For many, UpToDate is the medical application of choice for answering clinical questions at the point of care. It remains the most comprehensive app available for primary care and is available as a mobile app for individual and institutional subscribers to UpToDate. However, UpToDate isn’t the only choice out there for quick medical reference tools. We recently wrote a piece called, “3 Alternatives to UpToDate“, where we looked at reference apps that can hold their own against UpToDate. In particular, we were fans of Dynamed.
Dynamed from EBSCO was founded by a family physician, Dr Brian Alper. Dynamed covers over 3,200 topics and monitors over 500 journals. Although not as comprehensive as UpToDate, Dynamed is one of the most evidence-based apps available. Some studies have even found that Dynamed is more up to date than UpToDate. Dynamed continuously updates and pushes out weekly additions to all of their topics. Again, see our recent review of alternatives to UpToDate where we look at Dynamed along with a few other apps that are worth considering.
In our previous review, we were critical of Dynamed’s clumsy interface and the fact that Dynamed was only available as part of the Omnio app. With the Omnio app, Dynamed was buried in the submenus and difficult to access. You had to tap on “My Pages” to see your apps, such as Dynamed. This may seem like a minor inconvenience, but I found it an unnecessary barrier to the Dynamed app. Luckily, Dynamed has just relaunched their mobile app, tremendously upgrading the mobile experience. Most importantly, Dynamed is no longer part of the Omnio app, but rather a standalone app.
I have been using the new Dynamed mobile app while serving as the inpatient attending for my service. I have been attempting to use Dynamed for each inpatient encounter to answer questions from patients, residents on rounds, and my own clinical questions that come up daily. Before the latest update, the UpToDate mobile app was my go-to medical reference so I wanted to see how the new improved Dynamed app stood up versus the “gold standard”.
Let’s say we are working on a patient with multiple medical problems including congestive heart failure, endocarditis, hepatitis C, and new onset hepatic encephalopathy. How well does Dynamed work with such a complicated patient?
When you first open the app, it immediately pops up a list of the thousands of topics in the Dynamed database. The most useful feature on the front page is the search function. This search function is fast and easy to use and predictive in its results. The old Omnio version also included a table of contents view. I never really used that view, but was surprised to see it missing from the new version. Perhaps a future update will return it. You can also quickly update the app from the front page by clicking on the update icon along the bottom border of the app.
Let’s focus first on the new onset hepatic encephalopathy. The app quickly finds this topic and there is a very handy dropdown menu on the upper right hand corner that displays all the subtopics from Epidemiology to Diagnosis to Treatment to even ICD-9/ICD-10 codes.
For our hepatic encephalopathy patient, I wanted the residents to discuss how to make the diagnosis of hepatic encephalopathy. The app quickly allows you to see clinical criteria such as the West Haven Criteria. The app also contains many medical calculators or provides links to other website calculators, though I did not find that all of them were working. Like many apps, tapping a star at the bottom of the screen saves that topic to your favorites. You can also email or print any topic right from the app and take notes right inside the app on any topic.