Apps make it easier to communicate orthopedic concepts

Issue: June 2012

ByMatthew J. DiPaola, MD

ByOrrin I. Franko, MD

As the mobile device market continues to explode in growth, not only are patients turning to their handheld devices for answers to medical questions, but doctors are turning to their devices to help augment patient communication.

Orthopedics is a visual field. Models, drawings and posters have served many surgeons well in helping patients better understand their pathology and “see” them through a prospective procedure. Now, a bevy of new mobile apps provide the surgeon with convenient and cost-effective tools to enhance this process. In this month’s column we will highlight a number of patient education apps.

Decide apps

Orca Health is a software developer that is leading the way in terms of providing high quality orthopedic specialty education apps for patients. They have created a number of useful apps that cover various specialty areas including knee, shoulder, hand, foot and spine. They are named in a consistent manner: ShoulderDecide, KneeDecide, SpineDecide, etc. Each is designed in a similar manner. If you like one, chances are you will like the others.

The Decide apps have a consistent layout of three main menus: anatomy, condition and specialist. The anatomy menu takes the user on a tour of a virtual extremity. The 3-D diagrams are realistic, but still visually pleasing and conceptual at the same time. They provide a balanced level of detail: not so much that they feel like a gross anatomy text and not so little that they seem unrealistic to the surgeon. Unlike posters or paper handouts, the visuals rotate and move at the command of the user and can layer in detail such as muscle and ligament to provide an interactive experience. In addition, one can add or subtract labels to specific anatomic parts; helpful, in keeping patients from getting lost. One cautionary note, while your mobile phone may work, due to the larger screen, a tablet device is the best medium to appreciate the full detail of the visuals.

The condition section on these apps contains a tiled menu of conditions for each body part. A host of common diagnoses are listed for each app. The Knee-Decide app for instance, covers patellar tendinitis, knee arthritis and others. Clicking on a particular pathology brings the user to a diagram that is similar to the 3-D diagrams in the anatomy section, only the visuals in these sections add realistic features of the pathology red markers to denote the area of concern. The patient may also review examples of common X-rays, MRIs or arthroscopy pictures in this section. It has been our experience that such visuals aid patients in understanding their problems.

One of our favorite aspects of these apps was the email feature. In each pathology section, the user has the option to email a web-based hyperlink directly to a patient. The link contains information specific to the patient’s condition. Of the ones we checked, the information seemed accurate and readable.

DrawMD

DrawMD Orthopedics is a free iPad based app targeted at the same niche: enhancing patient education and communication. It is part of a series of apps brought to you by Urology Match LLC that gives the user the ability to draw simple sketches over the top of anatomical drawings. As far as patient education goes, it allows the user to flex a little more creative muscle than other tools. The user has the choice of choosing a new drawing or saved drawing. Going to the new drawing menu allows the user to pick from one of 10 different anatomical diagrams. The current list of diagrams is Netter-like anatomical depictions of the clavicle, shoulder, elbow, etc. The diagrams that come with the app are at the bone/ligament level and do not layer in any more detail like the Decide apps previously described. However, the app gives users the option to upload their own pictures, so the choices for demonstration are virtually limitless.

The differentiating feature of this app is its ability to allow users to draw over the top of any picture they desire. Simply pick a color and trace with your finger over the drawing and outline of a particular bone cut or implant shape, and that image will display over the top of the picture. Images can then be saved and sent to patients. The app is not content heavy. It keeps things simple and, to this end, it succeeds. Interestingly, if you had one of the Decide apps installed, you could take a screen shot on your iPad, save it and input it into drawMD to add your own spin.

Studies have shown that better communication with patients not only improves patient care, but may decrease the incidence of lawsuits. Apps that enhance patient discussions have many advantages over traditional models and posters. They are inexpensive, portable and take up little room. In addition, the apps that we have highlighted come free of corporate sponsorship. When used in context, apps like these can potentially enhance the physician-patient relationship.

For more information:

Matthew DiPaola, MD, is an assistant professor and shoulder and elbow specialist in the Department of Orthopedics at Wright State University in Dayton, Ohio. He is a writer for iMedical Apps and co-founder of Touch Consult, a developer of team-based medical software to improve signout. He can be reached at matthew.dipaola@wrightstatephysicians.org.
Orrin I. Franko, MD, is a PGY3 orthopedic resident at UC San Diego. He has an interest in promoting mobile technology within orthopedic surgery and founded the website www.TopOrthoApps.com to help surgeons and trainees find the most relevant orthopedic apps for their mobile devices. He can be reached at orrin@toporthoapps.com.
Disclosures: DiPaola and Franko have no relevant financial disclosures.