By Douglas Maurer DO, MPH, FAAFP
What do you do when you aren’t certain of how to treat a particular diagnosis? It is common for physicians in practice to talk to one another about “what to do” with a particular medical diagnosis. Some knock on the door of their partner and ask, others consult specialists, others turn to a trusted textbook, others look up potential answers in evidence based references such as UptoDate or Dynamed — some go to PubMed.
We all have mentors in our lives who we tend to “trust” regarding their medical opinion. As someone who prides himself on being an evidence-based medicine guru, my bias is to consult the literature, but that can be time consuming and even problematic when the literature is scarce on a particular topic.
SharePractice is an app that attempts to gather the “collective experience” of practicing healthcare professionals to aid in medical decision making. They term it a “social” medical reference.
The app was created by Dr Andrew Brandeis, a naturopathic physician, who runs an integrative medicine practice in San Francisco. Several of his practice providers are partners in SharePractice along with investors and application/web designers. SharePractice is completely free for verified healthcare professionals and medical students to use and contribute to. Potential users are verified via Doximity (see our recent article on Doximity and how they use your information).
The content of the SharePractice app comes from a variety of sources including PubMed, the Unified Medical Language System (UMLS) from the US National Library of Medicine, Emerson Ecologics (a natural healthcare and wellness website) and the input of the licensed healthcare professionals who have signed up and contribute to SharePractice.
Let’s walk through the app via a clinical case similar to one I saw in clinic recently. A 23 year-old female presents for treatment of an upper respiratory infection. She is concerned she may have influenza. Her past medical history is unremarkable and she has no known drug allergies. She has tried acetaminophen for a fever of 102, but is afebrile currently. Now let’s take a look at SharePractice to see what it may recommend for this patient.
When you first open the app, it immediately pops up a list of 13 medical specialties starting with “Dentistry” and continuing to “Family Medicine and Generalist” and “Surgery”. Across the bottom of the app are 3 icons: “Search”, “Activity”, and “Profile” (more on these later). You can also simply type into a “Search for anything…” window at the top of the screen.
Let’s try the “Search for anything…” option using “URI”. This brings up a list of “Diagnoses” including Croup, Epiglottis, Upper Respiratory Infection along with some unrelated diagnoses that contain the letters we searched for, including Urinary Retention. If you keep scrolling down, you will see a list of “Treatments” including the URI letters along with “Related” diagnoses such as the Common Cold.
Tapping on Upper Respiratory Infection brings up a diverse list of treatments including Super Bio Vegetarian (from Priority One Vitamins), Levofloxacin, Zinc and Vitamin C. You can tap on a “Dx Definition” to learn more about Upper Respiratory Infection. If you tap on one of the treatments such as Super Bio Vegetarian you see information on dosing of the supplement as well as ratings from providers who have used this on actual patients.
Tapping on “Super Bio Vegetarian” brings up information about the supplement and, not surprisingly, there is no data about efficacy regarding this supplement. In this example, you can see that 4 providers have used the supplement and you can view their comments if included. As a registered user, you can also add a “New Treatment” or comment on existing treatments for any condition. This is simple and intuitive to accomplish. You can also “share” treatments right from the app via text message, email, Twitter or Facebook.