Top 10 Apps for your Smartphone or Tablet:
Teaching and Learning in the Office
David Esho
Azadeh Moaveni
Andrew Sparrow
November 28, 2013
10:45 to 12:15
Faculty/Presenter Disclosure
• Faculty: David Esho
• Program: 51st Annual Scientific Assembly
• Relationships with commercial interests:
– NONE
Disclosure of Commercial
Support
• This program has received NO financial support
• This program has received NO in-kind support
• Potential for conflict(s) of interest:
– NONE
Mitigating Potential Bias
• N/A
Faculty/Presenter Disclosure
• Faculty: Azadeh Moaveni
• Program: 51st Annual Scientific Assembly
• Relationships with commercial interests:
– NONE
Disclosure of Commercial
Support
• This program has received NO financial support
• This program has received NO in-kind support
• Potential for conflict(s) of interest:
– NONE
Mitigating Potential Bias
• N/A
Faculty/Presenter Disclosure
• Faculty: Andrew Sparrow
• Program: 51st Annual Scientific Assembly
• Relationships with commercial interests:
– NONE
Disclosure of Commercial
Support
• This program has received NO financial support
• This program has received NO in-kind support
• Potential for conflict(s) of interest:
– NONE
Mitigating Potential Bias
• N/A
Overview
• The increasing relevance of apps to medical practice
• App categories you might find useful in your work
• Hands on Examples:
▫ Apps you can use to help you in your clinical work
▫ Apps that you can recommend for your patients
▫ Apps that you can use with your learners
• Q&A
What is an App
• App or application is a program designed to run
on a mobile device
▫ Smartphones ( iPhone, Blackberry, Android
devices, Windows mobile )
▫ Tablets ( Apple, Samsung, Sony etc..)
Apps and Patients
• Smartphone use in Canada rapidly rising
▫ In 2012:
▫ Smart phone use increased by 40%
▫ Tablet use increased by 100%
• Canadians increasingly likely to get their health
info from electronic sources
▫ 70% of Canadian internet users looked up medical
information online
▫ 34% of app use related to health/fitness/wellness
Apps and Physicians
• Increasing adoption of apps by physicians
• Fulfill multiple roles for a clinicians
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Education
Rx
CME
Reference
Tracking patient symptoms
App Categories that Every Physician
Should Consider having:
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Point-of-Care Reference
Drug Database
Note App
Textbook / eBook App
File Repository
Medical Calculator
Podcast/Video Player
Clinical Question
A 68yo M with gallstones and CAD is seen by a
general surgeon and deemed too high-risk for
cholecystectomy. He continues to have biliary
colic despite dietary tx and analgesics.
How well does Ursodiol work to dissolve
cholesterol stones when surgery is relatively
contraindicated?
Point of Care Apps
iPhone
Android
Blackberry
Medscape
Medscape
Dynamed (Skyscape;
free from CMA)
Tarascon Family
Medicine ($20)
Tarascon Family
Medicine ($20)
UpToDate ($$)
UpToDate ($$)
BMJ BestPractice mobile BMJ BestPractice mobile BMJ BestPractice mobile
site
site
site
Epocrates ($100/yr)
Skyscape 5-Minute CC
($99) or native app $99
or Epocrates
Skyscape 5-Minute CC
($99)
Wikipedia Apps
Wikipedia Apps
Wikipedia Apps
Dermatology
You are working with a clinical clerk today.
The clerk sees a diabetic patient with a new
bullous rash on the shins. The clerk is unsure of
the diagnosis.
What app could you use to come up with a
differential diagnosis of bullous rashes?
Dermatology Helper Apps
iPhone
Android
Blackberry
Google Images (free)
Google Images
Google Images
VisualDx ($100/year for
family practice;
$50/year for peds)
Derm101 ($10/month;
free 1 month trial)
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Derm101 ($10/month)
VisualDx (‘’)
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Skyscape Dermatology
Suite ($99 x1) –
Fitzpatrick’s Color Atlas
Skyscape Dermatology
Suite ($99 x1) –
Fitzpatrick’s Color Atlas
Skyscape Dermatology
Suite ($99 x1) –
Fitzpatrick’s Color Atlas
Scenario
The clinical clerk you are working with has seen a
30 y.o man with uncontrolled asthma.
You would like to start Advair. Your clinic rooms
are full, but your phone is in your pocket.
The same patient is also on lithium and ramipril.
Do you have to worry about interactions?
Drug Dosage Apps
iPhone
Android
Blackberry
Medscape
Medscape
Medscape
Epocrates
Micromedex
Epocrates
eCPS ($40/yr)
Epocrates
Micromedex
eCPS ($40/yr)
Skyscape: RxDrugs(free)
For Pediatric ER Drugs:
Pedi safe ($1)
Pedi safe ($4.50)
Drug Program Comparison
Use Case
Best App(s)
Very quick dose
lookup
Medscape, Epocrates, Lexicomp
Detail on adverse
effects, monitoring
Micromedex, Lexicomp
Canadian-specific
formulary
eCPS
Drug interaction
checking
Epocrates, Medscape
Opioid Conversion
Opioid Converter (Android), Opioids Dosage
Conversion (iOS), Opioid Morphine
Equivalence Table (PSS)
Scenario
• Ms. O’Brien is an 78 y/o new patient. She has a
history of atrial fibrillation and COPD.
• Your clerk has taken a history and notes she is
not on anticoagulants for her A fib.
• Ms. O’Brien has seen a cardiologist remotely but
doesn’t remember why she is only on aspirin.
What can you use to assess her risk of stroke on
her current regimen?
Examples of Useful Calculators and
Clinical Prediction Rules
• CHA2DS2-VASc Score, HAS-BLED score,
CHADS2 for Afib
• Ranson’s Criteria
• Pregnancy date calculator
• Modified strep score / McIsaac
• Well’s criteria / DVT Clinical Probability
• FRAX
Calculator apps
iPhone
Android
Blackberry
Calculate by QxMD
(free)
Calculate by
QxMD (free)
Archimedes (Skyscape;
free)
MedCalc ($10; used to be Archimedes (Skyscape;
free)
free)
Mediquations Medical
Calculator ($5.13)
Mediquations Medical
Calculator ($?)
Mdcalc.com
Archimedes (Skyscape;
free)
Ob (Pregnancy) Wheel
FRAX app ($5.99)
Not available...
CAROC.pdf
Mdcalc.com
Clinical Day
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Uptodate (membership connected)
Medscape (pharmaceutical funding)
MedCalc
Qx Calculate
DxSaurus
RX Files
Stat ICD 9
Insulin DM2
Figure 1
Patient Resources
• A family comes in with a child with a fever. What
handout could you give them quickly?
• Your G1P0 patient anxiously presents with a
number of questions regarding her pregnancy.
What apps can help?
• A type II diabetic sees you after a myocardial
infarction and is looking for advice on lifestyle
changes and disease management.
Techy ways to educate patients
iPhone
Android
Blackberry
WebMD
WebMD
Aboutkidshealth.ca
Aboutkidshealth.ca
Aboutkidshealth.ca
BabyCenter
BabyCenter
BabyCenter
My Heart & Stroke
Health
My Heart & Stroke
Health
Diabetes GPS
Diabetes GPS
Visual Anatomy
Consider setting up smartphone printing or using an outgoing no-reply
email address (as long as you warn about security implications)
Apps to use with patients
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MindShift
DrawMD
ImmunizeON
Lose It
Pepid
MedSpeak
Twitter
First Night on Call
• An elective med student resident is nervous
about his first overnight call.
• He is worried he won't know what to do in the
middle of the night when he is paged by the
nurse.
• He is also nervous about having to dictate, since
he has no idea what is expected in a standard
dictation on this rotation.
On Call Apps
iPhone
Android
MD on Call ($5)
MD On Call
Standard Dictations
Medscape
Quick Lab Ref
ECG Guide by QxMd
$~3
ECG Guide by QxMd
$4.75
Blackberry
Apps to use with your learners
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SoundBuilder
Auscultate
ECG Guide
Resuscitation
MD on Call
Read
Podcasts
The Future of Medical Apps
The Wireless Future of Medicine: Eric Tolpol
Q and A
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How do I get started
Which Apps are your favorites
Where can I find reviews of apps
Non medical apps you find useful
Getting Started with iPhone/iOS
iTunes
App Store
Apple ID & account
Getting Started with Android
• Buy an Android 4.0-compatible smartphone, e.g.
Samsung Galaxy S3/4
• Set up a google account and gmail
• Search and explore
▫ play.google.com/store
• Consider creating an outgoing email account
e.g. dr.kavanagh.noreply@gmail.com
Getting Started with Blackberry
• Download the following apps:
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Skyscape Reader (www.skyscape.com/reader)
DynaMed for Skyscape (www.cma.ca/dynamed)
Epocrates Rx (www.epocrates.com/mobile/blackberry/rx)
Medscape (www.medscape.com/public/blackberry)
Blackberry App World (appworld.blackberry.com)
MemoPad (preinstalled) for note taking
• Create quick home links to apps
Azi’s Favorite Apps (so far!)
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Qxcalculate
Epocrates
Evernote
CDC contraception 2010
BestPractice: as a website shortcut
AFP by topic
Andy’s Favorite Apps
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Lexicomp – drug resource
Figure 1 – Instagram for healthcare workers
LU Offline – Limited Use Codes
Read – Finding articles
CCS Lipids – CV risk scores to show patients
QxCalculate – medical calculators
Evernote – keeping track of info
Dave’s Favorite Apps
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Up to Date – Point of Care reference
MedCalc – Calculator Repository
Stat ICD 9 – Look up Dx codes
Pedi Stat – Genral Ped reference
DxSaurus – DDX generator
RX Files – Drug resource
iBooks – Storage of Pdfs
Useful Sites
• iMedicalApps.com
▫ Dozens of useful articles
▫ Top 10 lists for each platform
• cma.ca/k4p
▫ Knowledge for Practice
▫ Links to free online resources