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Using smartphones in medicine; practical examples

November 12, 2009

I had the privilege of being one of the docs who chatted with Sam Soloman about the most useful smartphone medical apps available. Check out the Parkhurst Exchange’s Practice Management article, that’s little snippet makes me sound so much smarter and more concise than I really am!

My iPhone sits in my scrub pocket or in a leather holster on my belt every day. I rely on it for the usual phone and message features, to handle quick e-mails, and listen to music on a daily basis. If I’m at work, ePocrates, Skyscape’s Taber’s Dictionary and the thankfully free MedCalc seem to see regular action. UpToDate is fortunately built into our hospital’s EMRs so I don’t tend to access it via my smartphone’s small-compared-to-a-desktop’s screen. I use a few other apps when I have more time to dig deep. Skyscape’s RxDrugs has a lot more Canadian and over-the-counter medications in its catalogue; Netter’s Atlas helps when straining to remember long forgotten things like muscular insertion points; and Diagnosaurus helps broaden my differential when I feel like I’ve wandered down the garden path.

PDAs are changing the way we practice. Yesterday, we wrote an “open book” pharmacology/prescribing exam, where the test was about choosing appropriate medications and writing clear prescriptions. If we pass this and other measures, we are then recommended to the College as sound prescribers and will be issued the appropriate registration numbers and duplicate (narcotics) prescription pads.

The object of the exam was not to test our recall of doses or to probe the bounds of our prescribing accurately for rare disorders. Rather, it was a test to see that we could come up with a reasonable drug choice given the patient’s context, using the resources regularly available to us. The questions got at things like: What anti-hypertensive medication would you start first-line for a diabetic patient? What would you do if they were still hypertensive after weeks on that drug? What might be a better choice for someone managing their chronic pain with hundreds of T#3s a month?

We were told to bring our PDAs, since those (and the CPS!) are our main prescriber tools. I think the nature of the questions – testing application and synthesis of knowledge rather than rote memory – and the allowance of our Smartphones was a reflection on the fact that medicine has changed. I don’t know about endorsing one brand of software over another, but some medical schools are even integrating smartphones into their education model.

We are trained to be critical thinkers, and there’s too much medicine to remember; offloading some of the raw data from our brains, there’s now more space to think carefully about why we do what we do, and about how it should be done.

7 Comments leave one →
  1. Nico permalink
    November 12, 2009 9:07 am

    We are trained to be critical thinkers, and there’s too much medicine to remember; offloading some of the raw data from our brains, there’s now more space to think carefully about why we do what we do, and about how it should be done.
    **
    I think this applies in nonmedical sciences too. I memorize the basics, but even my profs mention that they don’t see a need for rote memorization of bulk data, rather, how to find and apply it is the key.

    It seems a smarter way to do things.

    • November 12, 2009 9:26 am

      I’m glad that philosophy transcends medicine. It’s about time that we value big picture thinking and application over recall.

  2. November 12, 2009 9:28 am

    I think this is fabulous and about time too. It’s really a refreshing way to practice medicine – to use those tools that you’re comfortable with which allows you to make more informed decisions that you’re comfortable making.

    kudos to your school.

  3. Emme permalink
    November 12, 2009 4:41 pm

    This is v. interesting. I wonder if there are any popular iPhone apps for patients. As a confirmed hypochondriac I will have to look into that!

    • November 12, 2009 11:01 pm

      I know some of the diabetes tracking ones are popular but I haven’t specifically met any patients that use their iPhones for managing their health, yet.

  4. November 19, 2009 8:20 pm

    I’d like to hear your on-the-job playlist!

    • November 20, 2009 3:18 pm

      Well, it’s hard to listen to music at work, because I’m talking with people all the time… but I actually DO have a “medical-related” playlist…
      couldn’t find a way to send it properly, but FYI:

      the knife\deep cuts\10 is it medicine.mp3
      katscan\latest developments in the field of beat surgery1 – intro (it’s time for your medical).mp3
      Peaches 320kbps MP3 [2000 – 2006]\[2003] Fatherfucker5 – Peaches – Operate.mp3
      Zeromancer\Eurotrash1 Doctor Online.mp3
      the white stripes\get behind me satan2. the nurse.mp3
      pj_harvey-when_under_ether.mp3
      Dopplereffekt\Gesamtkunstwerk3 Scientist.mp3
      Velvet Underground\White Light-White Heat3 Lady Godiva’s Operation.mp3
      metric\live it out\metric – live it out – 06 – monster hospital.mp3
      Prodigy\The Prodigy – 2009 – Invaders Must Die Deluxe [V0]5 Take Me To The Hospital.mp3
      propaganda\outside world1 – Das Testament des Dr. Mabuse (13th Life Mix).mp3
      Requiem for a Dream\clint mansell (featuring kronos quartet) – 09 – Dr. Pill.mp3
      the chemical brothers\chemical brothers – we are the night\12 the pills won’t help you know (feat. midlake).mp3
      New York Dolls\New York Dolls9 Pills.mp3
      rise and fall of a decade\you or sidney\rise and fall of a decade – you or sidney 11 – sweet pills.mp3
      Electric Six Feat Jack White\switzeland (2006)\electric six – [02] i buy the drugs.mp3
      Velvet Acid Christ\Unknown Album\fun with drugs.mp3
      My Life With The Thrill Kill Kult\Unknown Album1 I Live For Drugs.mp3
      Wumpscut\Blutkind (Bloodchild) Disc13 Anaesthetics.mp3
      Spock\Unknown Album\Dr Mccoy.mp3
      Pop Will Eat Itself\The Pop Will Eat Itself Cure For Sanity6 Dr Nightmare’s Medication Time.mp3
      Die Ärzte\Runter Mit Den Spendierhosen, Unsichtbar7 Leichenhalle.mp3
      Klinik\Braindamage5 Fever.mp3
      Klinik\Braindamage\13 Sick in your mind.mp3
      Bakelite\Bakelite6 A Fever.mp3
      Distorted Reality\Unknown Album\Fever.mp3
      Ursula 1000 – All Systems are Cogo\Mo Horizons – 14 – Fever 99.mp3
      The Kills\The Kills – (2008) – Midnight Boom1.- U.R.A. Fever.mp3
      Suzanne Vega\Unknown Album\99.9 Farenheit Degrees.mp3
      Numb\There Is No Time (Disc 4)\10 Blood.mp3
      saltillo\ganglion6 – blood and milk.mp3
      Danzig\Danzig II_ Lucifuge9 Blood and Tears.mp3
      Coil\The Anal Staircase2 Blood From The Air.mp3
      Suzanne Vega\Best of Suzanne Vega_ Tried and True7 Blood Makes Noise.mp3
      Skinny Puppy\Bites\Blood On The Wall.mp3
      Lordi\Unknown Album\Blood Red Sandman.mp3
      The Vichy Government\Little Orphans Running Through The Blood3 Death On The Instalment Plan.mp3
      Danzig\blackacidevil\Hint Of Her Blood.mp3
      Manic Street Preachers\Lifeblood5 I Live To Fall Asleep.mp3
      gothic club classics – volume 1 (disc 1)7 – killing joke – love like blood.mp3
      Alabama 3\Power In The Blood2 Power In The Blood.mp3
      Die Form\Duality5 Rain Of Blood.mp3
      Chemlab\Suture7 Blunt Force Trauma.mp3
      Chemlab\Suture3 Chemical Halo (Drag-Strip Downloa.mp3
      Chemlab\Suture4 Codeine, Glue and You (Scorched R.mp3
      Chemlab\The Machine Age2 Suture (#1).mp3
      Chemlab\The Machine Age5 Suture (#2).mp3
      empirion\advanced_technology-19961-empirion_-_narcotic_influence_1-psyczint.mp3
      empirion\advanced_technology-19966-empirion_-_narcotic_influence_2-psyczint.mp3
      the knife\silent shout(2006)4 we share our mother’s health.mp3
      spinnerette\Ghetto Love EP2. Spinnerette – Valium Knights.mp3
      spinnerette\Ghetto Love EP4. Spinnerette – Bury My Heart.mp3
      hackers soundtrack7 – orbital – halcyon & on & on.mp3

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