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Expert shares information on medical apps for clinical practice

BOSTON — Mobile apps are becoming increasingly common in health care, with 20,000 available on iTunes and the Android Store related to medicine, according to Sameer Badlani, MD, FACP, chief health information officer at Intermountain Healthcare in Salt Lake City.

“Apps are like sushi: You really have to try a few and see what you like,” Badlani said during his presentation here at the ACP Internal Medicine meeting, where he discussed the various categories of medical apps and shared with the audience those he has found most useful.

Reference guides

Reference guides are essential for anyone in active practice, Badlani said, and highlighted three notables, stating that all are “excellent clinical references.”

1. DynaMed
2. UpToDate
3. ACP Smart Medicine

Dynamed and ACP Smart Medicine in particular, he said, have an important feature — their information is evidence-based. ACP Smart Medicine, specifically, uses a grading system to rank the quality of evidence available to support diagnoses and treatment recommendations.

“It’s very important that you recognize the evidence that you are getting – what is the evidence behind it? It’s ok if it’s best practice, it’s OK if it is anecdotal, but we as physicians need to know what we are absorbing and making the decisions based on.”

Other considerations when choosing a reference guide app are cost and usability. The latter, Badlani said, may soon be the most important reason to stick with an app.

Drug references

A benefit to all of the drug reference apps Badlani mentioned is that in addition to providing information on things like usual doses and renal changes, they also explain how each drug works.

“When I was in medical school … the guy who could remember the most was considered the best medical student, and somehow that’s how we treat our physicians ─ if you know everything you are the best, and I think that’s wrong,” he said. “I’m so glad that at least now we’re starting to think differently about being a doctor and about doing the right thing for every patient at all times, and these resources really help.”

Drug reference apps Badlani suggested are:

1. Epocrates
2. Lexicomp
3. Medimex

Badlani recommends trying the free version of Epocrates before buying any of their extras, and he suggests checking with your pharmacy in case your institution already has a subscription or can get a discount for any of these products. He also said most commercial EHRs have Lexicomp or Medimex already built in.

Clinical calculators

Badlani said there has been an explosion of clinical calculator apps. He suggests testing out a few to determine whether the user interface matches your needs.

1. MediMath
2. MDCalc
3. OxCalc

Antibiotic guides

Of two antibiotic guides Badlani highlighted, one is a favorite that he urged is “truly worth it.”

1. Johns Hopkins Antibiotic Guide
2. Sanford Guide

“I know some of you are big Sanford fans, and I apologize for hurting your feelings, but I’m a Johns Hopkins Antibiotic Guide fan.”

Through his residency and now in practice, Badlani said he purchased the Johns Hopkins app, which runs approximately $30 for 1 year, about $60 for 2 years and about $70 for 3 years.

Regardless of preference, he said an antibiotic guide is a must-have.

Miscellaneous

Other apps on Badlani’s list include:

1. MediBabble. A medical translator Badlani has not personally used, but has received good reviews.
2. CDC apps. Badlani said their influenza and HIV apps are particularly helpful because both diseases are continually evolving with new treatments and considerations.
3. Doximity. A social media app for doctors that Badlani said is a good tool to stay in touch with colleagues, keep track of CME and participate in talks about the most important articles in medicine.
4. Isabel. An app that helps with clinical diagnoses.
5. QxRead. A reader that includes different types of articles and has become quite popular.

“In this fast changing world, if you want to keep up, you have to look up online and that’s the beauty of Sanford, or Johns Hopkins or DynaMed … they generally have a rigorous process of updating. That’s why trying to read and stay up on information for me doesn’t make sense anymore as a doctor; I want information at point of care, so these are the tools I have found very useful,” Badlani said. – by Stacey L. Adams

For more information:

Badlani S. There’s an App for That. MTP035. Presented at: ACP Internal Medicine Meeting; April 30-May 2, 2015; Boston.

Disclosure: Badlani reports receiving honoraria from Health Impact, Salix, and Weiss Hospital. He also reports a consultant relationship with EXL.