarily a nursing communication system, Voalte1 is a platform that could benefit all providers in coming years.

Later this week, we will have a follow-up interview with Trey Lauderdale, VP of Innovation at Voalte, for more insights into the future of hospital communications

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iMedicalApps is honored to be hosting the medical blogosphere’s grand rounds this upcoming Tuesday.  It’s a time honored tradition, with legendary physician blogger, Nick Genes, helping organize the various editions.

The theme is going to be technology and medicine — with a special emphasis on artificial intelligence (think Watson!).

With that said, we need help from our readers! Along with finding our own links to post, we’ll be asking our readers to send us pertinent posts from the health care professional blogosphere or media.

We’ll be taking submissions until 10pm Eastern time Monday (April 11th), and will publish grand rounds on Tuesday (April 12th).

Please use our contact page to submit links!


Post image for Mobile Medical News Roundup from iMedicalApps

For anyone interested in mobile health, the pace of new developments, partnerships, and innovations is, at best, dizzying. For the busy healthcare professional, its nearly an impossible task to keep abreast of whats happening in this is rapidly growing field.

Our goal at iMedicalApps has always been to help our colleagues navigate this shifting landscape because we believe that mobile health technology is going to transform the way medicine is practice.

In this series, we scour through the latest in the mobile health world and pick a few articles that we think are interesting and convey some important development. Be sure to let us know what you think by adding your comments to this post.

This week, we came across some interesting posts on a town being designed around wireless technology including its healthcare services, a doomsday prediction about the iPad in enterprise applications, and a new tablet designed specifically for healthcare. Check out the list here.

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The Resuscitation Council is the United Kingdom body responsible for setting central standards for cardiopulmonary resuscitation guidelines — analogous to the American Heart Association’s role in setting the guidelines to ACLS (advanced cardiac life support) protocols.

To those not aware, cardiopulmonary resuscitation guidelines are the emergent steps taken when an individual’s heart stops beating, or if they are experiencing other life threatening cardiopulmonary anomalies.

The Resuscitation Council (UK) released iResus, a free iPhone medical app, in January 2010, aimed to help educate health care providers on ACLS guidelines. It includes adult and pediatric algorithms, with an interactive user interface.

Researchers in the UK wanted to see if the mobile app could be utilized to improve the performance of physicians in simulated emergencies. Low, Clark, Soar, et al (2011) performed a randomized control trial using the iResus app, and recently published their findings in the Journal Anaesthesia.

Their end conclusion further justifies the push for mobile medical apps at the point of care, and their research provided valuable data. However, there are aspects of the study that left us questioning certain protocols and practical utility of the medical app.
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