As of this writing, there are are over 100 medical applications for the iPhone and the iPod Touch in the iTunes App Store. (The link is here.) Less than six months ago, as the store was launched, I tried to guess what applications might become available. Let's revisit that list to see which apps have been released so far. (This is not meant to be an exhaustive list of applications, and please feel free to leave comments if the holes in my knowledge are obvious.)

• Drug database: Epocrates Rx is currently the most popular medical application for the iPhone. Several other drug databases are also available.
  
• Anatomical atlas: Netter's Anatomy Flash Cards is based on Netter's Atlas of Human Anatomy.
  
• Medical calculator: There are at least five. The most popular is Medical Calculator, which is free.
  
• Interface for electronic health records: There are several. iChart EMR is the most popular, for $139.99.
  
• Viewer of radiologic images: OsiriX, an open source program, is a DICOM image viewer. It's $19.99
  
• Interface for laboratory results: To my knowledge, there is no interface yet for viewing labs from companies like Quest and Bioreference.
  
• An expert system to help with differential diagnoses: A cursory review of the avvailable applications shows no expert system for differential diagnoses (which I'll definine as a program that produces differential diagnoses for a list of signs and symptoms).
  
• Messaging system for laboratory alerts and hospital pages: While there are no programs, to my knowledge, specifically for this purpose, many hospitals offer communication by SMS.
  
• Interface for medical devices (like ultrasounds and EKG machines): No programs are yet available.
  
• Dictation recorder: A search of [iphone AND dictation] reveals several apps, such as Voxie, and others which have yet to be released. I don't have personal experience with any of these programs.
  
• Device for electronic prescribing: No programs yet available, to my knowledge.
  
• Device for directly receiving and reading medical journals and podcasts: While there are many PDF readers for the iPhone, I haven't seen a program that automatically downloads medical journals (as is available for the Palm platform). Medical podcasts can now be downloaded directly to the phone.
  
• Medical book reader: Lexi-COMPLETE offers several medical books for the iPhone.
  
• Reminder system for patient visits and meetings synced remotely with the office through Mobile Me: Again, not yet available.
  
• Display for patient education videos: I've written previously about using YouTube as a source for patient education videos, but to my knowledge, applications specifically made for this purpose are not available.
  
• Medical simulator (ACLS, for example): While I know of no simulators, an ACLS reference is available for $4.99.
  
• Telemedicine device (pending the eventual release of iChat and a videoconferencing system): Not, to my knowledge, yet available.
  
• Interface for medical literature searches (Pubmed, Google Scholar): PubSearch is an interface for PubMed, and it costs all of $0.99.
  
• Word processing device for papers (I'm still waiting for a bluetooth keyboard): Several substitutes for Apple's built-in Notes application are available, but no bluetooth keyboard yet.
  
• Communication device for hospital teams (Using Twitter or another system): I'm not aware of any hospital team that uses Twitter (or Yammer). If you do, please write in.
  
• Secure system for messaging/emailing patients: Not yet available.
  
• CME course viewer (with text and/or video): Several are available, including Epocrates Rx and ReachMD CME.
  

Comments are encouraged so I can give you credit for pointing out applications that I've missed.

Lexi-Comp now offers their line of medical applications for the iPhone and iPod touch. The databases offered include Lexi Drugs, a drug database; Harrison's Practice, a diagnosis and management tool; Lexi-infectious Disease, a guide to diagnosing and treating infections, and Lexi-Poisoning & Toxicology, which includes detailed information on drugs and toxins; as well as many other applications. (There are now over a hundred medical applications in the iTunes App Store.)

Here's a video showing how physicians at the University of Calgary are using the iPhone to view radiology images to improve patient care. The title is "This is your brain on an iPhone:"


Physicians at the Cleveland Clinic have picked the top 10 medical innovations for 2009. For more details, you can download a booklet from the 6th Annual Medical Innovation Summit here.

1. Use of Circulating Tumor Cell Technology:

Use of new technology to measure circulating tumor cells as a predictor of success of chemotherapy.

2. Warm Organ Perfusion Device:

Warm organ perfusion device to preserve organs for transplantation during transplant.

3. Diaphragm Pacing System:

Use of a diaphragm (phrenic nerve) stimulator to enable paralyzed
patients to breath without the assistance of a mechanical ventilator.

4. Multi-Spectral Imaging Systems:

Improvements in multi-spectral image analysis to assess multiple protein pathway configuration in a single sample/cell.

5. Percutaneous Mitral Valve Regurgitation Repair:

Use of a special clip to percutaneously repair mitral valve regurgitation (MVR).

6. New Strategies for Creating Vaccines for Avian Flu:

Use of new strategies for creating vaccines for avian flu, including
genetically-engineered virus-like particles (VLPs) as the basis for
vaccines.

7. LESS and NOTES Applications:

Laparoendoscopic single-site surgery (LESS) and Natural Orifice
Transluminal Endoscopy (NOTES) for nephrectomy, cystectomy,
prostatectomy, colon resection, and other applications.

8. Integration of Diffusion Tensor Imaging (Tractography):

Integration of diffusion tensor imaging (tractography) with surgical
navigation of the brain to minimize damage to fiber tracts during brain
surgery.

9. Doppler-Guided Uterine Artery Occlusion:

Doppler-guided non-invasive transvaginal uterine artery occlusion for treatment of symptomatic uterine fibroids.

10. Private Sector National Health Information Exchange:

Use of a common exchange standard among participants to enable access through the Internet regardless of provider source.

A study in the New England Journal of Medicine looked at the diagnostic performance of coronary angiography by 64-Row CT — that is, whether a CT scan can accurately predict whether a patient has a significant narrowing of the coronary arteries. The study showed that CT angiograms have a sensitivity of 85% and specificity of 90%, suggesting that the new test is not yet accurate enough to replace coronary angiography. The accompanying editorial is titled, "Pay Now, Benefits May Follow."

--

Tech Medicine Links is a collection of selected developments in the world of technology and health care. Have a suggestion? Please email techmedicine@gmail.com.