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

One effect of the growing mHealth industry is the creation of interesting new ways in which patients, physicians, and other stakeholders are being connected – patients and physicians via FaceTime, connecting physicians to eachother, and even patients to their insurance company. HealthTap is a unique medical service launched on Tuesday that adds yet another dimension to how we communicate by allowing patients to get in direct contact with an expert physician for free via a smartphone.

The free HealthTap Express app available for both iOS and Android is a question and answer style app where patients can ask any questions and receive help from an expert physician who has volunteered to help via this service. There are over 5000 US-licensed physicians taking part in the scheme already and it is expected that many more will join soon.

As the folks at healthTap describe it,

5,000 doctors at your fingertips – with no waiting room, no copay, anytime, anywhere – for free! In addition, HealthTap Express allows people to get answers to any health question from thousands of America’s best doctors, at home or on the go, and gives doctors a Virtual Practice, where they answer real patient questions in real time, helping build their reputation, attract new patients and improve the quality of care.

HealthTap’s free web and mobile applications enable 24/7 access to personalized, relevant health information to help users find the best care and make better decisions about their health and well-being. Physicians participate on HealthTap to better serve existing patients and connect with potential new patients, all whilst demonstrating their expertise and commitment to helping people everywhere. In addition, they can build a social media presence – something many current physicians struggle with, yet is going to be increasingly important to building and maintaining patient panels.

Take a patient with sickle cell disease (SCD) living in a low-prevalence area. The absence of high-volume referral centers may mean a delay or lack of potential beneficial treatments. It’s not hard to imagine how a young patient with SCD may connect with a distant hematologist and discover available therapy. One could imagine the same scenario repeated itself for a patient with a rare malignancy in a low-prevalence area. An active physician on this kind of platform could reach patients all over the country.

As always, though, the elephant in the room is liability. healthTap appears to try to get around this by making it extraordinarily clear that there is no “patient-physician” relationship created. As they state in their Terms of Use,

While HealthTap Medical Experts are not your personal doctor or healthcare provider, and they do not practice medicine on or through HealthTap, they can be a resource for reliable, relevant general health information. You can even find tips (created by experts and others) that may be useful for you, which you can use to create your personalized health checklist.

And if that wasn’t clear enough,

We do not offer medical advice and are not a doctor. HealthTap is not a doctor and the use of HealthTap does not create a doctor-patient relationship.

HealthTap Express illustrates yet another way mobile technology can be used to improve doctor-patient communication. With the recent news that FaceTime is HIPAA compliant, one could argue that we are getting ever closer to the ability to conduct entirely virtual clinics. With the advent of HealthTap Express, patients will no longer need to resort to trawling google for a condition that explains their symptoms.

Source: HealthTap

Satish Misra, MD contributed to this post

By: Darwin Wan, MS III

Phrase Board is a free iPad app designed for patients with speaking difficulties. The app (iTunes link) itself is very simple and to the point. It essentially consists of a number of buttons that users can press to convey the message they want. “Yes” and “No” buttons are large, given the frequency of their usage.

Other messages including common complaints such as pain are easy to convey by pushing a few buttons to indicate the type, region and frequency of pain. A handy diagram also appears to allow users to point to the specific region of the body that the pain affects. This would be especially useful if the user has motor difficulties and is unable to point to tricky locations, say the lumbosacral region of the back.

Given that there are a significant number of patients with speaking and/or motor difficulties or may be intubated and cannot talk, many patients stand to benefit from Phrase Board.

Another useful function is the ability for the user to add custom, frequently used messages. This certainly does expand the range of the app, and allows users to better incorporate it into their daily lives.

The last function is a freeform drawing/writing function. This adds the ability to create personalized messages or pictures, and enables users to email creations to family and friends.

Phrase Board is a very simple app (all of the functions are basically covered in this short review) for a specific group of people. For those who have speaking difficulties but retain good motor function, navigating the app will definitely be a breeze.

Having worked with patients with physical disabilities in the past, however, I am aware that there are many for whom the app may be difficult to navigate. Those with less muscle control may find it difficult to accurately press the desired buttons, as slight touches are enough to trigger the iPad’s capacitive touchscreen. Thus it may take several tries for some users to select their desired message.

There is also what I would consider an important omission in that there is no option for the app to read out (i.e. voice synthesize) the entered messages; as it stands, the app merely displays the selected message, necessitating those involved in the conversation to look at the screen in order to get the message. It would not be possible for example, for a patient to get the attention of a nearby nurse with a loud audio message delivered from the app.

I would also have liked the selected message to appear more prominently than it does at the moment. Since there is no audio, other people must look at the screen to see the message, and if people do not know the user is trying to communicate via the app, they will definitely need a few moments to figure out what is happening, and where on the screen to find the message.

Overall, Phrase Board is a nice simple app that certain users with speaking difficulty may find useful. Patients are a diverse group of people, and the app will definitely not be a perfect fit for everyone. But since it is a free app (and other medical equipment may be very expensive), I would encourage potential users to give it a try to see for themselves if it is something they would use in their daily lives.

Likes

• Simple app that allows users to convey common messages quickly
• Custom messages and freeform drawing options

Dislikes

• No option for the app to read messages out loud
• Selected message not very prominent
• iPad’s capacitive touchscreen will frustrate users with less motor control

Pricing

• Free

Conclusion

Phrase Board is a straightforward app to help users with speaking difficulties convey short messages, though it may not be good for users with less motor control.

We posted an article a few weeks ago detailing how a form of Adobe’s flash player, the ubiquitous platform used to stream videos and play games, was coming to the iPhone operating system.  We were excited about this because many electronic health record (EHR) vendors developing web-based (“Saas”) EHRs, including Practice Fusion, Hello Health, and Care Cloud have relied on Adobe Flash technology for portions of the user interface. [Check out our video of Care Cloud’s EHR in action – using flash]

But with the upcoming release of the Apple iPhone Operating System 4.0, the hopes of having some semblance of flash on Apple’s mobile platforms is gone.

Dr. Felasfa Wodajo, a senior writer on this site, explained the how and why on his blog:
*********************************************
While this may seem like a repeat story, there was actually a little jewel buried in the “terms of service” for developers adopting version 4 of the iPhone OS, as they discovered last week.

Specifically, the new agreement forbids applications developed in languages other than those used by Apple or using different development tools than Apple’s own Xcode from being deployed on the iPhone or iPad.

A post by John Gruber, titled “New iPhone Developer Agreement Bans the Use of Adobe’s Flash-to-iPhone Compiler” started the melée.

This immediately set off a furor on the internet as it squarely prohibits Adobe from releasing the much discussed Flash to iPhone translator – the software we mentioned a few weeks ago.

Amazingly, Steve Jobs himself responded to a disappointed developer’s email, endorsing Gruber’s speculation as to Apple’s rationale with a terse but pointed response:

We think John Gruber’s post is very insightful and not negative:

-Steve”

Basically, Apple’s position is that developer tools differing from Apple’s will lead to inferior products, and negatively alter their ecosystem and user experience.  Understandably, developers chafe when told what tools they have to use for their craft.

While it is obvious requiring developers to use Apple tools helps keep applications from being made simultaneously available on multiple platforms and helps maintain Apple’s lead, I think this is a short-sighted understanding of the underlying strategy.

In just 12 months developers flocked to the iPhone platform in massive numbers – they can leave just as fast.

Apple has a very strong interest in controlling the manner in which applications are developed. They are very strict that any calls to the operating system (API’s) be made only according to published guidelines and they are miserly on transitioning “private” APIs to public.

In return, what Apple gets is the freedom to radically transform the platform underneath the applications – without the application base suddenly breaking apart. This is how, for example, they can bring in multitasking with only a minor ruffle to most apps or how they can reasonably claim 150k apps that worked on one device, the iPhone, will work on a brand new device, the iPad.

This is a major strategic asset, the effect of its absence can be seen on the windows platform where Microsoft has been shackled by its long tail of application incompatibilities, costing it years to make even evolutionary revisions to it’s operating system (see: Vista)

I am certainly disappointed that EHR vendors will not be quickly transitioning their Flash based user interfaces soon to my iPad. While much of the commentary has been based on catchy depictions of parking lot brawls between companies, it seems to me that each entity is more likely acting on its own long term strategic interests.

At the end of the day, EHR platforms utilizing flash will have to rethink their strategy if they want to have a presence on the iPhone or iPad.  This is unfortunate because the flash based EHRs potential is to provide a seamless transition and functionality from the mobile to desktop experience.

Iltifat Husain contributed to this post

Apple has made it clear that current iPhone apps will run on the iPad.  For many of the medical apps we’ve reviewed, its welcome news, but it won’t make the user experience of these apps any different.  However, there are a few medical apps currently on the iPhone whose user experience should be greatly enhanced by the iPad’s 9.7 inch 1024 x 768 pixel display.

The following are the top 5 medical apps we’re excited to see in action on the iPad.  This list is focused for health care professionals, and stay tuned for another list for medical students. Of note: These apps will only be great on the iPad if the developers port them over – basically, if the developers make a custom version of the app for the iPad.

(1) Blausen Human Atlas – When I think of the iPad in medicine, this app embodies one area in which the iPad could shine.  The Blausen Human Atlas includes 3D figures of human anatomy, an expansive medical glossary, over 1,000 still images, and a library of videos explaining common medical conditions like GERD and osteoarthritis.

Basically, everything in this app is designed with the goal of improving patient-physician communication. A provider who is trying to explain cholecystitis to a patient could access videos that explain the disease, still images to clarify any confusing points, and even 3D figures of GI anatomy to explain the corrective surgery.  The app performs admirably on the iPhone’s 3.5 inch display, but on a display more than twice this size – the iPad’s – it should shine.

Links: Blausen Human Atlas App Review
[iTunes Link]

Unlike many applications in the medical section of the App Store, Merck Manual is not made for medical professionals.  Instead, the app is aimed at lay people with no healthcare experience.  The app hopes to help these people understand medical knowledge easier.  We were definitely fans of the Professional Edition, which we recently reviewed.  The Professional Edition does a great job with synthesizing the information medical professionals need the most, and basically putting a medical encyclopedia in your hand.  I liken the Professional Edition to a Medical Wikipedia, at least in terms of the pertinent content it contains and the feel.  The user interface, navigation, and content are beautifully laid out in the Professional Edition, I was hoping to find the same features in the Home Edition as I was preparing for this review.

When the home screen opens up you’re presented with four main navigation routes, “Browse by Selection”, “Exploring the Index”, “Emergencies & Injuries”, and “Search”.  Unless someone wants to really learn medical knowledge for fun (weird?), I can’t see people clicking on the Browse by Selection category.  Rather, I’m sure the majority of people immediately type in what they are looking for in Search.

For the purposes of this review I’m going to use pneumonia as an example to look up.  When you type in pneumonia you’re presented with the different types.  Aspiration, Community Acquired Pneumonia(CAP), and Hospital Acquired Pneumonia(HAP) are the three that stuck out to me as some of the most common.  I clicked on Community Acquired Pneumonia as my choice.  From there you are given a great blurb about CAP and some high yield information. You are given information about causes, symptoms, diagnosis, treatment, and surprising to me, “prevention”.  I was impressed to see this included as one of the subheadings.  Prevention is often an after thought when people are looking up different conditions but is definitely essential to know, e.g., you should quit smoking to reduce your chance of getting CAP again.

When you’ve located the portion of medical information you actually want to read, such as treatment, and you see a medication listed, this app gives you the option to tap the word and you’re given the generic name of the drug without even having to navigate away from the App.  Throughout the text you are presented with hyperlinks of key words, somewhat similar to hw Wikipedia is set up.  The fact that you can copy and paste any of the text and even email articles out can be extremely useful.  It would be key to use the email function if you have a sick family member and you want the rest of the family to get a better idea of their condition, or if you want to access the information online at a later time.

What I liked:

• Navigation and User Interface are beautifully designed
• Hyperlinks within the text allow you to skip around related content easily
• Content is High Yield and presented so non-medical professionals can understand
• Ability to E-mail or copy portions of selected articles is a nice touch
• Bookmarking of your favorite articles
• Can manipulate text size
• Could see this actually improving a patient-physician relationship

What I didn’t like:

• Search feature is essential, yet you have to spell the word absolutely correct to access content in this manner.  When I typed in “pneu”, I did not get any results.  Its easy for me to type pneumonia, I’ve written the word on patients charts hundreds of times, but I could see how this would be annoying to the people the Home Edition is trying to reach.  A feature that offers you suggested words when you don’t spell correctly is crucial in this application.
• Pictures.  There are some pictures in this app, but they are definitely not enough.  In an app geared towards patients, it would be crucial to have a picture laden application.

Conclusion:

Overall, I really enjoyed using this application.  Even thought I’m from the medical side of the world, and I prefer the Professional Edition of the Merck Manual, I can see how non-medical people could find this application very useful.  I feel this application’s main competitor is Wikipedia.  Both have great content and provide the same sort of key information.  Nevertheless, The Merck Manual does have known MDs developing the application, so you can feel little bit more assured about the validity of the content in this application.

While reviewing this app, I realized it could be used in the clinic setting as well.  If you have a patient with a known diagnosis, you could give the patient an iPod Touch with this application on there and allow them to use the device to look up key information before the physician walks into the room.  This would allow the patient to have a better understanding of their condition, and allow them to ask more advanced and pertinent questions.  I still think the physician would need to talk for the same length of time, but the information that is said might be retained better by the patient if they had just read similar information on the mobile device.

All in all, if this App is used properly, it could definitely help improve the doctor/patient relationship.

[itunes]

[website]

By: Iltifat Husain, MD/MPH student, MS4

Medical Spanish, made by Batoul Apps, and available in the App Store for $6.99, just added audio to their top 25 medical app. As you can tell by the title, we’re definitely excited about the 2.0 version of this medical app. Some of the new features include audio for over 3,000 phrases, interactive bookmarking, a slightly different interface, and some new content. Did we mention there are over 3,000 phrases with audio now?

We reviewed Medical Spanish back in June and were definitely fans back then. The app even made our top 7 Medical apps list, coming in at #6. We’ll start the review by summarizing our last review, and then talking about the new features.

In our previous review, here is what we liked:

• Search function allows you to easily find thousands of key medical phrases / words instantaneously. By far the best feature of the App.
• The pharmacy section is great for giving instructions on how to take medications (dosage, timing, etc)
• You can use this app even if you can’t speak a single spanish word.
• Made by healthcare providers, so questions are on par.
• Thousands of phrases can help you with a full H&P and chief complaint.
• Can help you save time while you are waiting on the translator.

In our previous review, here are the things we didn’t like so much, and improvements we hoped for:

• A favorites section. It would be nice to have a favorites section where you could put the most frequently used spanish phrases.
• An option to where the application opens up to the search menu. I find myself using the search option 90% of the time.
• Hispanic patients tend to use more nontraditional medications, it would be helpful to have a section dedicated to some of the nontraditional med/treatments used by them.
• The developers have announced they will be adding audio to this app as well, which would be amazing.

The developers added 3 out of the 4 things we wanted to see in their new version of the app. They’ve added audio, bookmarks, and a section on commonly used medicinal herbs and plants by the Hispanic population.

Having a medical Spanish app with audio is nothing new. There is another medical app, called Emergency Medical Spanish Guide (EMSG) with this feature already. We tried out this app but were not fans because it lacked one of the most basic functions, a search feature. They also only have a couple hundred audio phrases. A search function is critical in a medical Spanish app because you don’t always have the time to go through every section to find out exactly what you’re looking for. Needless to say, with Medical Spanish adding audio, the EMSG app is nowhere close to the level of the updated version of Medical Spanish.

Audio feature and bookmarking:

To access the audio, you tap on a phrase, then a new section appears within the same page, with a play button and a star representing the bookmarks button. (Refer to the pictures). Once you tap the play button, you can stop the audio at any point in the phrase. This is all simple, fast, and fantastically done.

Issues and Improvements we’d like to see in the future:

Overall, we like the user interface, but we have some gripes with the organization of this app. The app opens up with a Review of Systems page, and lists the different systems. You have to scroll down to see other key sections, such as directions, and vocab. Also, the new medicinal herbs section is hard to find. You have to go to the vocabs section and then scroll down to medical plants. This section is crucial because almost all of us have encountered some Hispanic patients who use home remedies they get from local markets. The developers did a nice job of adding bookmarks for separate phrases, but why not add bookmarks for actual sections of the app? We’d like to be able to bookmark sections such as diagnostic tests and medicinal plans. It would also be nice to search for these sections of the app as well, instead of just specific phrases.

With it’s collection of extensive medical phrases and audio, we’d love to see this app have the ability to be a medical Spanish teaching app for healthcare providers. The developers could make a teaching mode, where they would add English audio along with the Spanish audio translations. Can you imagine making a customized playlist using the bookmarks section, then playing it on your way to work? In this manner you could memorize all of the Spanish physical exam instructions, along with anything else of your choosing.

Who this app would be great for:

Every healthcare provider who deals with a large Spanish speaking population.

Conclusion:

Our title of this review explains it all, we’re smitten with this Medical Spanish app. The developers took all the suggestions we made in our previous review and basically nailed them. With the addition of extensive audio, this is a definite must have application for healthcare providers who deal with large Hispanic populations. Unlike other medical Spanish audio apps who have only a few hundred audio phrases, this application has over 3,000. Even if you speak Spanish this could be useful for finding those key medical phrases you might not know. The user interface is quick, stable, and easy to use. The sky is the limit for this medical application and in the future we’d love to see a teaching function added. Oh, and is this app worth the $6.99 asking price? Most definitely.

[itunes]

[website]

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.

[itunes]

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We have an updated review of this application highlighting it’s new features. The review can be found here.

Medical Spanish is an app that helps you communicate with Spanish speaking patients in a health care setting. The app has a very detailed description in the App store, so I won’t get into the “nitty gritty”, but instead I’ll focus on the usefulness of the app. I’ll touch on this later, but you can use this app even if you do not know a single word of Spanish. (Scroll below after the conclusion section for a more detailed review of the App).

What I like about this App:

• Search function allows you to easily find thousands of key medical phrases / words instantaneously. By far the best feature of the App.
• The pharmacy section is great for giving instructions on how to take medications (dosage, timing, etc)
• You can use this app even if you cannot speak a single Spanish word.
• Made by health care providers, so questions are on par.
• Thousands of phrases can help you with a full H&P and chief complaint.
• Can help you save time while you are waiting on the translator.

Improvements that could be made:

• A favorites section. It would be nice to have a favorites section where you could put the most frequently used Spanish phrases.
• An option to where the application opens up to the search menu. I find myself using the search option 90% of the time.
• Hispanic patients tend to use more nontraditional medications, it would be helpful to have a section dedicated to some of the nontraditional med/treatments used by them.
• The developers have announced they will be adding audio to this app as well, which would be amazing.

Who this app would be great for:

• Doctors (Residents), PAs, nurses, and medical students who have a high Hispanic patient population.
• If your hospital / clinic is lacking a sufficient amount of translators, which is pretty much everyone.

Conclusion:

For anyone in the health care profession who has been waiting on a translator in order to ask just a few simple questions, this app could save you some frustration. I think this is a great app if used correctly and I would recommend it to the above people. This application doesn’t replace a translator but definitely would help you save time.

I think everyone out there at some point has been waiting outside a patient door but a translator isn’t available. This app could help you ask some key questions until the translator arrives. This app would also be useful for people who don’t need translators but might not have the best medical Spanish. I have peers who know Spanish well, but sometimes still have difficulty using their Spanish in a medical setting, this app would be great for them.

I think its important how you actually use the app as well. Trying to do a full H&P without knowing any Spanish beforehand would be difficult, but getting the chief complaint would definitely be doable.

I could see this app being used in pre-rounds. You could even write down the key questions you want to ask the patient before you enter their room. The search function is very very crucial, and I mention this throughout the review. It allows you to use this app in front of the patient because it is extremely quick and efficient.

At $6.99, it is not the cheapest app, but like I mentioned above, if you use it correctly it can save you time and frustration. Also, the developers have mentioned they will add audio to the app soon, which should make it even more enticing.

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Further Review:

This is a very extensive medical app, with thousands of words and phrases. The homepage (1st picture), starts with the Review of Systems and if you scroll down it has a “Basic Spanish” section. On the homepage there are 5 hot buttons at the bottom of the screen. These are Pain, Numbers, Physical Exam, Prescription, and the Search function. I found the Pain, Prescription, and especially the Search function to be the most important in this app.

The Pain section is done very well. We’re often told in medicine to use PQRST to assess for Pain, Provoking, Quality, Radiation, Severity, and Timing. It would be difficult to ask these questions of a patient if you don’t speak good Spanish, because you would not be able to understand their responses. To prevent this from happening the Pain section mostly asks close ended questions. Here’s an example of what I mean: “When is the Pain better? Worse?”, followed by “In the Morning? In the evening? After Resting? After exertion? After any activity?” This theme is followed often in the App, which I think is a great idea. It allows someone who does not understand Spanish to still get key information.

I know what some of you might be thinking, we’re also taught in medicine not to ask close ended questions. But those types of questions will help you get a head start in case the translators are all busy (which often times they are).

The numbers section is self explanatory, translating English numbers to Spanish. The Physical Exam section includes questions on medical history, along with full physical exam directions. It mostly translates commands, which can be particularly useful when you are doing the Cranial Nerve part of your exam.

The pharmacy section includes Instructions, Medications, Quantities, Side Effects, and Suggestions. The most useful section of pharmacy by far is the Instructions section. Its great because you can tell a patient exactly how you want them to take a particular drug, and even write it down for them using this section.

The search section is where this application shines, by far. Refer to my second picture for an example of using the search function. I typed in hurt and those were some of the results that came up. I even typed in sorry, and a whole host of empathetic phrases popped up. Like I said before, this application has thousands of words / phrases, and the search function makes it fun to use this application, and drastically more efficient.