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What’s in your pocket? Medical Apps
for iPhones, iPads…
Rebecca Raworth, IMP Librarian, Nov. 2, 2010
Image on left from ht...
Smart band-aid
Mobile websites
PubMed for handhelds
iTunes store
Healthcare uses
Dr. Richard Watson shows Gustavo Pinor an X-ray of his
sprained ankle on an iPad. (Jean Lachat/Sun-Times)
Patient education
Patient monitoring
Airstrip OB
Medical education
http://www.uci.edu/features/2010/08/feature_ipad_1008
13.php
Reference
C P Cannon. Cardiology's move online—and onto my iPad . Volume 376,
Issue 9740, 14 August 2010-20 August 2010, Pages 505.
Taber’s medical dictionary
Instant ECG
Instant ECG
OxiriX
iAnatomy
ResolutionMD Mobile
MedCalc (medical calculator)
Clinical guidelines
Epocrates (e.g. drug interactions)
Epocrates (e.g. Pill Identifier)
Lexi-comp
Diagnostic tool
Productivity apps
Dropbox
Dragon dictation
Podcasts
Star Walk
Free news sites
Medical App reviews
Weaknesses of iPad
• Does not support flash
• Can’t project for presentations
• Can’t multitask
Infection risk?
(http://www.nydailynews.com/news/2009/11/24/2009-11-
24_they_cut_ties_over_flu_fears_hosps_tell_doctors_to...
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  • Today I’m going to show you some iPhone and/or iPad apps and mobile websites. Some apps are free, some cost money, and some useful tools are on the Internet and don’t need an app as they can be accessed directly on Safari (browser).

    Let people know that a drawback of the iphone and ipad for teaching purposes is that it can only display on a projector Apple propriety apps, so I have to show you want the apps look like with images on ppt. I have brought my ipad and iphone here for those who want to explore them.
  • Why am I doing this presentation? Because I think ipads and iphones and other wireless devices aren’t just fun fads, they’re the future of medicine. Can save health care costs by monitoring people outside of hospital beds. The Federal Communications Commission and the Food & Drug Association signed a memorandum of understanding (MOU) on July 27, 2010 that each agency would work with the other to create an efficient regulatory structure for wireless-enabled medical devices and services. The agreement has a five-year sunset provision built into it.

    Smart band-aid sticks on your body and has sensors that measure your heart rate and perform real time analysis. This can link to a wireless device so that you get the info on your iphone no matter where the patient is. Th4ey already exist for physiological processes (blood pressure, activity level level, persperation…
  • Last week I took part in a webinar called “Medicine & the iPad: lessons from an early adopter” by Dr. Don Dizon.

    Dizon explained how he has implemented the iPad into his medical practice, he initially planned to use the iPad for personal use but now uses it 80% of the time for professional purposes. He used to use a tablet PC but much prefers the iPad for its weight and great images. Dr. Dizon is the Director of Medical Oncology, Integrative Care, and Co-Director of the Center for Sexuality, Intimacy and Fertility at the Program in Women's Oncology at Women and Infants Hospital of Rhode Island. He is an Associate Professor of Obstetrics-Gynecology and Associate Professor of Medicine at Alpert Medical School of Brown University.

    You don’t need an app for everything as many sites are mobile-enabled
  • Keeping up to date

    NEJM pdf article view
  • Same article but I’ve used my fingers to make the print appear bigger
  • But remember that both the iPad and the iPod Touch and the iPhone also have internet access via Safari. Sometimes you’ll find what you want on the internet and won’t need an app.

    Many websites can tell when you are accessing them via a smartphone and automatically show you the mobile version of their website.
  • Current Awareness

    Nejm – more and more journals have iphone/ipad app

    NEJM This week iphone app – access full text of current issue (free for now), articles published online in past 7 days, classic images in clinical medicine, weekly audio summaries, and more…
  • Pubmed On Tap
  • Where to find apps:

    There are more than 5000 healthcare apps for smartphones* (Pew Internet Project, 2009)

    YouTube has a growing collection of medical-related content

    Lots of good, free apps available, also through itunes. You can buy them via iTunes on your laptop, pc, smartphone or iPad

    Some apps require you to register first, most don’t
  • Physician-patient relationship & education
    The screen size allows for visibility for more than one person so it’s good for patient education. A doctor can actively engage the patient while writing or typing on a tablet, no different than they would with a notepad or chart in front of them. It’s ideal as docs don’t have to turn their backs on patients to enter info into a desktop computer or have a laptop screen between them. The Mayo clinic has videos of procedures for patients to view

    Cedars-sinai medical center – iPads being used to enhance physician-patient relationship and for patient education.
    The Florida Hospital for Children uses iPads as a way of explaining tests such as CT scans and MRIs to children with videos and interactive Q & A features.
    St. Luke’s Health System in Boise, Idaho has loaded educational videos on iPads so that patients can learn about heart and vascular procedures.
    Australia – Aborginal health workers are using the iPad in daily rounds with elderly patients at their home as the iPads are connected to a secure database in Sydney
    Ormond Beach, Florida – Florida hospital, oceanside uses an iPad to conduct speech therapy with stroke patients. The patients speak through the iPad or iPhone to their care team
    Chicago - a plastic surgeon uses the iPad to demonstrate to patients what they might look like after breast reconstructive surgery
    an emergency room doctor showing patients radiographs of their injuries (photo)
    St. Louis, MO: Children’s Hospital uses iPads for education, distraction and preparation by showing patients how physicians prepare for surgery, and educating patients about their procedures or conditions
    -other places are using iPads for checking X-ray images EKGs and patient monitoring programs

    Diagnosis & Patient Monitoring
    Jikei – launched an iPhone app to help assist diagnosing stroke systems in patients. The system sends CT images of brain aneurysm patients to doctors’ iPhones so that decisions for surgery can be made quickly
    Kaweah Delta Health Care uses iPads for x-ray images, EKG results and other patient monitoring programs
    it's lighter than a laptop and has a longer battery life than many laptops, making it convenient for doctors to take on rounds.“
    And now a team of doctors at a hospital run by Kobe University has actually used the iPad during a surgery as a display. In the video embedded below, you can see a doctor (or assistant) zooming in and out of images shown on the iPad’s screen during the procedure.
    It’s not really an elegant solution, as not only the device is wrapped in plastic, but it also requires two people to hold it in place and to show the screen to doctors.

    Electronic medical records
    the iPad is light weight and very portable, allow doctors to view electronic medical records, wherever they are
    Can be integrated with EHRs/EMRs and point of care systems
    Emergency room doctors are using them to order lab tests and medication
    Another hospital that has embraced the iPad is MetroSouth Medical Center in Blue Island. Once doctors there learned that they could access the hospital's electronic medical records with the iPad, 'it went through here like wildfire,' said Dr. Richard Watson, an emergency room physician at MetroSouth. 'At least half of our staff here in the emergency room has their own iPad and carries it and uses it.'“

    Save paper, go green
    Save paper, go green some docs are having their patients use ipads to fill out paperwork

    Reference
    -medical residents are using them as a quick reference to look up drug interactions and medical conditions
    Easy to carry a library of medical reference texts around

    Saves Time
    Dictation instead of typing or writing notes
    Listening to medical podcasts while exercising or doing something else

    Geolocation
    Compass and camera and gpps allow for development of an augmented reality app which could help navigate a clinician or patient around a hospital or find a test in the library


  • Another example of patient education
  • Patient monitoring

    Airstrip cardiology monitoring

    Also makes one for obs that includes fetal heartbeat and maternal contraction patterns — in virtual real-time directly from the labor and delivery unit to a medical professional's mobile wireless device
  • AirStrip OB
    • Approved by FDA in 2006.
    • Owned by AirStrip Technologies, San Antonio, Texas.
    • Works with iPhone, BlackBerry and a variety of Windows Mobile devices.
    • Requires a password and user ID, complies with federal privacy laws.
    • Similar applications are now in the advanced stages of development for cardiology and critical care, with a goal of seeking FDA clearance soon.
    • Now being used at the Birthplace at Community Hospital in New Port Richey and the Baby Suites at Brandon Regional Hospital.
    Visit www.airstriptech.com for more information. Visit www.communityhospitalnpr.com for information about the Birthplace.

    Before physicians and nurses can use AirStrip Technologies solutions, their hospital must acquire a server that is provided and installed by AirStrip. The hospital must also have the correct interfaces between the AirStrip applications and hospital systems providing the data.
    AirStrip applications are provided to doctors via subscriptions, which are purchased by the hospital for physicians. Check with your hospital for availability.
    Doctors who want to use AirStrip must have a smartphone or other mobile device with a data plan. AirStrip solutions work on a wide variety of supported devices on virtually every cell phone carrier.
    Once the first three steps are completed, prospective users can register their device and download the software. Upon completing the registration process, users will receive download instructions via email. Click here to register now.
  • More and more med schools, including the Northern Ontario School of Medicine, are handing out iPads to new med students. They load them with medical texts and more so that the students have a library at their fingertips, wherever they go. Students often add flashcards and other study guides and mnemonics guides and visual diagnosis keys

    Loyola Univ - has given iPads to all of its orthopedic residents as part of a pilot program

    NOSM's Incoming Medical Students Will Use iPads to Access Interactive Medical Applications and CollaborateThe Northern Ontario School of Medicine's (NOSM) Entry Class of 2010 have started their classes well equipped to access interactive, experiential medical applications and references, no matter where they may be studying as part of NOSM's distributed, community-engaged medical education model. "The iPads will also provide the students with flexible access to innovative applications, curriculum resources and collaboration tools," says NOSM's Director of Technology and Information Management Support, Tariq Al-Idrissi. NOSM is the first medical school in Canada, and the third in North America, to distribute iPads to medical students as part of their technology package, which is paid for by student technology fees. Textbooks and journals are available on the iPads

    Stanford - Students commencing medical school and master's of medicine program at Stanford this year will all get an Apple iPad. The school is trialing a program to see whether the devices are practical to integrate into the academic curriculum and they want to save paper and “go green”. More from Stanford officials:
    The decision to provide the devices was prompted by a desire to give students flexible access to the content that they need whether it is a virtual cadaver in dissection lab, annotated lecture slides and videos in the classroom, or journal articles for evidence-based practice in clinic.

    UC Irvine’s incoming med students each received Apple iPad tablet computers loaded with everything necessary for the initial year of course work.

    University of Chicago Medical Center plans to provide iPads to all of its internal medicine residents, expanding on a pilot program launched earlier this year. Pulmonary specialists at the hospital also use iPads to explain lung disease to their patients.

    Test preparation: flashcards, texts, heart rhythms and EKGs…

  • Here’s an example of some Skyscape student apps and prices
  • Reference

    Skyscape sells medical books for iPads and iPhones. These all cost money. For physicians they have over 600 clinical resources in over 35 specialties, current guidelines…

    Android, Blackberry, iphone/ipad/ipodtouch/palm/symbian/windows mobile/pocket pc
  • Unbound medicine also sells books: drug guides, medical references, lab and diagnostics, dictionaries, evidence tools, etc. All cost money, 99 cents to $160 for each app
  • Netter’s Atlas of Human Anatomy – Skyscape - $76.95 (or $14.95 for individual sections, for example, “lower limb”)

    In middle is Netter’s musculoskeletal flash cards – $39.95
    What I liked about this app:
    Frank Netter’s beautiful drawings
    ability to search easily for a structure
    radiographic and MRI correlates of anatomy
    quiz mode useful for exam review
    opportunity to use professional anatomy drawings to explain a problem or a procedure to a patient
  • textbooks
  • Free
    Some titles are stand alone apps not amalgamated with other titles

    Compatible with iPhone, iPod touch, and iPad.
  • Professional edition 29.99

    Compatible with iPhone, iPod touch, and iPad.
  • An electrocardiogram rhythms interpretation guide that helps you learn and review ECG patterns
    99 cents Compatible with iPhone, iPod touch, and iPad.
  • Study guides

    There are quite a few specialty apps, too, like this neurosurgery one

    Lots of flashcards available for studying, too
  • Clinical Practice - Imaging

    Compatible with iPhone, iPod touch, and iPad 19.99

    OsiriX has been specifically designed for navigation and visualization of multimodality and multidimensional images: 2D Viewer, 3D Viewer, 4D Viewer (3D series with temporal dimension, for example: Cardiac-CT) and 5D Viewer (3D series with temporal and functional dimensions, for example: Cardiac-PET-CT). Allows you to download standard DICOM format images

    Zoom, pan, change contrast on images with finger motions & also measure parts of the image (apple devices only)

    Can search by patient
  • iAnatomy
    Compatible with iPhone, iPod touch, and iPad.
    99 cents
    anatomy atlas of the face, neck, chest, abdomen, and pelvis. -75 images with 60 actual CT scans of the chest, abdomen, and pelvis -New cadaveric images of the face and neck!
  • Free
    Telemedicine and mobile healthcare (mHealth) are changing the way that medicine is practiced today.

    ResolutionMD Mobile enables information and images to be accessed by healthcare professionals at a convenient time and place. ResolutionMD Mobile delivers a complete acute telemedicine solution directly to your mobile device. It provides the instant access to 2D & 3D images and reports regardless of the patient's location. You can now provide the same level of care that you would if you were actually there with the patient.

    Support for both Wi-Fi and cellular data networks (including 3G & 4G) allows for cost-effective delivery of world-class care to even the most remote patient populations.

    Licensed by Health Canada for diagnostic purposes
  • Clinical Practice – medical calculator

    Free
    Compatible with iPhone, iPod touch and iPad and more
    Huge selection of formulas
    Bibliographic refs for each formula
    Can customize list of your favorite equations
  • Diagnosis – Visual diagnosis (Derm) - decision support tool
    Visual dx


  • 99 cents

    Compatible with iPhone, iPod touch, and iPad.

    Helps perform differential diagnosis
  • free
  • Clinical guidelines
  • Clinical practice guidelines
  • PEPID – free and pay version
    Clinical decision support info/tools

    Has a drug interactions generator that resides on the device so you don’t need a wireless, lab manual, dosing information, EBM, drug db, symptom checker…
  • Drug information

    Iphone/ipod/blackberry/palm/android/online/windows mobile

    Continually updated clinical data: drug interactions, dictionary, symptom assessment, calculator

    There are four different versions of Epocrates you can have on your iPhone or iPod Touch.  Each version offers different features and subscription fees.  The default application in the App Store is free, which is what I’m showing you.
    Epocrates Rx (Free)
    Epocrates Rx Pro ($99 per year)
    Epocrates Essentials ($159 per year)
    Epocrates Essentials Deluxe ($199 per year)

    Here’s an example of the drug interactions screenshots
  • There’s also Drug Info – Information on thousands of drugs.  This includes mechanism of action, pharmacology, drug pricing, ability to add custom notes, and all the other basic drug info you could possibly want.

    In the paid versions of Epocrates there’s also an infectious disease treatment guide, a brand name OTC drug products section, a section on alternative meds and an IV compatibility checker, disease monographs etc.
  • Free

    Compatible with iPhone, iPod touch, and iPad.
  • 30 day free trial – dental & pharmacotherapy dbs

    Medical software for smartphones, PDA, and desktops - specializing in pharmacology, drug interactions, dental info, disease, formulary services, ...
  • ICD codes

    This app is designed for both iPhone and iPad
    29.99
  • Free – many paid apps have free versions too, that do less

    Compatible with iPhone, iPod touch, and iPad.
  • Free Snellen Eye Chart lets you randomize the Snellen or Tumbling eye chart with smooth animation
    Compatible with iPhone, iPod touch, and iPad.
  • iWorks – documents may be converted to MSWord and exported back to the PC

    PDF Reader pro (.99 cents)– a pdf reader, can save files from a web browser, search for specific words, send emails from within the app

    Evernote (free) – note taking software syncs notes between my pc and ipad. Store web clippings & photos

    Amazon Kindle app

    Instapaper - Description
    Save web pages for later offline reading, optimized for readability on your iPhone or iPod touch's screen. Free for iPhone/iPod. $5 for iPad

  • -free
    Dropbox is software that syncs your files online and across your computers.
    Put your files into your Dropbox on one computer, and they'll be instantly available on any of your other computers that also have Dropbox installed (Windows, Mac, and Linux too!). If you edit a document in the dropbox folder at home as soon as you press Save dropbox will sync the file with all your other computers and mobile devices. Because copies of your files are stored on Dropbox’s secure servers, you can also access them from any computer or mobile device using the Dropbox website. You can read what you’ve saved on dropbox even if you’re out of wifi range

    Dropbox replaces:
    Emailing file attachments to yourself and other people
    Using USB drives to move files between computers
    Renaming files to keep a history of previous versions
    Complicated backup software and hardware

  • Dictation
    allows you to easily speak and instantly see your text or email messages. In fact, it’s up to five (5) times faster than typing on the keyboard. With Dragon Dictation you can also dictate status updates directly to your Social Networking applications (Facebook and Twitter) or send notes and reminders to yourself….all using your voice. So when you’re on-the-go, stop typing and start speaking – from short text messages to longer email messages, and anything in between.
  • Evernote makes it easy to remember things big and small from your notable life using your computer, phone, and the web. And it’s free.

    Capture it - Type a text note. Clip a web page. Snap a photo. Grab a screenshot. Evernote will keep it all safe.

    Organize it - Everything you capture is automatically processed, indexed, and made searchable. If you like, you can add tags or organize notes into different notebooks.

    Find anything fast - Search for notes by keywords, titles, and tags. Evernote magically makes printed and handwritten text inside your images searchable, too.

    Access it anywhere as it automatically syncs with your laptop/desktop/mobile device/phone
  • CME & staying up to date

    Lots of specialty podcasts (dental, dermatology, gastroenterology, neurology, oncology…)

    Lots of journals have podcasts, too.

    Johns Hopkins
    Mayo Clinic
    CDC
    Lancet
    CBC’s white coat, black art
  • Lots of non-medical apps for fun:

    Alice in Wonderland – interactive kids books

    Books (iBooks, Kobo, Kindle…)

    Tide tables, music, art

    Recipes (epicurious)

    newspapers


    Star walk $5

    Hold the iPad up to the night sky and move it around, and this app will show you exactly what stars, galaxies, planets, and other objects you’re looking at. It pops up constellations as they appear and plays spacey ambient music in the background. Has a moon phase display…
  • I don’t have time to look through so many apps. Where can I find reviews of good apps?

    MobiHealth
  • Another medical apps review site
  • Doesn’t support flash but can see videos on YouTube
  • Can the iPad become the iGerm?
    -use disinfectant cleaner every day
    -if using with patients don’t put down on patient’s bed or table, use an iPad stand

    J Hosp Infect. 2010 Jun;75(2):138-9. Epub 2010 Mar 17.
    The necktie as a potential vector of infection: are doctors happy to do without?
    McGovern B, Doyle E, Fenelon LE, FitzGerald SF.
    PMID: 20299125 [PubMed - indexed for MEDLINE]

  • The future - Iphone can synchronize with medical devices such as glucose monitors and obstetrical equipment. The FDA has been monitoring this kind of use and an FDA official has stated that the iphone may ultimately be regulated as a medical device!

    The End!
  • Transcript of "What’s in your pocket"

    1. 1. What’s in your pocket? Medical Apps for iPhones, iPads… Rebecca Raworth, IMP Librarian, Nov. 2, 2010 Image on left from http://www.imedicalapps.com/2010/04/ipad-healthcare-review-medical-care-use/
    2. 2. Smart band-aid
    3. 3. Mobile websites
    4. 4. PubMed for handhelds
    5. 5. iTunes store
    6. 6. Healthcare uses Dr. Richard Watson shows Gustavo Pinor an X-ray of his sprained ankle on an iPad. (Jean Lachat/Sun-Times)
    7. 7. Patient education
    8. 8. Patient monitoring
    9. 9. Airstrip OB
    10. 10. Medical education http://www.uci.edu/features/2010/08/feature_ipad_1008 13.php
    11. 11. Reference
    12. 12. C P Cannon. Cardiology's move online—and onto my iPad . Volume 376, Issue 9740, 14 August 2010-20 August 2010, Pages 505.
    13. 13. Taber’s medical dictionary
    14. 14. Instant ECG
    15. 15. Instant ECG
    16. 16. OxiriX
    17. 17. iAnatomy
    18. 18. ResolutionMD Mobile
    19. 19. MedCalc (medical calculator)
    20. 20. Clinical guidelines
    21. 21. Epocrates (e.g. drug interactions)
    22. 22. Epocrates (e.g. Pill Identifier)
    23. 23. Lexi-comp
    24. 24. Diagnostic tool
    25. 25. Productivity apps
    26. 26. Dropbox
    27. 27. Dragon dictation
    28. 28. Podcasts
    29. 29. Star Walk
    30. 30. Free news sites
    31. 31. Medical App reviews
    32. 32. Weaknesses of iPad • Does not support flash • Can’t project for presentations • Can’t multitask
    33. 33. Infection risk? (http://www.nydailynews.com/news/2009/11/24/2009-11- 24_they_cut_ties_over_flu_fears_hosps_tell_doctors_to_dress_casual.html)
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