If one wanted to get an idea of the potential of the iPhone as a tool for bedside medical and surgical education, this application by Modality and Elsevier would be a good starting place to get inspired. While it seems obvious that a portable device with a great user interface, a sophisticated operating system and great multimedia features should be a shoe-in for portable medical education, what is equally true is that the critical ingredient remains great instructional content.

“Procedures Consult: Internal Medicine – Musculoskeletal” brings together a highly detailed review of orthopedic bedside procedures, such as aspiration of small and large joints, splint application and reduction of joint dislocations, with a well crafted user interface to create an application that will genuinely be useful for emergency room physicians and junior orthopedic residents.  This review will cover how this medical application for the iPhone and iPod Touch goes about teaching these procedures.

The content is derived from Elsevier’s Procedures Consult website, which is a curated video site describing over 270 procedures spanning several disciplines. (Please see the recent review of the companion application “Procedures Consult: Internal Medicine – General” on this website. The content for this application is derived mostly from the emergency medicine/musculoskeletal section. The information for each procedure consists of pre-procedure and post-procedure check lists as well as step-by-step instructions of the procedure itself, accompanied by references. In addition, one or more videos for each procedure is embedded into the app, available for immediate viewing. Surface landmarks are shown graphically as is a simplified 3 cut-away dimensional graphic of the relevant deep anatomy. Some procedures, such as shoulder reductions, are also accompanied by a representative radiographs of the problem.

What I liked about this app:

• the attention to the relevant surface and deep anatomy, as well as the indications for each procedure is very helpful
• videos are of high quality and are embedded directly in the application. (refer to other Procedures consult review for more details)
• the techniques themselves are well-described and, I believe, few practitioners will find much cause to quibble with the instructions

What I did not like about the app:

• not much really, perhaps the post procedure care is unrealistically detailed for the typical bedside interaction

What I’d like to see in future versions:

• the content for this application is aimed mostly at ED procedures, which is surely a good market, however a future application with a more orthopedic focus, including closed fracture management and even surgical procedures would certainly be appreciated

Conclusion:

While there has been a proliferation of medical instructional websites over the last five years, bringing that information to the bedside is more than just a convenience, it is a critical next step. Websites and mobile applications will not replace peer-reviewed scientific literature nor the principle of apprenticeship in medical training. However, I can easily imagine when all post-graduate trainees are routinely expected to refer to mobile applications such as this one before undertaking unfamiliar procedures. This will undoubtedly reduce errors and enhance the care of our patients.

Title of app: Procedures Consult: Internal Medicine – Muscloskeletal

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Dr. Wodajo is a guest contributor to the medical app review team and we feel privileged to have him on board. He brings an extensive clinical background to the reviews. His blog can be found at http://www.orthoonc.com.

Procedure apps appear to be all the rage lately in the mobile medical world, and rightfully so. These instructional apps are a valuable resource to those learning how to do procedures in the health care world. We reviewed another Procedures app recently, Procedures Consult-Internal Medicine, that covers a wide variety of procedures. However, this app focuses on one specific procedure, and is a fraction of the cost.

Procedures – Subclavian Line, is a $2.99 app produced by MeisterMed. You might remember one of our previous reviews on a MeisterMed app, PediDoser. We weren’t huge fans of that app (although to their credit, PediDoser has a 3.5 star rating in the App Store). Nonetheless, once I tried out this current app for this review I was definitely impressed.

I’ve had the opportunity to do a few subclavian lines as a medical student, and the experience is exciting and frightening at the same time. The best way to learn at first is to see, but unfortunately you don’t always have a good view, or the resident might not be the best teacher. Thats where this app comes in.

The navigation is pretty simple. When the app opens you have the option to view the procedure details or watch the full video. In the procedure details section you have a few different options, from step-by-step instructions to complications and coding numbers. There is also a toolbar at the bottom of the screen. It contains navigation tools, bookmarking, and an option to write custom notes. The bookmarking feature was not useful, but the custom note feature was a nice touch.

Video:

The video is approximately 10 minutes long and included within the app. You don’t need internet access to view the video. It shows the full procedure being done from start to finish. The audio component of the video is instructional. I found the audio to be layered nicely with the video. The instructions were concise, high yield, and the explanation of the procedure was excellent.

What I liked:

• Simple, easy to use
• Great Price
• Ability to take custom notes
• Video is standalone, no Internet access required
• The verbal explanation during the video is done well
• There is a separate text section step by step instructions.

What I didn’t like and Improvements that could be made:

• Overall video is great, but at 10 minutes in length, it would be nice to see the video broken into separate sections that are easy to access.
• It would be nice to see text inter-laid with the video on the crucial steps of the procedure, so you can view the video without always needing the audio
• The step by step text instructions only contain one picture. More pictures would be nice additions to this section.

Conclusion:

This is a great medical application for those learning how to do subclavian line procedures. It’s simple, easy to use, and easily accomplishes its goal of teaching how to put in a subclavian line. Like I’ve mentioned with past procedure applications, there is no substitute for getting lots of supervised practice before actually doing this procedure on your own. However, this app definitely reduces the apprehension felt when attempting this procedure for the first time under supervision. I could also see it helping speed up the learning time needed for this procedure.

The previous procedures app we reviewed, Procedures Consult-Internal Medicine, had 25 procedures explained(including subclavian line), but costs $39.99. We really liked that app, but if you don’t need access to all those procedures or don’t want to spend that much right now, then this app is a great buy at $2.99.

I’d definitely recommend this medical application as a must have for 3rd/4th year medical students, interns, residents, and other healthcare professionals who are learning to do subclavian lines.

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1)PalmDoc.net has a great review on an app to help you train for performing lumbar punctures. The last app we reviewed, Procedures Consult-Internal Medicine, also has an excellent example of how to perform lumbar punctures. But the beauty of the Lumbar Puncture app is it’s only $1.99, as compared to the $40 for Procedures Consult. Procedures Consult consult packs 25 different procedures, so if you just need something for Lumbar Punctures, check out the LP Procedures app instead.

2) Merck Manual just released another iPhone app called Home Edition & Procedures, and it’s been getting some buzz on the internet. The app is supposed to provide quick and easy medical knowledge for patients. A CNET author goes far enough to say it will help save on co-pays and "countless" visits to the doctor, we’re not sure if we’d go that far. We’re gonna try to get a copy of the app for a review. Here is the CNET article. Melodika.net has a writeup on this app as well.

Everyone in the medical field has heard the phrase, “See one, Do one, Teach one”. When you’re a budding medical student and intern, you’re taught to watch a procedure being done at least once, then to perform the procedure under supervision, and then after performing the procedure successfully, teach one.

The Procedures Consult:Internal Medicine App aims to help improve the success of this learning process. This $40 app packs 25 Internal Medicine procedures explained in detail through text, pictures, and videos. The app itself takes up a staggering 462 megabytes of space on your iPhone or iPod Touch. For that much space allocation one would think the app better be good. After using this app over the past week and seeing the responses from other medical students, interns, and residents, I can assure you, it’s better than good.  This app is going to be making our soon to be released Top 10 list of Medical Apps for Residents.  This is an extensive review of an app that is well deserving of the attention.

Procedures Consult is actually a product from Elsevier, a publisher of medical and scientific literature. This app is derived from the site, Procedures Consult, where the same type of information you find there can be found in the app. On the website you can access more procedures than the procedures consult-internal medicine app. In order to access their website there is a fee. I called the company to ask them their rates since they are vague on their website and I’ll update this post when I get a call back. However, the price of the iPhone application is $40, and it’s a one time cost.

Now, back to the medical application itself. When you open up the application you can search, bookmark, or view all the different procedures at once or by type. There are 25 procedures available to view, ranging in varying levels of complexity. You can learn how to perform an arterial blood gas sampling procedure to more complex procedures such as performing an LP, thoracentesis, or abdominal paracentesis.

In this review I’m going to use the thoracentesis procedure as an example to show the functionality of this app. The thoracentesis procedure is found under the “aspiration” category. Once you select thoracentesis you are brought to a page with the Pre-Procedure information, along with many different options. On this page you have options to view the Procedure text/pictures, Post-Procedure text/pictures, make a bookmark, increase the size of the text, and most importantly, view a video of the procedure being done.

The Pre-Procedure page includes a great deal of information including indications, contraindications, equipment, and anatomy. Along with this great text information, you’re given excellent pictures to view as well. This type of format is repeated in the Procedure and Post-Procedure pages as well. The text and pictures on the Pre-Procedure, Procedure, and Post-Procedure pages are very handy when you’re not in a setting to view the videos or if you want to brush up on certain parts of the procedure quickly.

Video:

The video section is fantastically done(the last three pictures are of the video). Once you choose the video option, you are brought to a page with an option to view different parts of the procedure(refer to pictures). This is great because it takes out the need to fast-foward and rewind constantly. A moderator talks you through the whole procedure. Procedures Consult has done an excellent job in mixing graphic images with actual images. This useful when showing anatomy graphics so one is able to better understand the procedure. The videos also have moments where you are shown “clinical pearls” and given information about a key step in the procedure. Once you’re done with one section of the procedure, the application automatically goes on to the next video, but gives you five seconds to cancel this continuation.

Each section on the video page is about one to two minutes in length. The thoracentesis videos total to about eight minutes. The videos themselves are concise, informative, and have a nice pace. They even walk you through getting consent from the patient and the key risks to talk about. The post-procedural video clips are nice as well. The thoracentesis post-procedural video clip even tells you how to submit the pleural fluid to the lab.(i.e. EDTA tube is submitted for cell count and differential). In the wards, I’ve definitely been scrambling around with residents trying to make sure we have the correct tubes being sent off for the right information. The videos make this application absolutely shine.

Unlike other applications we have reviewed in the past, such as the Blausen Human Atlas and Clinical Orthopedic Exam, the Procedures Consult app has stand alone videos. I can’t stress this enough. The overall consensus among our group of reviewers is that stand alone videos are key because not everyone has Internet access available at all times. In the hospital my Internet access varies from good to bad. Since this could be considered a “study” application, having the videos available to you without the need of an internet connection is invaluable. You could even be sitting in a plane viewing videos of procedures, although the person sitting next to you might get a bit queasy. Having the videos built into the app takes up a massive amount of space, almost half a gig, but it’s well worth it.

What I liked about this app:

• Stand alone application, no Internet connection required.
• Procedures are explained in a concise and clear manner.
• Procedure pages do a great job of providing informative text mixed in with pictures.
• Videos are fantastic and replicate the feeling of actually watching a procedure, yet also provide great graphics to help explain the procedure.
• Starts with the page you last visited.
• Bookmarking
• Option to increase/decrease text size.

What I didn’t like and Improvements that could be made:

• An option to delete procedures not used in order to save space on your iPhone or iPod touch. Some of the procedures, such as ABGs or Phlebotomy won’t be accessed too much, and you could save some space by deleting them.
• Greater explanation of why the procedure is being done and the pathophysiology leading to the need of the procedure. (i.e. pathophysiology behind pleural fluid collection)
• When fast forwarding and rewinding the videos very quickly I found some lag time and had the application crash. Overall though, the application is stable and I rarely had any issues.

Who this app would be great for:

Residents, Interns, 4th year medical students, and others in the healthcare field who want an aid to help learn procedures quicker. It’s also for those who want to look like all-stars in front of their upper levels and attendings (paging all gunners….).

Conclusion:

As you can read from the above, the Procedures Consult-Internal Medicine app, developed by Modality, was a hit. When I showed this app to other medical students, interns, residents, and fellows they were stunned. The overall feeling was this app would help you learn procedures more quickly and decrease some of the anxiety that comes with doing the more complex procedures. The Procedures Consult app definitely does not replace the invaluable learning that occurs with the hands on practice of physically doing the procedure, but it definitely helps you learn the procedure quicker and become more efficient.

When I asked colleagues about the price of the app($40) they didn’t think it was cheap, but they didn’t think it was overpriced either. Some of the more experienced fellows didn’t think the app would be as useful for them, but all the 4th years, interns, and residents loved it.

It should also be noted this application can improve patient safety, for obvious reasons. Residency programs really need to take note of this application. Having the ability to view videos, pictures, and text of a particular procedure on your mobile device right before you need to perform the procedure is fantastic.

I urge those who are considering buying this app to check out the Procedures Consult website. The iPhone and iPod touch application version is basically like having the website in the palm of your hand, but without the need of an internet connection. The Procedures Consult website allows you to try the online version free of Procedures Consult for 30 days. The sample videos on the website correlate closely to the videos you’ll see in this application. They show samples of the text and pictures that correlate closely to the app as well. For $40 flat, you can have 25 internal medicine procedures, with text, pictures, and videos, in the palm of your hand to use at your viewing pleasure.

With this app you’ll be on your way to looking like an all-star in the wards and thats something we’d definitely recommend. For interns and residents, this is a must have application.

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The Procedures Consult website can be found here.

Note: This app was reviewed in consultation with interns, and residents.

This App recently received a significant update, including a number of suggestions made by the iMedicalApps team and readers. These changes include the ability to email links of useful videos and PubMed links, a “search” feature, and the ability to save particular entries to a “favorites” list.

One of the most enjoyable aspects of orthopedic surgery is the role of physical examination in diagnosis. The patient may tell you their knee (or hip, shoulder, etc) hurts “sometimes”, and if you’re lucky, they might tell you under what conditions. Your job is figure out which of that joint’s particular ligaments, labrum or tendon is injured.

Luckily, for almost every musculoskeletal ailment, there is a specific physical maneuver to discover the underlying problem. Often, there are several maneuvers for each problem. And, therein lies the problem: How do you remember the specifics of each maneuver, its indications, and the positive and negative findings when its been months or more since the last time you used the maneuver?

It’s with a warm welcome that CORE (“Clinical Orthopedic Exam”) arrives. This iPhone medical application packs a significant amount of text and video for a price of $29.99. Hopefully it will help herald in a new generation of bedside clinical decision-making applications.

Continue on for the full review of the Clinical Orthopedic Exam medical app (This app is for primary care providers as well!).

The authors of CORE were ambitious in their scope. They assembled almost 250 physical exam maneuvers, encompassing all the extremities as well as the spine. For each exam, they have included step by step instructions, positive and negative findings and, most critical, a short video clip of the exam being performed. If that’s not enough, they have also included peer-reviewed references and a quick summary of inter and intra-observer reliability for each exam.

The authors have chosen to store the videos on YouTube, no doubt in part to decrease the size of the application but also to allows them flexibility in the future. There is also a remarkably long legal disclaimer that greets you every time you launch the application. Personally, I find it hard to imagine the “my iPhone made me do it” defense but I suppose there is a proud attorney somewhere who wrote that opaque text. (Editor note: Internet access is required in order to view the videos on this application, Wi-Fi, 3G, or EDGE)

What I liked about this app:

• The sheer scope of exams is an impressive achievement. Covering tendinous, neuropathic, ligamentous problems for each body part
• Reporting reliability statistics for each exam is appropriate and admirable
• Navigating by tapping a body part is very intuitive, also appreciated is having the option to navigate textually
• Being able to view the video within the application is good design

What I did not like about this app:

• The descriptions of test statistics are so full of abbreviations, they are difficult to read – this could be improved (perhaps by small pop-ups when tapped?)
• There are a few navigation quirks. For example the “pathology” button duplicates the “back” button. Traversing the statistical explanations is a bit awkward and tests with more than one name still have their own entries, etc
• The application does not remember where you left off, forcing you to click through the disclaimer and navigation every time you enter

What I would like to see in future updates:

• Sound in the videos would be nice – for some of the videos you have to watch a couple of times to figure out what is being done
• Bookmarks so you can choose your favorites
• Anatomical drawings for selected disorders to make the concept underlying the exam clearer
• A text search box for text based navigation.

Conclusion:

CORE is a great addition to the burgeoning collection of medical applications on the iPhone. On their website, the developers state their interest is developing applications that focus on the musculoskeletal system with the motto “Solutions based on evidence not opinion”. Their target users are healthcare providers in orthopedics, neurosurgery, family medicine, physical therapy, rheumatology, among others. If their first application is any indication, it seems we will have more to celebrate in the future.

iMedicalApps Addenum:

We agree with Dr. Wodajo’s overall review of the app, it’s an excellent application for doing the musculoskeletal portion of the physical exam. We’d like to also stress how this is a great medical application for primary care physicians. All primary care physicians know how important a strong musculoskeletal physican exam can be, as they are often the first line for presenting symptoms.

Dr. Wodajo mentions how having the physican exams available on youtube allows the application to be more flexible, but as we mentioned in our Blausen Human Atlas app review, we think it’s important to have the videos built into the app. Many providers might not have internet access available to them, and even portions of hospitals don’t always have a reliable connection. To users without dedicated internet service, we’re hesitant to recommend this application.

However, if you do have dedicated internet (Wi-Fi, 3G, or EDGE), as most providers do, then this is a brilliant application and we’d definitely recommend it.

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By: Iltifat Husain, MD/MPH, MS4 and Yousif Alkadhi, MD

One of the toughest aspects of medicine is communicating medical conditions and procedures to patients who have limited medical knowledge through the use of only words. With clinic times becoming shortened, this communication is often under strain. The new 2.0 version of the Blausen Human Atlas application aims to help providers with this type of communication. This app allows medical professionals access to a vast library of 3D video animations and images that aid in explaining medical conditions to laypersons.

The Blausen Human Atlas, made by Blausen Medical Communications, and available in the App Store for $19.99, has been in the AppStore for a few months, but the new 2.0 version is a big update. In their description of the Human Atlas in the App Store they state that the recently released 2.0 version includes 150 3D animations, a medical glossary with over 1,500 terms, 1,200 detailed still images, 360 degree rotatable 3D human figures, and the ability to purchase additional smaller atlases. Of note, this is not a stand alone application and an Internet connection is required in order to access the medical glossary, images, and videos. In the following review, we’ll go over a brief summary of how the app works and how applicable it is to healthcare settings using our own experiences with the application over the past few days.

The Human Atlas app has three basic features you can use for navigation: 3D human figure, medical glossary, and videos. These navigation pathways can be seen once the human atlas is selected.

3D human figure

The 3D human figure rotates 360 degrees and you are able to zoom in and out. You can choose to view the human body based on different systems, the below picture has the digestive system selected. If you want to show your patient the pancreas you can rotate this image 180 degrees. Other systems you can choose include circulatory, digestive, immune, muscular, nervous, respiratory, skeletal, and urinary. Although we like this function, we found the images available through the glossary to be more detailed and helpful for patient explanation. Also, when you maximize on the zoom the anatomy is not as clear. In a clinic setting it would be better to use the detailed pictures in explaining key anatomy, and then use the 3D figure to show how the anatomy is connected with the rest of the body.

Medical Glossary

The medical glossary can be accessed through an unnamed tab located on the right side when the Atlas is opened. The medical glossary has a search function and contains simple medical definitions as well as complex procedures. Our experiences with the glossary yielded mixed results. We liked how when we searched for “prostate”, the results show not only medical conditions (enlarged prostate, prostate cancer) but also show procedures (prostatectomy).

The results show related medical terms and videos. As you can see in the above picture, once a medical term is selected related pictures appear. Video results for the above search include a video on Prostate cancer and Prostate removal. However, when we searched for acute lymphocyte leukemia (ALL), only one image appeared, yet there is a nice video on ALL in the video library of this application. Overall, we found the medical glossary to be a great feature that usually delivered excellent detailed images and videos related to the topic of interest.

The images in this Human Atlas are very functional and definitely can be used in practice. Not only can anatomy be explained by using the pictures, but different pathologies can be explained as well. In the below picture showing prostate cancer, key anatomic structures related to the prostate are shown (bladder, urethra, seminal vesicle). You can also zoom in on these individual pictures.

Videos

The video section is where this application truly shines. Videos can be accessed not only through the glossary’s search results, but also through a separate video toolbar available when the Human Atlas is opened. WiFi, 3G, or EDGE is required to view the videos. The below picture shows a few of the video categories. The different categories are cancer, circulatory, digestive, ear, endocrine, eye, immune, muscular, nervous, pediatric, reproductive, respiratory, skeletal, skin, and urinary. All the main specialties are covered.

Within each category are a number of related videos that last approximately one to three minutes and include an audio explanation that is in sync with the video. In the circulatory section, video topics range from explaining heart bypass surgery to how the valves in your heart work. This type of diversity of topics is found in every video section. You can get a better idea of how the videos look in the following link provided by the company. Once your selected video ends, the application shows your related videos, definitions, and slides. You can see this in the below picture after viewing a video on appendicitis.

Quite simply, we found the videos available in the Human Atlas to be brilliant. Our colleagues and patients thought the same thing as well. Patients enjoyed the 3D animation and the simple explanations. The videos were successfully able to explain conditions such as GERD, osteoarthritis, and others to our patients. They are aesthetically pleasing and explain medical conditions in a laypersons’ terms. Eventually we would like to see an option for Spanish explanations to the videos. This would be invaluable because of the increasing Hispanic population.

The videos are especially useful for specialists who need to explain complex and simple concepts. An example of this is in the cancer video section, where there are videos explaining Cyberknife Radiosurgery and Intensity Modulated Radiation Therapy (IMRT), but also great videos explaining less complex concepts, such as chemotherapy and biopsy procedures.

What we like about this App:

• A vast library of medical information
• Aesthetically pleasing 3D animation videos do a fantastic job of explaining medical conditions and procedures in laypersons’ terms to patients.
• Patients enjoy looking and listening to the concise videos.
• Pictures are very functional and show different pathologies
• The glossary contains definitions for procedures as well as basic medical terms.
• Every major specialty is targeted (cancer, circulatory, digestive, ear, endocrine, eye, immune, muscular, nervous, pediatric, reproductive, respiratory, skeletal, skin, and urinary)

What we don’t like as much, and improvements that could be made:

• Stand Alone videos. Our main concern is the inability to use this application without an Internet connection. WiFi, 3G, or EDGE are required to view the videos, pictures, and glossary. The advantage of streaming this information is you save storage space on your device, but we feel this application is too powerful and good to have this limitation. It’s worth sacrificing 200 or more megabytes of space on your phone.
• The ability to have a video explained in Spanish.
• Ability to bookmark images or videos used most often, or even making a playlist of videos for a certain type of patient.
• Currently the option to buy more detailed individual atlases does not work.

Who this application would be great for:

Every healthcare provider could find a use for this application. Primary care providers could use the videos and images to explain more commonplace conditions, such as GERD, osteoarthritis, diabetes, and more. Specialists and Surgeons could use the videos and images to explain complex procedures such as heart bypass surgery, Angiography, Roux-en-Y Gastric surgery, and more. Pediatricians can use this application to show parents the mechanism of allergies and how ear infections occur. With the vast amount of information available, almost every provider can find some way to use this application.

*Note, The application’s full features can only be used with an Internet connection (WiFi, 3g, or EDGE).

Wrap-up:

After a few days of using the 2.0 version of the Blausen Human Atlas application, we feel it’s a must have for healthcare providers and well worth the $19.99 price tag, especially since it can be used on a daily basis. It’s easy to use, provides an enormous amount of information, and most importantly, does a great job of helping you explain relevant medical information to patients through pictures and short concise videos. Often times, diagrams and posters in the patient’s room are inadequate in explaining key concepts, but this application is the solution to this problem. The 3D video animation is what makes this a must have application. If used correctly, we feel the videos can not only be used to explain medical knowledge, but also help save time. The videos could be shown to patients while they are waiting to see their provider, enabling the patient to have a better understanding of the medical concept or procedure before the doctor even walks into the room. This would increase patient satisfaction as well, especially if your practice has long waiting times.

As we mentioned above, our main complaint with this application is the inability to use it without an Internet connection. If you only have EDGE available the videos lag, which is not an ideal experience. Having the videos included in the application would increase the storage space required on your iPhone or iPod Touch, but the loss in storage space would be well worth it. If you have a WiFi connection or dedicated 3G connection in your health care setting, then this application is a must-have. We look forward to the future innovations that this application is likely to bring to the healthcare field.

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The American Heart association is offering a First Aid / CPR app, titled "Pocket First Aid & CPR". There have a number of CPR and First Aid apps already in the app store, but this is the first one that has the backing from the people who actually set the standard (AHA).

Some of the more notable features about this app are the illustrations, videos, and ability to store important medical information (insurance information, doctors information). The videos include the guy we have all grown to love from ACLS training (ha). The app also has information from a broad variety of medical topics that might require acute care, such as choking, bites, burns, and more.

The nice thing about this app is you don’t need cell phone reception to use this. It’s a stand alone app, which means you need to have wi-fi to download it since its a pretty big size (68 mb because of videos). The fact that you can easily update this app is nice, and will help you stay on top of standard of care.

I’m a bit surprised by the price, $3.99. I know the AHA paid Jive Media to make the app, but it would have been nice if the price was lower and I think more people would be inclined to buy it.

Now only if the American Heart Association (AHA) could come out with an app for ACLS training. It would be easier to learn from that and keep your memory fresh, instead of having to carry the cards around in the white coat.

You can find information about the app here. If you want to check out the app in the App store here is the link. There is a video of the app in action that I found here.