Sandeep Jauhar writes about the "night float" system — in which interns are required to care for patients during the night shift — in Slate. (FWIW, my personal experience with night float was terrifying but invaluable.)
Wikipedia, which was never a particularly authoritative resource for medical information, now has plenty of competition. Google just released Knol ("a unit of knowledge"), which allows anyone to author authoritative articles about any topic. Many of the topics on the home page, interestingly enough, are related to health and medicine. Clinical Cases and Images has a review.
And finally, Nick Genes writes that he's passed on the stewardship of the medical blogosphere's Grand Rounds to Dr. Val Jones and Colin Son. Thanks for all your good work, Nick.
Roundup of New Health and Medical Apps for the iPhone
Wednesday, July 23, 2008
Joshua Schwimmer, MD, FACP, FASN
Image via WikipediaThe number of applications in the iTunesApp Store for the iPhone and iPod Touch is growing rapidly, and a surprising number of them are related to health and medicine. Here's a sampling. (The links will take you directly to the applications in iTunes.)
iChart a digital medical record system designed for iPhone, has been released by CareTools.
iChart has been designed to act as an electronic “personal medical assistant” and focuses on streamlining the daily “chart, bill and fill” routine of every healthcare provider. iChart leverages the advanced capabilities of iPhone and iPod touch to warehouse patient data, and images, in addition to providing an updated list of medications, drug interactions, pharmacies, billing codes and complaint specific clinical templates. Synchronization of new information is accomplished wirelessly using secure web technology and iChart allows a single provider or entire healthcare network to automate medical data capture and effortlessly look-up patient related information using an efficiently designed “touch and tap” interface.
PointsCalc, an application for dieters, allows you to quickly estimate the number of "points" in a given food.
Quitter tracks how long you've been cigarette-free and how much you've saved by not smoking.
Glucose-charter, an application for diabetics, is a blood glucose reporting tool (as well as a "food information display"). My Life Record is a personal health record (PHR).
One of the most powerful features of the My Life Record software are the ability to keep an official, verifiable copy of your exact medical chart within reach of your iPhone. While other personal medical applications rely on you or your doctor to enter the information into a program, My Life Record uses patent pending technology to take your exact medical record and retain it for your own use, for sharing with your doctors, for sharing with your family, or for any other purpose that a legally verifiable copy of your medical record is needed
If you have experience with any of these applications, please feel free to post a comment.
Image via WikipediaFreeMD. A virtual emergency room physician. From the website:
Hi, I’m Dr. Stephen Schueler, an emergency room physician, and your virtual doctor. Type a symptom or condition into the box and a menu will appear. If you select a topic marked "Virtual Doctor" I will interview you and tell you what’s wrong. I’ll help you decide if you need to see a doctor, and why.
Four percent of physicians reported having an extensive, fully functional electronic-records system, and 13% reported having a basic system. In multivariate analyses, primary care physicians and those practicing in large groups, in hospitals or medical centers, and in the western region of the United States were more likely to use electronic health records. Physicians reported positive effects of these systems on several dimensions of quality of care and high levels of satisfaction. Financial barriers were viewed as having the greatest effect on decisions about the adoption of electronic health records.
Instead of taking daily snapshots of the patient's levels of blood proteins, the company's nanosensors should allow for continuous monitoring of changes that occur over periods of only a few hours.
Nearly eight years after the critically acclaimed series, Hopkins 24/7, ABC News returns to Baltimore's Johns Hopkins Hospital for a new six-part documentary entitled Hopkins, which delves even deeper into the world of caregivers at this hospital. Hopkins offers a rare look at the impact this high pressure profession can have on doctors' personal lives. For four months ABC News' high definition cameras had unparalleled access to this legendary hospital and to more than a hundred caregivers and patients who gave their consent to be filmed. Hopkins captures astounding scenes of medical crisis, with young doctors forced to make life and death decisions on the fly. The result is a stunningly intimate portrait of the men and women who call this hospital home.
How much is your life worth? According to the EPA, $6.9 million.
Image by Josh Bancroft via FlickrA few weeks ago, I cataloged 22 types of medical applications we might see released for Apple’s iPhone. Number 1? A drug database. And on July 11th — along with the opening of the “App Store” on iTunes — Epocrates Rx, the free mobile drug reference, was finally released for iPhone and iPod Touch.
It’s about time. Losing this application — an encyclopedia of essential knowledge in your pocket — was the hardest part of switching from the Treo to iPhone last year. Sure, you can access drug information on the web, through UpToDate or the Epocrates website, but it’s not the same as having this database available anytime.
Epocrates Rx for the iPhone was worth waiting for. The freestanding application in Apple’s newly released App Store is polished, takes full advantage of the iPhone’s interface, and has features not found in any other version.
In the last several days, I’ve taken the application through a stress test in the office and in the hospital, and while it’s occasionally crashed and rebooted the iPhone — this is version 1.0, after all — it’s been a pleasure to use. Here are some initial observations and screenshots.
It’s quick. The interface is speedier than on the Treo. (The problem, of course, is when it crashes and you have to wait to reboot your phone.)
Appearance matters. Tap a drug name and the screen scrolls horizontally, revealing a menu listing dosing options, contraindications, reactions, and other information. Tap on “adult dosing” and the screen scrolls again. Few interfaces are this elegant and intuitive.
The pill ID is actually useful. I thought the feature allowing you to display the appearance of a medication was gimmicky, not useful. Until today, when a nurse asked me to confirm the identity the home medication of a hospitalized patient. A colleague also recently told me that she uses Epocrates "all the time" to help identify patients’ birth control pills.
To summarize: if you have an iPhone, get Epocrates. If you don’t have an iPhone — and were worried about getting one because of the lack of medical software — worry no more.
A Link to All iPhone Applications in the App Store Sorted by Release Date
Sunday, July 13, 2008
Joshua Schwimmer, MD, FACP, FASN
A longer post reviewing the medical apps in the iTunes store is forthcoming. Meanwhile, here's a useful bit of advice for all you iPhone owners. Enjoy.
Image via WikipediaIf you're like many iPhone owners, you're trying out dozens of new apps from the iTunes store right now.
As you browse the store, you've probably also discovered that new apps are being released daily, but there's no simple way to identify them. (SimStapler? Not so useful. Byline, a client for Google Reader? Very useful.) Running iTunes and navigating to the screen which lists all the new apps takes four to five steps. Not very efficient.
Wouldn't it be great if there was a link to the iTunes store which showed all new iPhone applications, sorted by release date? Here it is: tinyurl.com/newiphoneapps
Drag the link to your browser bar, and you have one-click access to all the new iPhone apps.
On days like this, I really appreciate tinyurl. Here's the longer version of the link:
The quality of a conversation depends on the medium, and the newest and most successful medium for conversations on the net is FriendFeed.
First, some background: a month ago, I introduced a new way of eavesdropping on doctors and medical students who use a service called Twitter. (To understand FriendFeed, you have to talk about Twitter — the reasons for this will soon be apparent.) In two years, Twitter — a combination of microblog, chatroom, and social networking phenomenon — has become the standard for rapid, informal communication on the internet. Even doctors — not early adopters of new communication technologies — have developed a presence on Twitter. (See here for the RSS feed summarizing the conversations of Doctors on Twitter.)
But Twitter has many problems. First, it's a victim of its own success — Twitter has become so overloaded with users that it's frequently offline. For a service that so many people depend upon daily, this is maddening. (And obviously, this also makes it unreliable for clinically important purposes.) Twitter also limits posts to text alone — no pictures, video, or other types of links allowed. Finally, it’s difficult to follow the decentralized conversations on Twitter. (You can appreciate how difficult this is by looking at the feed — all those @’s are users replying to one another.)
Enter FriendFeed, founded by a few ex-Google employees. The entire service is based on an obvious concept — that people you like can introduce you to information you’re likely to enjoy. (Strangely, although the concept is obvious, it’s difficult to wrap your brain around, and it took me months before I really understood it.) Briefly, FriendFeed allows you to create a stream (or feed) of your activities on the net — blog posts, pictures or videos you like, comments on Twitter, and data from over 40 other services that you may choose to share. Other people can then “subscribe” to you, see what you’re doing, and post comments on your feed.
Twitter currently has twice as many users, but FriendFeed is catching up fast. The advantages of FF are many, including stability, the ability to easily track conversations, and the ability to post items from different media. This post is not meant to be an exhaustive comparison of the two services, but I do want to highlight some important differences and introduce a new place for discussions related to medicine: the Doctor’s Room on FriendFeed.
“Rooms," which are discussion areas for communities centered on a particular topic, are a recent feature of FF. Anyone can create one, so as an experiment, I created one for doctors and medical students at www.friendfeed.com/rooms/doctors. Users can post items to the room or have their feeds — for example, blogs, posts on Flickr, Twitter postings — imported to the room. In the Doctor’s Room, I’ve imported all the conversations of doctors and medical students who use Twitter as well as the feeds from many popular, recently updated medical blogs.
The Doctors Room on FriendFeed is a potential alternative to at least two services: 1) the Doctors on Twitter feed — if you’d like, you can even reply to Twitter posts directly from FF; and 2) Medlogs.com, an aggregator of medical blogs — FF has the advantage of allowing you to comment on posts and mark those that you like.
Check it out. Comments and suggestions — either here or on FriendFeed itself — are welcome.
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Technical details and issues, for those interested:
1. The posts on Twitter are displayed on the main page without usernames. If you hover over the “Twitter” link, it shows you who posted it. Hopefully FF will correct this in the future.
2. Currently only administrators can add new feeds to the room. I’ve added many users I know as administrator. If you’re an administrator, feel free to add feeds (blogs and other doctors and medical students on twitter) to the room.
3. If you’re not an administrator, and you’d like me to add your medical blog or Twitter name to the FriendFeed room, please email efficientmd@gmail.com.
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