by Paul Villaire FNP-BC.
Do you use medical apps in your practice? If you are like me being able to quickly access valuable information that will help in the assessment , diagnosis, treatment and disposition of your patient is life saving literally for the patient and us. We are time pressed, patients want to be seen on time and not have to wait forever to get home, back to work, pick up the kids or whatever is next on their calendar. I am sure all of you have had that feeling at some point in your career , that feeling when you are behind and your appointments are backing up, the waiting area is full and all you want to do is crawl under a rock and hide. We live in a society that expects fast, convenient service, we want it now and we want our way right? Fast visits may not always happen as we strive to provide safe, effective, efficient care. Wether you are a seasoned provider or just starting out , any advantage to enhance your practice is a plus. Finding the best apps for your toolbox will help you improve your practice efficiency and improve patient satisfaction. But at the same time ensure you are using evidenced based, peer reviewed products.
There are literally hundreds of apps for a multitude of specialties, calculators, and pharmacology references. So many choices with so little time to try them all out. Most of us rely on word of mouth and often more than not get the “ here check this app out” from one of out colleagues. Many of us already have our favorite apps loaded, but some practitioners may still be old school using hardcopy reference tools-which is fine, or you may be a student Nurse Practitioner just staring out, either way knowing what resources are available can only help you in the long run.
You can down load most apps from your phone, portable device, or computer from your app store that on already on your platform and most of the most useful ones are free! There are other that have subscription services that are upgrades and some come at a cost. Ok so let’s get started, here are a few of my favorite apps that I have downloaded and use frequently.
This app provides drug prescribing information for brand, generic and OTC medications. I find my self using this app at least once per day. The dosing calculator is especially helpful when applying weight based dosing for pediatrics. You can get the basic explore version which provides the features listed below.
- Adult and pediatric dosing for FDA-approved and off-label indications
- Black box warnings, contradictions, adverse reactions and drug interactions
- Safety/monitoring, including pregnancy risk categories, location safety ratings, monitoring parameters and similar drug names
- Pharmacology, including metabolism, excretion, subclass and mechanism of action
- Manufacturer, DEA/FDA status and approximate retail price
- Pill ID
- Clinical practice Guidelines
- Athena text
You can also purchase the Epocrates plus version for a yearly subscription. The plus version provides the basic explore features in addition the following features.
- Disease Information
- Alternative Medicine
- IDC-10 and CPT Codes
- Infectious disease treatment
Epocrates screenshots (Source)
UptoDate is another app that I use frequently and find it to be extremely valuable . UptoDate is a clinical decision support resource tool associated with improved outcomes. It is easy to use with a search capability that allows you to search for clinical diagnosis, symptoms, medications etc…It provides assessment, recommended work ups, differential diagnosis, treatment recommendations, and patient teaching resources just to name a few. UptoDate is research based and as the title suggests it is updated frequently to ensure the most recent recommendations are available. I find that this resource is best used on a desktop or laptop because the it is information and text dense. It is also a subscription service, which many institutions purchase for their employee use.
UpToDate screenshots (Source)
US MEC US SPR/ US Medical Eligibility Criteria (US MEC) for Contraceptive Use, 2016
If you are prescribing contraceptives or providing counseling this free app is very informative and a wonderful tool to have at your fingertips. Once opened it is easy to use and navigate. You can search MEC by condition, method, or selected practice recommendation (SPR). Also included are full guidelines, provider tools, resources and includes recommendations for using specific contraceptive methods by women and men who have certain characteristics or medical conditions. The recommendations are intended to assist health care providers when they counsel women, men, and couples about contraceptive method choice. These recommendations for health care providers were updated by CDC after review of the scientific evidence and consultation with national experts who met in Atlanta, Georgia, during August 26–28, 2015. ns. The information for this app was obtained from the CDC.gov website.
US MEC US SPR screenshots Source.
ACOG Women’s Healthcare
Looking for a good app for women’s healthcare? Then look no further than ACOG app from The American College of Obstetricians and Gynecologists. There are other apps that specifically act as pregnancy wheels, but this app is more inclusive. Download the ACOG app and stay connected with authoritative information from the leading experts in women’s health care. Get valuable tools, resources, and clinical guidelines to help you in your practice. I especially like the Estimated Due date Calculator which according to ACOG is “the first app strictly based on joint recommendations from ACOG, the American Institute of Ultrasound in Medicine (AIUM) and the Society for Maternal-Fetal Medicine (SMFM) for determining pregnancy due dates.” The app also provides practice bulletins, opinions, immunization info, news headlines and more. The download is data heavy but is worth the time it takes to complete the download.
ACOG Screenshots Source.
Have you ever had to think about what the probability is that your patient may have a DVT or pulmonary embolism, or are wondering whether you should sent your patient to the emergency department for a head CT? Or maybe you want to look up a patients BMI or their risk factors for heart disease or stroke using the ASCVD Risk algorithm. Well there is an app that can help provide guidance and clinical decision-making tools. The creators of MD Calc provide clinical calculators in practical easy-to-use format while also providing concise, targeted , expert-written content to support decision making. This app has approximately 275 different calculators in all categories and specialties from A to Z. I use this app frequently and really appreciate having it available. It is user-friendly and easy to download. Once downloaded you do have to sign up for an account and agree to its terms, it offers e-mail updates which you can easily opt out of. If you are on your computer you also search for the web page and use it there as well.
Family Practice Notebook
I like this app because it covers most areas that are seen in Family Practice and some for the Emergency Department where most Family Nurse Practitioners work. It is easy to navigate and does not get to dense with excessive information which I do sometimes find with UptoDate.
The content provided contains interlinked topic pages divided into a tree of 31 specialty books and 722 chapters. Content is updated monthly with a systematic approach to peer-reviewed articles, bulletins, key texts in addition to conferences and workshops. A list of monthly updates may be found on the site. New approaches to medical problems are referenced with supporting studies, and further reading is often suggested on general medical issues.
So here we are at the end of the review of a few of the apps that I find most helpful in my practice. A word of note be cautious and do your homework on the apps that plan to use in your clinical practice. Ensure that they are peer-reviewed and if you are fortunate enough to have clinical resources provided by your institution or employer all the better. We would love to hear from you and please provide, feedback and suggestions so that we can share our best practices and ideas! Thank you.
Paul Villaire is the founder of American Family Nurse Practitioner and is board certified Family Nurse Practitioner currently working at United States Naval Hospital Guam.