Whether diagnosing a heart defect in a newborn or discovering a life-threatening rumble in a elderly man’s abdomen, I think all clinicians can relate to that surge of excitement we feel when we discover something that we could use to help a patient. But as I’ve progressed through my training, I’ve also observed how these findings inevitably lead to confirmatory tests – echocardiograms, ultrasounds, and so on. Our clinical acumen is simply not good enough. I’ve often heard the argument that, for this reason, the stethoscope is an outdated tool. Perhaps it almost was. Companies like Thinklabs, however, feel very differently and are reinventing the stethoscope to meet the needs of modern medicine. Meet Thinklabs’ ds32a digital stethoscope with the Stethoscope Medical App for the iPhone. Together, they not only improve the clinician’s ability to hear sounds, but also to review and share the audio and waveforms – all on the iPhone.

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It is a great pleasure to present this interview with Pieter Kubben, a Dutch neurosurgeon who is an impressive amalgam of clinician, researcher, and software engineer. He is currently in a neurosurgical residency while completing a PhD in intraoperative MRI-guided surgery for brain gliomas. As if this is not enough, as a “hobby” (his term), he also writes software, with a particular interest in computerized decision-support systems.

He has three iPhone applications currently in the App Store, including his newest one implementing the WHO surgical checklist(iTunes link). His other apps, Neuromind and SLIC, have been downloaded 8,000 times. Importantly, he is not just writing the software, but is also publishing his ideas in medical journals to spur changes in the way clinical decisions are made in the future. We encourage you to follow his blog at http://digitalneurosurgeon.com or on Twitter @DigNeurosurgeon. It is exciting to see a one individual with so many talents and to think about the great ideas yet to come from someone with such broad perspectives – we delve into some of those ideas in this interview.

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The first app I downloaded on my iPhone was Epocrates. I didn’t think twice about it, and in a way I assumed it was my obligation to do so before I saw patients in the hospital.  Such high regard for this medical app elicits thoughts of a deep history, but it really burst onto the scene in the late 90s on the classic palm PDA platform.  Epocrates quickly gained market share because it offered key functions for free, unlike its competitors.  This tactic of offering some functionality for free has not changed over the years.

Unlike its arrival to the Palm PDA platform, Epocrates is considered the first medical application for the iPhone and iPod Touch platforms.  The free version of the application is one of the most heavily downloaded medical apps in the App Store.

There are four different versions of Epocrates you can have on your iPhone or iPod Touch.  Each version offers different features and subscription fees.  The default application in the App Store is free, but in order to get the premium versions you can upgrade either online or through the app.

• Epocrates Rx (Free)
• Epocrates Rx Pro ($99 per year)
• Epocrates Essentials ($159 per year)
• Epocrates Essentials Deluxe ($199 per year)

In this article, I’ll review Epocrates – Essentials, the second premium level offered, and also go through the key features offered in each level of subscription.  This is the largest medical app we’ve reviewed to date, content wise – so there will be lots of pictures!

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Over the last few months, a great deal of time has been expended on the “hot competition” between Apple and Google in relation to smart phones. Much of this interest probably had to do with a partially imagined story of a once close friendship between Apple and Google, founded on their mutual enmity of Microsoft, now fractured on the rocks of competition and greed. While the truth probably isn’t as dramatic, whatever conflict exists is much less interesting than where they may overlap – especially when imagining where medical technology could go and how it would affect medical professionals. As most readers are undoubtedly aware, much of the recent discussion in the blogosphere on this topic (at least before January 27) was about the rapid ascent of the Android platform. The emergent themes were that the open and mutable nature of the Android operating system, the entry of multiple handset makers, and the absence of any restriction on software publishing will inevitably make Android the dominant smart phone platform of the future. The historical analogy given was desktop computing, where commodity hardware and a minimally restrictive operating system made Microsoft Windows the de facto standard, despite many obvious flaws. But, it seems this analogy is flawed and here’s why.

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With over 100,000 apps available for the iPhone/iPod Touch and billions of downloads since the App Store opened just under two years ago, the market is clearly hot. And with the release of the iPad, expect a new flood of apps into the market.  However, a recent article in the New York Times suggests that even with the wealth of options, people generally use only five apps despite having downloaded far more.

The average iPhone or iPod Touch owner uses 5 to 10 apps regularly, according to Flurry, a research firm that studies mobile trends. This despite the surfeit of available apps: some 140,000 and counting.

Another finding that the article notes is that even thought hundreds of thousands of apps are available, the entire user group is generally exposed to the same few thousand apps.

A survey of iPhones, iPod Touch and Android users conducted in July 2009 by AdMob, an advertising network that helps people promote their applications on smartphones, found that people discover apps most often by browsing app stores. And even though the iTunes store is bloated with offerings, people tend to gravitate to the most popular….

“…The top apps featured at the store do change out,” Mr. Putney said. “But most users will never see more than 1 percent of the total apps available.”

These findings are important for iPhone/iPod Touch/iPad users, app developers, and even us here at iMedicalApps, and here’s why. For users, this means that finding the best apps requires some work – a conscious effort to search the app store for things that interest you. That includes looking beyond the most popular medical apps. For developers, this means that reaching potential customers requires finding ways to climb that popularity ladder. For the Malcolm Gladwell enthusiasts, this means finding the Mavens, Connectors, and Salesman (from Tipping Point) – basically the people with large social (or professional) networks who are most likely to adopt early and spread the message about your great app. And for us here at iMedicalApps, it means actively looking for that diamond in the rough, languishing at the bottom of the popularity rankings, and helping our readers discover useful apps they wouldn’t have seen otherwise.