Here is a roundup of some of the best medical apps we loved over the past year in no particular order. 

LactFacts

Most healthcare professionals and patients are aware of the benefits of breastfeeding. And it is universally recommended by both the World Health Organization and the American Academy of Pediatrics among numerous other healthcare organizations.

Proven benefits to the mother include: decreased risks of breast and ovarian cancers, decreased risk of postpartum depression, and even decreased risk of common chronic diseases, including type 2 diabetes and cardiovascular disease.

Proven benefits to the infant include decreased risk of atopic dermatitis, gastroenteritis, and a higher IQ later in life. Additional beneficial associations regarding less risk of autism, cancer, asthma, are seen in observational studies. Consequently, the number of women breastfeeding their children continues to increase.

Here on iMedicalApps, we have examined several breastfeeding apps over the years and recommend readers consider LactMed from the NIH and Breastfeeding Management 2. Those excellent apps focus on medication safety and general guidance on breastfeeding, respectively.

And now there’s a newer breastfeeding app called LactFacts. The app comes from the Institute for Breastfeeding and Lactation Education (IABLE), a non-profit focused on promotion and support of breastfeeding.

The IABLE team has developed an outstanding point-of-care/evidence-based medicine app for breastfeeding. LactFacts tackles a clinical question about breastfeeding each week and includes a synopsis of the findings with links to PubMed and their own LactEd website. Additionally, they produce a free podcast that is also accessible via the website. Finally, members of IABLE can access even more resources online, including patient handouts, a video and image library, and more.

Likes

  • Concise summaries of clinical questions on breastfeeding with links to the article and more
  • Podcast series on a variety of topics with links from the app
  • Links to handouts on breastfeeding from IABLE (requires membership)

Dislikes

  • Requires IABLE membership to get patient handouts
  • Some answers to clinical questions very concise
  • Won’t completely fill the need for a concise reference on breastfeeding

Taping Handbook

The “craze” of Kinesio taping dates back to the 1970s in Japan and Kenzo Kase, a Japanese chiropractor. He combined his know-how of human anatomy and musculoskeletal manipulation and worked with industry to create a special type of tape that was durable, flexible, and hypo-allergenic (for most). From there, the phenomenon went global. Today, thousands of practitioners and likely legions more of patients apply Kinesio tape for everything from common musculoskeletal conditions to complex medical conditions, including stroke.

I still recommend it to patients willing to try something that is relatively low cost, has some evidence to support its use and likely minimal risk of harm.

One of the most common questions of athletes and practitioners interested in Kinesio taping is the “how-to” of applying it. Where does it go for a particular condition/body part? How should it be cut/applied? A new app called the Taping Handbook provides step-by-step instructions for Kinesio taping of more than 40 body regions from head to toe, including common conditions such as shoulder pain, tennis elbow, low back pain, knee pain, Achilles tendinopathy, and plantar fasciitis.

Likes

  • Step-by-step instructions with quality illustrations
  • Detailed information on anatomy of each body region
  • Taping applications well-divided by body region/medical condition

Dislikes

  • No videos on proper application; only pictures
  • No information/evidence on Kinesio taping
  • Not available for Android

Evidence Alerts

The new Evidence Alerts app brings the evidence-based medicine (EBM) know-how of McMaster University and pairs it with the fabulous DynaMed Plus to “alert” you to the latest and best EBM content customized by you, the user. The app allows users to input their DynaMed Plus and/or institutional PubMed account information for full content/article access.

I love evidence-based medicine! Talking about the latest medical evidence and debating if/how/when to apply it to a particular patient at the point of care is what led to my interest in medical apps and my writing for iMedicalApps. How to keep up with the medical literature is a challenge. “Information mastery” is a concept coined by EBM experts in the U.S., Canada, and the U.K. In the U.S., information mastery was championed by Slawson and Shaughnessy, who described the vast medical literature as a “jungle” and used the metaphors of “foraging” and “hunting” to navigate that environment. If you wanted to find an answer to a specific question, you needed a “hunting” tool such as UpToDate, DynaMed, or Essential Evidence Plus. If you wanted to just wander through the jungle and see what was new, you would use a “foraging” tool such as the Daily POEMs, Prescriber’s Letter, or Journal Watch. In short, hunting tools help you answer clinical questions at the point of care, and foraging tools alert you to new information.

In the internet age, another skill is also badly needed by medical professionals: information management. How do we manage this information that amounts to thousands of articles per month indexed on Medline? The EBM experts at McMaster University have teamed up with DynaMed Plus to provide Evidence Alerts — abstracts and commentary on the latest clinical studies in a new “foraging” tool. DynaMed from EBSCO was founded by family physician Brian Alper, MD. The app, now called DynaMed Plus, covers over 3,200 topics and monitors over 500 journals.

Likes

  • Daily EBM “best/latest” studies compiled by DynaMed and McMaster University to your device
  • Customizable for content, institutional access for PubMed and DynaMed Plus accounts
  • Available for iOS and Android

Dislikes

  • Interface not as robust as Qx Read regarding “look” and retrieval of saved content
  • Some features from McMaster University are “hidden” in submenus; DynaMed Plus integration bug
  • Expert commentary should be “upfront”

2019 GOLD Pocket Guide

Chronic obstructive pulmonary disease (COPD) is defined as a “common preventable and treatable disease, characterized by airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. Exacerbations and comorbidities contribute to the overall severity in patients.” This definition comes from the 2019 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. While there was no update to the GOLD Pocket Guide last year, the app received an update in 2019.

COPD remains the third leading cause of death and few interventions decrease mortality for chronic COPD. Smoking remains the most common cause of COPD and remains relevant despite the recent decrease in tobacco use in the U.S. (amid an explosion of e-cigarette use, especially among teenagers).

To make a formal diagnosis of COPD, providers must perform spirometry. A post-bronchodilator FEV1/FVC <70% is consistent with a diagnosis of COPD. Spirometry classifications are then broken down by the patient’s FEV1. The 2019 GOLD guidelines recommend “grading” a patient via the revised ABCD assessment. Non-pharmacologic and pharmacologic treatment is then based on the revised ABCD assessment grade.

The drug market has exploded with new treatments for COPD over the past 5 years. Physicians are inundated with inhaler acronyms: SABA, SAMA, LAMA, LABA, ICS, and combinations of the above. The problem with most guidelines like this is the lack of tools to help providers accomplish these tasks at the point of care during a busy clinic. How are physicians to know which medications should be utilized and in what sequence? The new GOLD guidelines have been released with a companion app of the GOLD Pocket Guide that aims to make this process easy to complete.

Previously on iMedicalApps, we favorably reviewed the COPD Pocket Consultant app by GlaxoSmithKline. Despite its Big Pharma backing, the app was the only one available that included a number of COPD symptom questionnaires such as the COPD Assessment Test (CAT). The other commonly used symptom questionnaire, the modified Medical Research Council (mMRC) scale can be found on the medical calculator app, MedCalX. The prior “official” GOLD app was last updated in 2017.

The 2019 GOLD Pocket Guide app brings the GOLD guideline PDF to life on mobile devices. It is the only COPD app you likely will need. The revised ABCD patient assessment tool allows providers to properly classify and treat patients at the point of care without paging through a long PDF. The caveat is that the evidence of efficacy for many COPD medications is weak when it comes to true patient-oriented outcomes and the GOLD guidelines contain a significant amount of expert opinion and pharmaceutical company ties.

Likes

  • Only app containing the current 2019 GOLD guidelines for COPD
  • Includes revised ABCD assessment, CAT, mMRC scale, and treatment selector calculators
  • Available for Android

Dislikes

  • Doesn’t include evidence rating for recommendations
  • Lots of wasted space and some viewing issues (at least on my devices)
  • App not as intuitively designed as it could be

Medicare’s “What’s Covered”

In January, the Centers for Medicare and Medicaid Services (CMS) launched a new app called “What’s covered.” The app takes some of the most popular information from the Medicare website and puts it in the palm of patients and providers hands via an intuitive app. Medicare coverage is booming especially as our population ages and states expand coverage. For example, in 2015 over 54 million people had Medicare coverage. This is expected to explode by over 30% to more than 80 million by 2030. Reportedly, nearly two-thirds of Medicare beneficiaries use the internet daily, and Medicare coverage and prices are frequently searched items.

Per CMS, “approximately 15 million page views annually for coverage-related content on Medicare.gov and 1-800 MEDICARE receives over 3 million coverage-related calls each year.” The app will likely decrease those numbers dramatically assuming the app gains traction both in the news, word of mouth, and by providers “prescribing” the app to their patients. The primary focus for the app is on the common “what’s covered” preventive services questions. For example, the app will give patients rapid answers to whether or not a mammogram is covered and how frequently they can get them. The app contains key information on both Part A and Part B coverage and the prices for what is/isn’t covered in those two areas.

“What’s covered” contains valuable information for patients and providers alike regarding what’s covered in Medicare Part A/Part B plans. The app has an intuitive search function with bottom-line, upfront answers about specific services that are or are not covered followed by more detailed information such as age and gender restrictions, the frequency of coverage, price, etc. The app emphasizes those preventive services that are or are not covered (such as USPSTF recommendations) and both hospital and outpatient information. All data is available on the Medicare website, but the app is more user-friendly regarding Medicare — what’s covered.

Likes

  • Comprehensive answers to all of our Medicare questions for Part A/B
  • Intuitive interface with multiple modalities to find information
  • Available for Android

Dislikes

  • Requires our Medicare patients to own a smart device
  • Some additional clicking and scrolling required to get to the information
  • Not many links or comprehensive references available in the app

Women’s Preventive Services Initiative

Wouldn’t it be nice to have all of the recommendations from USPSTF, Bright Futures, and the American College of Obstetricians and Gynecologists all in one place? ACOG thought so too and they teamed up with the U.S. Department of Health and Human Services and the Health Resources and Services Administration to create the new Women’s Preventive Services Initiative (WPSI). It brings together the health maintenance recommendations specifically for women from numerous key groups into one (relatively) easy-to-navigate website/web app.

The website includes a searchable well-woman chart, recommendations by category such as age, pregnancy, HIV, cancer, etc. To aid in implementation, the website includes an entire social media toolkit, handouts, and downloadable charts. The website is mobile-friendly, but there is no dedicated app, unfortunately.

Using the WPSI web app, we can quickly determine which preventive services a particular woman needs based on the best available evidence.

Likes

  • Comprehensive lists of women’s preventive health recommendations
  • Ability to view by subject, age, condition (i.e., pregnancy, HIV, etc.)
  • Quality social media toolkit, handouts for providers and patients

Dislikes

  • There is no app per se, but the website is mobile-friendly
  • Some recommendations are more evidence-based than others. Not every recommendation comes with a level of evidence rating or clear reference
  • Scrolling in the app can be cumbersome for some sections with multiple clicks/links
  • Women’s Preventive Services Initiative

Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.