Apps for Family Practice Residents


 

APPS FOR HEALTHY HABITS (FOR PATIENTS):  Healthy Lifestyle Phone Apps.pdf

 

 


GENERAL


AppShopper

$FREE iOS  No Android version as of 7/2103

Most high-quality medical apps, especially those from major publishers, won't go from $100 to $0.99 but many apps do go on sale periodically. There's an app for that, actually a bunch of them, but this iOS app seems to do a decent job of a) allowing you to flag apps you care about, b) notifying you with an email or alert when their price drops. Any app which implements this sort of "watchlist" function reliably (and there are many Android equivalents) can save money on medical apps.

 


Evernote

$FREE (w/ premium features avail for $ on a subscription basis) iOS, Android, Blackberry, etc.-just search 'evernote'

A server-based note-taking and sharing service with implentations for every conceivable platform. I.e., create a document or note* in your web browser and it's synced to your phone or tablet and vice versa. Share a note* and it's immediately updated for everyone when you change it. Lots of potential for amassing and/or sharing a pool of medical reference material. Google it for lots of reviews and discussions of how various people are using it. *A "note" can include any or all of the following: images, phone numbers which activate a call on your smart phone, formatted or plain text of course, audio recordings, videos, attached files .doc or .pdf, links to websites.

 


Skyscape

$FREE app w/ add-on content varying from free to $$$ per title. Available for every platform-search 'skyscape'.

The 800-lb gorilla of medical apps. Within the app, you can rent or buy just about any pocketbook you've seen in a white coat plus a bunch more. They have a standard format for presenting information. Some may like the consistency. Others may prefer stand-alone versions of their references or more elegant interfaces. Unbound Medicine seems to be their major competitor in terms of offering alternative implementations of many of the same references. (Search Unbound Medicine in an app store to bring up all their titles.)

 

 

PRIMARY CARE/CLINIC


Color Atlas of Family Medicine

$125 as an app for iOS or Android or $70 as a Kindle e-book*

Ed. Note: I put this app first in primary care, in part because it's just really good, but also because it epitomizes much of what I think FM residents should aspire to be: bold, broadly-competent, integrative, practical, patient-centered, collaborative. Many of the other apps on this page hone in on some specific issue or problem and do a great job of addressing it. This app, like the print Atlas it's based on, goes BIG in every sense of the word (scope, ambition, delivery and, yeah, price). -JDK

 

The Color Atlas app showcases high quality images yet delivers the full content of the macrosomic 4195g text on which it's based. A valuable derm reference, of course, but as a true generalist's compendium, it's 2,000 images cross numerous specialties (optho, ENT, OB, EM, etc) w/ a strong emphasis on outpatient medicine. Slit lamp pics, otoscopy, oral lesions, chest xrays, skin findings in liver disease, newborn skin conditions, wet preps and cervical findings, if it's visual or has some visual component, the editors have included it. And while the pics are the draw, the text is excellent w/ concise history, exam, diff dx, and management sections for each topic. Treatment reccomendations include SOR (strength of rating) and references.  If you are going to buy any FM text--whether for snatches of odd down-time reading or for reference in clinic--you'd be hard pressed to do better.

 

YouTube Demo  Screen shots and review

Reviews of print version of Atlas on Amazon

 

*Caveat re: price for Kindle version: Before you grab the Kindle version for the bargain price, download a free preview to the specific device or devices you'll want to use it on. Is it easy and intuitive to navigate? Do charts and other graphics display well? Can it be searched easily and does it display results in an effective way? Does it just mention other relevant chapters (for instance under differential dx) or does it link to them? The app versions do all of this well. Kindle can butcher image-heavy texts and often works better for books read linerly than it does for references in which one skips around. The price looks like a bargain but will only be one if it works well enough on your device to encourage frequent use.

 


Diabetes Standards of Care

$FREE  iOS  Android

A nicely-done mobile implementation of the annual American Diabetes Association annual review article "Standards of Medical Care in Diabetes." Addresses just about any question you would have about diabetes management with the official reccomendations.

 


Geriatrics at Your Fingertips

$20 iOS Android

Published by American Geriatrics Society. Organization of app and search function a little clunky but content is very good.  I've actually used this more in the hospital than the clinic. Looking at it now, I should be using it more often outpt. Wide range of topics:  how to handle acute agitation/delirium (hint, it's not lorazepam), dx and management of dementia, depression in older adults, falls, hearing loss and tinitus, appropriate prescribing practices in geriatrics (including "De-prescribing: When and How to Discontinue Medications.")

 

iGeriatrics

$3 iOS  Android

Combines all of the AGS's free clinical information offerings into one easy to use app $3; includes information from the following titles:

* Beers Criteria * Geriatrics Cultural Navigator * GeriPsych Consult * Guide to Common Immunizations * Management of AF * Prevention of Falls

 


Screening/Healthcare Maintenance Apps

 

AHRQ ePSS (USPSTF Screening Reccs)

$FREE iOS  Android

Enter your patient's gender, age, sexual activity and smoking status and get all the relevant screening recommendations from the US Preventive Services Task Force ranked by strength of reccomendation from A (standard of care) to D (don't offer it).

 

Pap Guide

$FREE iOS  No Android version as of 7/2103

From the App description: "pulls together and presents guidance to clinicians on cervical cancer screening and Pap smears. Organized by female patients' age and/or circumstance, Pap Guide advises doctors when to start doing Paps, how to incorporate HPV testing, when to stop, how often to do them, how to manage the results of Paps. It also offers guidance on how HIV, pregnancy, and hysterectomy may impact screening regimens and results management. The main source of guidance is the 2012 ASCCP et. al. consensus guideline supplemented by guidelines from ACOG, the US Dept. Health & Human Services, and more."

 

A related but not free app (?$10)from the American Society for Colposcopy and Cervical Pathology (iOS  Android) incorporates all the actual alorithims from the ASCCP's latest guidelines. Probably only worth it for those doing colposcopy, LEEPs or who need the guidelines' many algorithims in their pocket for reference but don't need the basic teaching on who, when, how to screen. May be worth it to those with Android devices unable to get the Pap Guide.

 

ACP Immunization Advisor

$FREE  iOS  No Android version as of 7/2103

Does this patient have an indication for pneumovax? Can I give Tdap to this immunosuppressed pt? What vaccines are recommended for pt w/ asplenia or chronic liver disease? HIV? Healthcare worker? Men having sex w/ men?

See Shots under Peds for another app which summarizes CDC immunization reccs but is more geared toward childhood vaccination.

 

 

MATERNAL-CHILD HEALTH


Perfect OB Wheel

$2-4 iOS  No Android version as of 7/2103

Paper wheels are sooo 2000-and-late. There are a ton of electronic ones out there, many free and some built into general 'medical calculator' apps but this is a particularly good one. Lots of flexibility in how you date and what your output data is. E.g. get EDD from LMP (of course) but also get the date range for a particular gestational age range based on EDD (helpful when ordering US or labs that GA-specific), figure out gestational age at some specific past date based on known EDD, etc.

 


GBS Guide

$Free iOS No Android version as of 7/2103

Ah, the rules for GBS prophylaxis are easy...if you do it every day. Otherwise, it's a nightmare of 'if/then's. From the app description: "GBS guide organizes and presents the practical and hard-to-remember guidance on intrapartum antibiotic prophylaxis and newborn management in order to prevent invasive GBS disease of the newborn. CAVEAT: Based on 2010 CDC Guidelines. GBS practices vary from institution to institution. Double check your conclusions, but this is a great place to start.

 


Bili Calc

$2 iOS  Android

A clean, portable implementation of the AAP nomograms for hyperbilirubinemia. Includes everything on bilitool.org but super easy to use on your phone, doesn't require internet.

 


Fetal Heart Rate Monitoring

 

EFM Guide

$Free iOS No Android version as of 7/2103

The beauty of Dr Steinberg's apps is their careful, faithful condensation of wordy guidelines. The only people who won't find this helpful are those who know the NICHHD's 2008 electronic fetal monitoring definitions by heart. For everyone else, from med students through MCH seniors brushing up on questions like "can you have a couple nonrecurrent variables in a Category I strip?" this app's super helpful. Has visual examples of basic strip findings, definitions of all common terms, and basic info on management of findings like recurrent variables.

 

Fetal Heart Rate 5-tier

$3 iOS  Android

A digital implementation of a color-coded 5-tier strip-reading system which attempts to deal with the ambiguity so many strips falling into Category II under the NICHHD's 2008 3-tier system. Not officially used at UNMH as of 7/2013-ie don't put 'Orange' as your assessment of a strip in a labor note-but food for thought and lists the 3-tier category for the strip info you enter as well as it's own 5-tier assessment.

 


CDC Apps: STDs, Contraception

 

STD Tx Guide

$FREE iOS Android

Based on the CDC's 2010 Guidelines, this app allows one to quickly drill down to specific tx options for all the common STIs as well as infections in which the specific pathogen is not known such epididymitis, PID, proctitis. The full Guidelines with their 489 references are included for the fastidious but remain tucked discretely out of view of the harried clinician.

 

CDC Contraception 2010

$FREE  iOS  No Android version as of 7/2103 but ?coming

Based on US Medical Eligibility Criteria for Contraceptive Use, 2010. Meant to help clinicians understand the relative risks of different forms of contraception for women with a vast range of characteristics (e.g. age, parity, breast-feeding) and health conditions (hypertension, depression, headache). Not the most elegant GUI in every instance but very useable and more likely to be on hand than a poster or website.

 


Prenatal care, Drugs

 

Ilithyia: Evidence Based Prenatal Care

$FREE iOS  No Android version as of 7/2103

Created by attendings and residents at a Family Medicine residency, this app attempts to compile recommendations for basic prenatal care and their relative evidence base (A, B, C). One can enter a GA, say 22 weeks and pull up a list of the reccomended Counseling, Exam, Tests and Follow-up for that GA. One can also view topics like Caffeine, Air Travel, and Hot Tubs to find recommendations for specific circumstances.

Huge potential benefit to residents scrambling to remember everything/know everything in this area, but exercise some caution as it was put out in 6/2012 and has not been updated as of 7/2013 which suggests it might not be a living, evolving, updated project.

 

LactMed from Nat'l Library of Medicine

$FREE  iOS  Android

"A database of drugs and dietary supplements that may affect breastfeeding." Same info you can find online at the LactMed website but always in your pocket. You may not need it often but when you do have a question about meds and breast-feeding, you need this--not Epocrates or Lexicomp or any other general meds reference.

 

ReproTox

$FREE (w/ some hoops*)  iOS  Android

Compiled by a non-profit foundation, "REPROTOX contains summaries on the effects of medications, chemicals, infections, and physical agents on pregnancy, reproduction, and development." Basically, when it comes to drug or toxin questions with pregnant women, skip the generic drug refs and go here.  *As a trainee, you can get a license to unlock the app's content but it involves some emailing. Start at their site.

 

 

EMERGENCY MEDICINE


PalmEM

$20-30. iOS  Android

A pocket reference for that other super-broad field of medicine. Stripped-down, bullet-point presentation of basic ER topics supplemented with high quality images. Fast, smart search feature: typing 'pust' pulls up 'Rash', 'peni' pulls up the 'Phimosis and Paraphimosis' and 'Priapism', 'carb' pulls up 'Antidotes,' 'Carbon Monoxide,' and 'Pulmonary Fundamentals.' Includes a 'Pedi Tape', the digital equivalent of the Broselow Tape. It won't measure the kid but, if you figure out length, age OR weight, it will give you the size-appropriate: vital signs, tube sizes, bolus quantities, PALS drug doses, asthma and croup drug doses, IV doses for hypoglycemia, and a bunch of other urgent/emergent-type drug dosing.

 

As important as any feature of the app today (7/2013) is that the developers are actively adding, correcting, updating content and tweaking the GUI which is nice for any app but perhaps most so for a medical one.

 


Basics of Emergency Medicine from EMRA (EM Residents Association)

$3 (but variable) iOS No Android version as of 7/2103 BUT there is a paper version for $10

Both a pedagogic tool and a 'reference' this ultra-concise app starts w/ 20 common CCs and proceeds through red flag sx, hx, dx, tx. Continually alerts you to key issues be they key questions to ask, key tests to order, key steps to take or avoid, key things to document. Sure to make your thought process, workup and presentation at least 100% more thorough and complete.

 


EMRA Antibiotic Guide

$16  iOS  Android

This stripped down reference contains empiric abx reccs for just about every injury, infection, mechanism you can think of. Pearls accompany certain diagnoses and it tells you when no treatment is recommended but this is far from a comprehensive or detailed ID reference. For that, see Johns Hopkins Abx Guide.

 

 

 

 

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