Joshua Schwimmer, MD, FACP, FASNTechnology in Medicine
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Roundup of New Health and Medical Apps for the iPhone

Joshua Schwimmer, MD, FACP, FASN
The App Store iconImage via WikipediaThe number of applications in the iTunes App 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.
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Review of Epocrates on the iPhone

Joshua Schwimmer, MD, FACP, FASN
App Store shows it has an update for me!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.

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Also posted on The Efficient MD.
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A Link to All iPhone Applications in the App Store Sorted by Release Date

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.

Apple Inc.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:

http://ax.phobos.apple.com.edgesuite.net/WebObjects/MZStore.
woa/wa/browserRedirect?url=itms%253A%252F%252Fax.phobos.appl
e.com.edgesuite.net%252FWebObjects%252FMZStore.woa%252Fwa%25
2FviewRoom%253FfcId%253D285119007%2526id%253D25204%2526ign-m
scache%253D1%2526sortMode%253D2

The preview page on tinyurl.com is preview.tinyurl.com/newiphoneapps.

Enjoy! If you liked this, please link back. For most posts on the iPhone and Medicine, please visit The Efficient MD blog.

(Thanks to Kirk McElhearn for describing how to create bookmarks for the iTunes store.)
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The New 3G iPhone, Doctors, The App Store, and Medicine

Joshua Schwimmer, MD, FACP, FASN
I've taken a long break from writing about the iPhone, and you might be sick of hearing about it. But be prepared — in less than a month, things are about to get very interesting.

Why? Not only will the new faster & cheaper 3G iPhone be released, but more importantly, the iPhone will now be open to third party software — that is, programs created by developers other than Apple. And why is this important? In the words of David Pogue, technology columnist for the New York Times, this means there will now be three major operating systems: the Mac, Windows, and the iPhone. (My apologies to Linux.)

This is only a small exaggeration. The iPhone has huge potential as a mobile computing platform, especially for physicians.

Sure, other mobile platforms exist — the Treo, Windows Mobile devices, tablet computers — but none have the graphics capability, the memory, the computing power, the form factor, and the ease of use of the iPhone.

What follows is the result of a brief brainstorming session about potential applications of the iPhone for doctors. Some have already been announced for the iPhone, are available on other platforms, or are currently in development. Let's see how many of these applications are eventually released and sold in the App store. My guess? All of them.
  • Drug database
  • Anatomical atlas
  • Medical calculator
  • Interface for electronic health record
  • Viewer of radiologic images
  • Interface for laboratory results
  • An expert system to help with differential diagnoses
  • Messaging system for laboratory alerts and hospital pages
  • Interface for medical devices (like ultrasounds and EKG machines)
  • Dictation recorder
  • Device for electronic prescribing
  • Device for directly receiving and reading medical journals and podcasts
  • Medical book reader
  • Reminder system for patient visits and meetings synced remotely with the office through Mobile Me
  • Display for patient education videos
  • Medical simulator (ACLS, for example)
  • Telemedicine device (pending the eventual release of iChat and a videoconferencing system)
  • Interface for medical literature searches (Pubmed, Google Scholar)
  • Word processing device for papers (I'm still waiting for a bluetooth keyboard)
  • Communication device for hospital teams (Using Twitter or another system)
  • Secure system for messaging/emailing patients
  • CME course viewer (with text and/or video)
What other application ideas can you come up with?

Related Posts: Previous Tech Medicine Articles on the iPhone

Image Credit: MIMvista

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Some housekeeping. On jschwimmer.net, a new tumblelog, I'll automatically be posting links to articles (like this one) as well as posts from The Efficient MD, Kidney Notes, and Twitter. If you'd like to read all my posts in one place, please visit jschwimmer.net or subscribe to the RSS feed. Thanks.

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iPhone Medicine Watch: Epocrates on the iPhone

Joshua Schwimmer, MD, FACP, FASN
"I'd like to get an iPhone, but..."

In the hospital, when I use my iPhone, I hear this all the time. What are the two biggest reasons doctors give for not switching to the iPhone? 1) They don't want to change their carrier to AT&T and 2) The iPhone can't run Epocrates or other third party software.

Most physicians have used Epocrates, which is a popular drug reference database accessible through PDAs and the internet. Back when I owned a Treo 650, I used Epocrates all the time. When I switched to the iPhone, I missed having immediate access to the Epocrates database -- though the inconvenience of having to access Epocrates through the internet was minor.

This month, the biggest complaint about the iPhone -- that it can't run third party software -- has been answered with the release of the iPhone SDK (software development kit). And to the surprise of many physicians, Epocrates was one of the first products to be showcased.



Health care professionals who are iPhone users -- or plan to purchase one -- are waiting until June, when the application store for third party iPhone software will go live. Realistically, however, our enthusiasm should be tempered by the understanding that third party software like Epocrates has already been available for the Treo and for Windows Mobile. Seen this way, iPhone users are only getting now what they should have received all along.

On the other hand, the iPhone is a unique platform. The part of the Epocrates video (shown above) that received the most enthusiastic response was the demonstration of the pill finder, which takes advantage of the iPhone's interface to identify and display medications based on their shape and color. In a handheld device, this feature is truly novel. The potential for a flood of new medical applications which take full advantage of the iPhone's strengths are what's really exciting for physicians. Will that be enough to make the iPhone the doctor's PDA of choice? We'll see.

(Also posted on The Efficient MD.)

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Medical Uses of the iPhone (Part 2)

Joshua Schwimmer, MD, FACP, FASN
I'm back. I was away on vacation in the North woods of Minnesota, in a cabin by a lake, without Internet or mobile phone service. Very different from life in New York City, and a quiet place to read, write, and think.

So of course, when I returned I bought an iPhone.

This wasn't a surprise. I've written about potential medical applications of the iPhone and I've agonized over significant usability issues for those switching to the iPhone from the Treo or Blackberry. So I knew what I was getting into. And like 90% if iPhone users, I'm very satisfied. It really is worthy of the hype.

Previously I discussed potential medical uses for the iPhone for both providers and patients. I'm interested in ways that people are using the iPhone for health care. Here are a few examples and resources:

The Life Record electronic medical record has an interface for the iPhone.

Dr. Salvatore Volpe writes the iPhone Medicine Blog.

Medical Marketing and Media
wonders whether physicians will get their continuing medical education credits on the iPhone. (As an aside, I routinely email myself articles from UpToDate and read them later on the iPhone.)

Unbound Medicine offers access to multiple reference materials formatted for the iPhone.

Heart Imaging Technologies offers a system for viewing medical images on the iPhone.

In the future, I'll be writing more about the iPhone and medicine. If you're aware of any medical resources for the iPhone, or if you have ideas for potential applications, please feel free to comment.

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Medical Uses of the iPhone

Joshua Schwimmer, MD, FACP, FASN
As I was walking to the dialysis unit today, I couldn't help thinking about the iPhone -- mostly because I had to walk through a crowd of people who were waiting outside an AT&T store to buy one.

The iPhone (in case you haven't watched any media for the last three months) is Apple's new phone, combining a video iPod, a touch screen phone, and an internet device with several other "breakthrough" features.

That's all well and good -- but how might the iPhone be helpful to doctors and patients?

MedGadget, back in January, had this to say:
Apple's iPhone has got a lot of people excited... including the Medgadget crew. Why? Well, among its other uses, it's a powerful medical device. For instance, you can use the iPhone to:

1. Watch medical podcasts [or videocasts; see an intro to medical podcasts here]
2. Dial 911

Sure, you could always do this before on a separate iPod and cell phone, but convergence is key. Later this year, we expect to hear about the first patients that diagnosed their MI via medical videos watched on their iPhone, and were able to alert EMS with the very same device.

Then, hopefully, Steve Jobs will add a defibrillator to the second-generation iPhone...
A portable device for watching medical videocasts and listening to podcasts would be helpful for medical education and displaying medical information for patients, but as MedGadget points out, you don't need an iPhone to do that -- you could use a regular video iPod.

One way to really leverage the special nature of the iPhone would be to use its integrated YouTube player. There's an increasingly large amount of medical education videos on YouTube -- for example, clinicalcases.org reviews pathology cases and echocardiogram teaching cases. There are many videos designed for patients as well.

Imagine a patient-physician encounter where the doctor pulled out an iPhone and punched up a video on YouTube that explained the patient's medical condition or the procedure about to be performed.

Or a physiology discussion where a process was illustrated by someone's iPhone playing a computer generated image like those seen in The Inner Life of the Cell.

If you have any more ideas for using the iPhone, please feel free to comment.

(I've posted a longer discussion on using the iPhone to improve productivity on The Efficient MD.)

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