It is well recognized that when there is a language barrier between patients and physicians, the quality of care delivered suffers. With the rapid rise of patients for whom Spanish is their primary language, this is becoming an increasingly urgent issue to address.

Ultralingua, Inc. has published the Vox Spanish-English Medical Dictionary and Verbs app ($49.99) to help bridge this gap. The app is available for iPhone, iPod touch, and iPad. Read on to see whether this app can help you take better care of your Spanish-speaking patients.

Features:

The app provides these key features:

• English-to-Spanish and Spanish-to-English word translations

• Search function

• Verb conjugations

• A number pad that instantaneously spells out the number in the selected language

• The ability to look up any word with a single tap

It is important to note that this app does not provide any sort of instruction or lessons on how to speak Spanish or form sentences.  It provides translation only, with no definitions or meanings of words.  Additionally, it is specifically a medical dictionary, meaning that ordinary, non-medical terms may not be found (in the screenshot below, I tried to search “girl,” with no results.)

Therefore, this app would be most useful to practitioners or students with at least some background in the Spanish language.  As far as medical terms go, however, this dictionary seems to be thorough.  It even includes different bacterial and fungal species.

User Interface:

Overall, the user interface is decent, but takes a little getting used to.  Because it is not completely intuitive, Ultralingua has kindly provided us with an instruction page that briefs the user on how to navigate the app and use the key features, complete with picture demonstrations.  This short guide can be accessed by tapping on the little lightbulb icon in the bottom left-hand corner.

For the most part, even without taking a peek at the user guide, the app is pretty easily navigated after a few minutes of experimentation.  For example, you might think the clock icon at the top will translate times, but it actually displays your search history.

As mentioned earlier, you can tap on any word and be taken to a translation of that word immediately.  The languages will also instantaneously swap.  This is a handy feature, though I wouldn’t have known it existed without reading the user guide.  At times it was also a little hard to tap the words with enough precision that the translation would come up.

Uses in Practice:

This app would be most useful in practice for looking up a few quick terms.  Even fluent Spanish speakers may not know how to translate some obscure disease, especially if they were trained in an English-speaking country.  The search function is fast enough that a doctor could even look up a word in front of a patient.

The conjugation feature is helpful, but would probably be too tedious to use during a patient conversation.  This app helps facilitate and improve physician-patient communication for the conversational physician, but for the practitioner with little to no Spanish knowledge, it will be of limited use.

Price:

• The paper version of the Vox Medical Spanish and English Dictionary sells for $35, vs. the $49.99 for this app.

Likes:

• Thorough dictionary of medical Spanish terms
• Decent UI with short guide to fill in the gaps
• Fast search function
• Provides a medical student or practitioner with a quick reference in their pocket

Dislikes:

• It’s got “granulation” but not “grandmother.” Though not intended to be a comprehensive dictionary, it would have been helpful to include some non-medical words that are commonly used in patient conversation, e.g., family members for taking a family history. This is yet another reason why this app might not be as useful for users who lack a solid background in Spanish
• Does not include audio.  Pronunciation of a different language can be tough, especially with unfamiliar words.  Adding an audio component, where the user can hear a speaker pronounce the word correctly, would be tremendously useful and provide a strong reason for someone to choose the app rather than the paperback dictionary

Overall:

• If you’re at least a decent Spanish speaker who would like to improve the clarity of your conversations with patients, this app is a good reference.
• It’s fast, easy to use, and mobile, and future updates including audio pronunciation and a few select non-medical terms would greatly improve its usefulness.
• If your Spanish proficiency is so limited that you desperately need a translator to begin with, this app is probably not worth the price.

iTunes Link

I was introduced to Harrison’s Manual of Medicine via Access Medicine back in my first year of medical school (most academic centers have a subscription to Access Medicine).  I needed to find a good resource for my PBL(Problem Based Learning) small group sessions and it seemed the easiest to read for a kid fresh out of undergrad.  Later on I found resources such as UpToDate and eventually developed the ability to actually understood research papers, but Harrison’s Manual of Medicine was great to read early on.  Not only is it great to use in Medical School, but It’s a textbook you’ll often find in the clinic setting and is read and referenced by practicing providers.

It would then only seem natural to have the full text or even the online version (via Access Medicine), translated to a mobile application.  When you search for Harrison’s in the App Store you’re presented with 3 Apps!  Inherently, I thought I’d only have one option.  There is a version by Unbound Medicine, Skyscape, and MedHand.  The price to access/download each is $59.99, the key difference is that the MedHand version does not require a yearly subscription.  You pay the flat rate of $59.99.  Also, the MedHand version is a stand alone application, not requiring you to access the internet, unlike the others.  Because of these advantages, the MedHand version was chosen for a full review of Harrison’s Manual of Medicine(17th edition).

When you open up the application you are presented with a list of common topics, ranging from organ systems, such as Cardiology, to topics such as Care of the Hospitalized Patient.  I can’t imagine anyone thumbing through these individual topics, and the best method to proceed is to use the search option provided.

The search function is the highlight of this application.  For the purpose of this review, I’ll be looking up endocarditis.  You are given a list of pertinent articles based on your search.  However, the beauty of the search function is you are given a tab to narrow your search down based on what you’re looking for, e.g., you can refine the search based on image, tables, and treatment options.  I found this to be extremely useful because finding key tables, in this case, the Duke Criteria related to Infective endocarditis, can be very useful.

Once you’ve found what you’re looking for you can click on your topic of choice, and you’re given an abridged version of the content you would find using Access Medicine or the actual textbook (the disappointment in this will be explained later)

What I liked:

• No Subscription required
• Stand Alone application! Does not require a connection to the internet
• Search feature is robust and the highlight of this application
• Ability to Bookmark topics, and a History section is present
• You’re given instructions on exactly where to find more detailed info within the full Harrison’s manual at the end of sections

What I didn’t like so much, and what could be improved upon:

• You have to go into your settings menu on the iPhone to change text size! And even then, you’re only given 3 options, Small, Normal, Large. There is no ability to change text size within the application.  When using this app you have to use it with a small text size, otherwise you’ll find yourself scrolling entirely too much.
• Overall User Interface is not clean and seamless, especially when compared to other applications, such as the Merck Manual series.  Icons and navigation menus are gaudy and not clear at times.
• The biggest knock on this application is it doesn’t include the full text that you can find using Access Medicine.

Conclusion:

Overall, the team at MedHand did a decent job of bringing the abridged version of Harrison’s Manual of Medicine to mobile form.  The User Interface and navigation needs to be made more seamless.  With all the aesthetically pleasing medical applications out right now, you would hope this application would follow suite soon.

The biggest knock on this application was mentioned above, the lack of full text (look at the pictures in this section to see the difference in content size).  I don’t know if MedHand wasn’t able to bring the full because of contract rules, but I found this to be bothersome.  The reason many medical professionals read Harrison’s Manual is for a detailed explanation of etiology, pathologies, and treatment options.  Harrison’s Manual is not the first thing you turn to if you want to look up a topic you can read quickly.  For that you use UpToDate or Epocrates.  Rather, Harrison’s has traditionally been great because of the detailed knowledge it provides.

This being said, if you want an abridged version of Harrison’s Manual, that has a great search feature built in, than you can try this application.  This application is unique in the App Store because it doesn’t require a subscription, like the other Harrison’s Manuals in the App Store, and is stand-alone(not requiring an internet connection).  But if you want the full text, like most would, than your best option is to use the mobile form of Access Medicine when you’re at your academic center or practice.  Also, the Merck Manual – Professional Edition is a fantastic alternative reference application that offers the same set of features as well, just not the iconic name of “Harrison’s”.

[itunes]

[website]

Addendum:

One of our commenters made a great point that I was unaware of. There are two versions of Harrison’s: Principles and Manual. Its odd because the edition numbers are the same, and the branding method seems odd and confusing. Nevertheless, this app is Harrison’s Manual, which is an abridged version of Harrison’s Principles. The overall review pointed out the app is an abridged version of the text you find via Access Medicine, which still holds true.