Compatibility: iPhone (3GS and later), iPad, iPod Touch (3rd generation and later). Available on the Apple App Store.
Requires: iOS 5.1 or later
Purpose of the App Review:

  1. Will this app be of use to me to help me determine what the next step in management for my patient will be?
  2. What value will I get from using iCath for my cardiac patients?

Introduction:

In this climate of change in the American healthcare system, insurance companies, CMS and all third party payers want appropriate and efficient use of resources for the care of patients. Indications for catheterization and revascularization, especially with constant changes in criteria, can sometimes be clear as mud.

iCath was developed by Dr. Weston Hickey, a Cardiology fellow at Oklahoma University Health Sciences Center, as a clinical tool to help determine a patient’s eligibility of a catheterization or revascularization based on the most up to date appropriate use criteria from the American College of Cardiology and the Society for Cardiovascular Angiography and Interventions and  the COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation) trial.

User Interface:

The interface for iCath is refined and it is very easy to operate with clear instructions on the home page.

The app consists of three parts: Diagnostic Catheterization Appropriate Use Criteria, Revascularization Appropriate Use Criteria, and the appendix.

The “Diagnostic AUC” tab contains over 166 indications for diagnostic cardiac catheterization. Based on a patient’s results from other tests and diagnostics, you can choose a descriptive factor that best fits the patient’s previous test results (echos, stress tests). A final recommendation is made about whether or not diagnostic cath is appropriate, inappropriate or uncertain for your patient.

The coronary revascularization AUC has over 180 clinical scenarios and, similar to the diagnostic tab, will make a final recommendation of whether it is appropriate, inappropriate, or uncertain for the patient to receive this intervention.

The appendix is a grab bag of information about cardiac patients with tips, tables and definitions of terms used in the app.

So let’s take a patient who has a known history of obstructive CAD. You can choose this option when advancing through the app, it will then ask you a series of questions. Asymptomatic vs symptomatic? Medically managed vs managed with revascularization interventions? Low, intermediate or high risk?

I chose a patient who was asymptomatic, medically managed but high risk of coronary artery obstruction. Based on the results, it would be “appropriate” to catheterize this patient.

Price:

  • Free

Likes:

  • Easy to use with clean user interface
  • Intuitive navigation
  • Accurate, up to date information based on the latest ACC guidelines
  • Appendix provides clinically high yield information

Dislikes:

  • Lack of multimedia use
  • Would like to see links to official guidelines embedded in app

Healthcare providers that would benefit from the app:

  • Cardiologists
  • Inpatient providers
  • EM physicians
  • Any provider that consults Cardiology for catheterization or revascularization

Conclusion:

  • Keeping up with cardiology and incorporating new information and guidelines into your practice is easier said than done. iCath delivers on its promise: it’s a tool that elucidates appropriate use criteria for diagnostic catheterization and revascularization.
  • It’s not fun to play around with or visually appealing; however, it is very simple to use, it has the latest guidelines from the ACC and SCAI for your convenience, and it’s priced perfectly (free). A link to the most updated guidelines embedded in the app at the end of some of the decision trees (especially when the appropriate use criteria are “uncertain”) would be helpful.
  • The app can easily be used on a daily basis, especially for providers working wards and cardiologists to navigate through lengthy appropriate use criteria.

iTunes Link

iMedicalApps recommended?

  • Yes

Rating:

  1. Overall: 4.5/5 Stars
  2. User Interface: Clean, intuitive, easy to navigate. 5/5 stars
  3. Multimedia Coverage: 3/5. Transitions are clean but otherwise, it’s a very simple app.
  4. Price: 5/5 Stars.  This app is currently free.
  5. Real World Applicability: 5/5 Stars. Will easily be used daily for cardiologists, or those caring for patients on wards.