How To Use An Mhealth App On Iphone Or Ipad

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1 Medical Applications for the iphone Navigating in a World of Apps Lori Fitterling, MLS Digital Services/Reference Librarian Homecoming, CME September 19, 2015

2 What is an App Anyway? Computer programs or software installed on mobile electronic devices which support a wide range of functions and uses which include television, telephone, video, music, word processing, and Internet service. [MeSH] Mobile apps are applications designed to run on smartphones or mobile devices. Two reasons for this discussion: 1. Increase in use of mobile apps in the clinical setting 2. Need for evaluation/review of application software as used in medicine

3 Why Should I Use Apps? The variety/availability of mhealth apps makes them more versatile in clinical settings Computers are often not available and mobile devices can be the most efficient way to retrieve urgently needed information Patients use of apps have increased and they may be using apps to look up information while you are out of the room

4 Some Medical App Facts If you didn t already know. More than 1 billion smartphones and 100 million tablets in the world More than 100,000 health apps are available in itunes/google Play Market in 2017 estimated to be $26 billion mhealth apps are mobile device applications intended to improve health outcomes, deliver health care services, or enable health research (Powell) Little or no certification/regulation of medical apps due to rapid changing technology and app lifespan

5 Evaluating Apps Look for: Industry/medical community Recommendations Reviews: imedicalapps.com Licensed content Subscription-based apps Peer Reviewed Watch out for: Always read REVIEWS Costs Advertisements Claim to treat everything Medical equipment claims (Blood Pressure tracking or glucose monitoring)

6 Three Good Point of Care - Clinical Decision Support Apps UpToDate Subscription Installed App Log in once Earn CME/CE/CPD Bookmark favorite topics Easily access search history Contact authors with questions VisualDx Subscription Installed App 1,356 unique diagnoses 29,661 unique images 50,004 finding-diagnosis relationships 5,699 medication-diagnosis relationships Content reviewed by physician experts FirstConsult Subscription to Clinical Key Installed App Elsevier content Peer Review Integrates with EMR s

7 Free Drug Reference Apps Epocrates Rx The popular free version has pictures of pills, a pill identification program, a dosage calculator, a drug-drug interaction checker, and some formulary lists. Drugs can be listed by generic or trade name or by class and it shows over-the-counter (OTC) medications included (herbals are only in the paid subscription version). Medscape Mobile This combination medical reference and drug database has over 7,000 prescription, over-the counter, and herbal drugs and a drug-drug interaction checker. Drugs are listed by class and with dosing interaction, side effect, pharmacology and cost information. There is no automatic drug dosing calculator or formulary information. Micromedex Drug Information This drug database has detailed information which includes Pharmacokinetics, monitoring, toxicology and clinical teaching pearls. There is no dosing calculator, formulary information or drugdrug interaction checker.

8 Clinical Pharmacology App Subscription Database Elsevier/Gold Standard Smart search Drug to drug interactions Adverse Reactions Pill Identifier

9 PubMed4Hh PubMed for Health PubMed4Health PubMed for Handhelds (PubMed4Hh) is an app for discovering relevant health information at the National Library of Medicine. Journal abstracts, TBLs ("the bottom line" summaries) and full text articles (requires subscription to journals) can be accessed anywhere the Internet is available. It features: PICO (Patient, Intervention, Comparison, Outcome): search with a well-formulated clinical query askmedline: a free-text, natural language search tool Consensus Abstracts: Search using PICO or askmedline then select concurring abstracts from journals CQs: Use Clinical Queries to search journal articles. Indicate Category (therapy, diagnosis, etiology, prognosis, clinical predictions guideline) and Emphasis (specific, sensitive) to focus search strategy Journal Browser: read the latest abstracts and TBLs of MEDLINE indexed journals Archive: save search results for reading later, retrieved citations may be sent by from any of the featured tools

10 Evidence Based Clinical Update Tool ACP Clinical Guidelines Mobile App The American College of Physicians (ACP) produces evidence-based clinical practice guidelines, which means that the guidelines follow a rigorous development process and are based on the highest quality scientific evidence. Internal medicine physicians and other clinicians can now access these clinical recommendations in virtually any setting via the ACP Clinical Guidelines app. Available for free, the ACP Clinical Guidelines app includes recommendations from ACP s clinical practice guidelines and guidance statements. Users can conveniently access clinical recommendations and rationale, summary tables, algorithms, and high value care advice for all currently active ACP guidelines in an easy to read and interactive mobile format.

11 New England Journal of Medicine App New England Journal of Medicine App - Recent articles published online in the last 7 days, including research, reviews, commentary, and case materials. - Images classic images of medical conditions from Images in Clinical Medicine. - Audio Weekly audio summaries and a selection of four full-text audio reads of Clinical Practice articles, streamed directly to your iphone or ipod Touch (internet connection required). - Video A selection of four procedure videos from Videos in Clinical Medicine, streamed directly to your iphone or ipod Touch (internet connection required). The New England Journal of Medicine (NEJM.org) is the world s leading medical journal and website. NEJM publishes peer-reviewed research and interactive clinical content for physicians, educators and the global medical community.

12 DrawMD and Figure 1 Developed by Visible Health, DrawMD displays anatomical pictures that physicians can draw on top of and layer as needed to help explain hard-to-visualize concepts. The drawings can by ed to patients. Figure 1 is a community for professionals to safely share clinical cases and discuss treatment. Join over 150,000 healthcare professionals expanding their knowledge of medicine and contribute your own medical cases in a privacy-conscious way. --Discuss presentation, diagnosis, and treatment with other experienced and knowledgeable doctors, nurses, and medical professionals in real time. ----Safely share images with automatic face blocking, simple removal of identifying patient details, and an easy to use in-app consent form.

13 Calculate QxMD Calculate (Medical Calculator) by QxMD Developed by a collaboration of clinician experts from diverse backgrounds Point-of-care tools in the areas of cardiology, internal medicine, nephrology, general practice, hematology, gastroenterology, emergency medicine, oncology, orthopedics, respirology, neurology, neurosurgery, general surgery and obstetrics. Converts recent research publications into practical handheld tools - knowledge translation at its best Automatically adapts to your self-described clinical practice Unique Question Flow technology gets you answers, fast Detailed references with Pubmed integration Comprehensive and insightful results Elegant design and intuitive interface SI and Imperial units More than 150 Unique calculators and Decision Support tools

14 Personalized Medicine App READ QxMD Provides a single place to keep up with new medical & scientific research, read outstanding topic reviews and search PubMed. This iphone & ipad app provides a simple interface that drives discovery and seamless access to the medical literature by reformatting it into a personalized digital journal. Get full text PDFs with one tap Keep up with the latest new research that will impact your practice Browse through 1000s of outstanding topic reviews Search millions of articles from PubMed and our database of outstanding topic reviews Read your favorite journals or browse article collections Access full text through your university/institutional subscription or via open access publishers Share articles with colleagues over , Twitter and Facebook Organize and review your personal collection of articles

15 Mindfulness Health Intervention Apps Headspace Mindfulise Buddhify 2 Smiling Mind

16 Another Interesting App VisionSim: Braille Institute's VisionSim (v3.0) app for iphone and ipad was developed to allow people with healthy vision to see the world through the eyes of a person experiencing one of nine degenerative eye diseases. The eye diseases that are simulated are: age-related macular degeneration, cataracts, chronic open-angle glaucoma, corneal edema, diabetic retinopathy, homonymous hemianopia, macular degeneration, retinal detachment, retinitis pigmentosa. The application uses the camera in the iphone or ipad along with digital filters to allow the user to experience the symptoms of a particular disease. Using sliding touch-screen controls, the user can manipulate the severity of the symptoms. Still images from the simulations can be saved by the user and stored or shared.

17 Are YOU app-literate? What apps are YOU using?

18 Bibliography 1. Powell AC, Landman AB, Bates DW. In search of a few good apps. JAMA May 14;311(18): doi: /jama PubMed PMID: Mani M, Kavanagh DJ, Hides L, Stoyanov SR. Review and Evaluation of Mindfulness-Based iphone Apps. JMIR Mhealth Uhealth Aug 19;3(3):e82. doi: /mhealth PubMed PMID: Stoyanov SR, Hides L, Kavanagh DJ, Zelenko O, Tjondronegoro D, Mani M. Mobile app rating scale: a new tool for assessing the quality of health mobile apps. JMIR Mhealth Uhealth Mar 11;3(1):e27. doi: /mhealth PubMed PMID: ; PubMed Central PMCID: PMC Martínez-Pérez B, de la Torre-Díez I, López-Coronado M. Mobile health applications for the most prevalent conditions by the World Health Organization: review and analysis. J Med Internet Res Jun 14;15(6):e120. doi: /jmir Review. PubMed PMID: ; PubMed Central PMCID: PMC "Google can bring you back 100,000 answers. A librarian can bring you back the right one." Neil Gaiman