Contributed by Dr. Chandi Chandrasena
In last week’s blog, I shared some important reasons why clinicians should consider adding medical apps to their patient care toolbox, and some key questions to ask before deciding which ones are right for you. If you’re still reading, I can only assume I’ve caught your interest and you are ready to venture into the wonderful world of apps.
Or, perhaps you looked at the list of questions I provided and are feeling overwhelmed, concluding that it is better to download the apps I recommend with the hope that I have already done the work. If so, this post is for you.
My app recommendations presented here are a mixed bag. I was asked to limit the apps to the ones I felt were most relevant. But this proved to be a difficult task – there are so many wonderful apps. For this post, I’ve looked mainly at point-of-care and guideline apps. Should this blog become wildly successful, I may be welcomed back and can recommend more apps geared to different specialties.
The apps I have presented below are not listed in any particular order. To download, go to the Google Play Store or Apple’s App Store.
UpToDate by Wolters Kluwer
This app needs no introduction, as most physicians have heard of or used UpToDate at some point in their career. But not all have used the app version. It’s a great point-of-care app, which requires a subscription to use. It uses Lexicomp as the drug database.
A subscription is about $519 US per year, and discounts are available for CMA, OMA, and CCFP members, as well as for residents and medical students.
Dynamed by EBSCO
This point-of-care app was founded by a family physician and is now owned by EBSCO. It uses Micromedex as its drug database. Similar to UpToDate, use of the app requires a paid subscription, which is about $395; if you have a CMA membership, it is free.
This app is developed by the Canadian Pharmacists Association and is literally the old blue CPS we used to have in our offices in days of yore. I remember it fondly, with its paper-thin pages and miniscule font. I am unsure why we ever left that format, as it was a great doorstop for the ever-closing exam door.
The new and improved RxTx includes the same information as the old book, plus regular updates, Health Canada advisories and a limited medical calculator. It unfortunately cannot do multidrug interactions and doesn’t provide LU codes. It also will not hold the exam door open. Cost varies on the functionality. The basic drug database is $239, and this increases if you wish to have guidelines and such added. It is free with the cost of CMA membership.
By now, you may be sensing a pattern involving the CMA. I can categorically state that I do not have any affiliation with the CMA, other than buying a membership so I can have access to these apps and other clinical content.
The Joule app is easy to use, has a searchable database for InfoPoems, InfoPratique and CMAJ. It offers access to Dynamed, RxTx and Clinical Key.
Clinical Key gives access to 1,000+ texts, 600 journals, handouts, practice guidelines, podcasts and videos. Journals include AFP, Lancet, BMJ, NEJM and many others. It also provides access to a librarian who will answer your research questions. All this for the $195 cost of a CMA membership.
Thrombosis Canada (Free)
This guideline app provides clinical guidelines and algorithms for the use of antiplatelet agents and oral anticoagulants. It is easy to use and allows you to enter anonymous patient data and achieve individualized recommendations. It was developed by Thrombosis Canada and was last updated in November 2019. The app is bilingual.
INESSS Guides (Free)
This guideline app was developed by the Institut national d’excellence en santé et en services sociaux (INESS) and supported by the Quebec government. Their website, available in French and English, outlines their methodology and answers all pertinent questions.
This free app was originally developed in French and is now available in English as well. It is a great app that gives you antibiotic prescribing information and guidelines for various chronic diseases including dementia, type 2 diabetes, STI, indications for testing and more.
CDN STI Guidelines (Free)
This very useful guideline and treatment app was developed by the Public Health Agency of Canada. It examines the Canadian Guidelines for Sexually Transmitted infections and provides treatment recommendations and advice on diagnosis. I particularly like this one, as antibiotic resistance is constantly changing and it offers up-to-date options.
Anti-Infective Guidelines (MUMS)
This is an app version of the infamous “Orange Book” anti-infective guidelines that was first released 20 years ago. This was a game-changer app for me, as I used to carry that orange book with me everywhere. I would write across the front page with a black Sharpie daring anyone to take it from me. I would glare at anyone who would even look at it. Now that it is on my iPhone, I am quite happy to lend my tattered paper copy! The app is also updated – there was a free update released about a month ago. This wonderful book/app is developed by MUMS Health/PAACT CME. This app is $24.99.
Visual Anatomy Lite (Free)
I would be remiss if I didn’t recommend an anatomy app of some sort, and decided on this free, simple option.
This basic anatomy app allows physicians to refresh their memory about the human anatomy. It is also a good app to use for educating patients. There are a large number of paid apps that are more comprehensive and potentially much better, but this is a good starting point.
GRC-RCMP Drugs Awareness (Free)
This simple app was developed by the RCMP to educate about drugs and illegal activities. It was recently updated to remove cannabis from the illegal list.
Where else can you learn the many names used to refer to certain drugs? The app discusses the drug, its effects, visible signs and symptoms of usage, myths and truths, information for parents, legal status and more. It also provides numbers to call for help and outlines ways to prevent drug abuse. It is a necessary app for the medical toolbox, but also a good one to recommend to patients.
Aspirin Guide (Free)
This has made it to my list of recommended apps, as the big question in my clinic lately seems to be, “Do I stop ASA, or do I start?” I was not able to find a great algorithm online to help me with my clinical decision until now.
Developed by researchers at the Brigham and Women’s Hospital (Harvard Medical School), this app helps clinicians decide who is a candidate for low dose ASA in primary prevention of atherosclerotic cardiovascular disease (ASCVD). It walks you through a screen-by-screen algorithm that allows you input anonymous patient specific data, and it gives you a clinical summary with NNT and NNH for ASA. Brilliant!
TELUS EMR App (Free to TELUS EMR users)
I’m biased in that I use PS TELUS EMR, but I do recommend this app to fellow users. This is a rather easy-to-use app that adheres to all privacy regulations. It allows you to manage your schedule and your patients, giving you access to their charts anytime of the day. Who wouldn’t want to work 24 hours a day!
The real advantage of this app is the camera. I often use it in the office, as it allows me to take pictures of rashes or medical anomalies and download them directly into the EMR. It does not store the photos on your phone.
Another unique feature is the ability to dictate directly into the EMR using the microphone function. At times it is faster to dictate into my app while I am sitting at my desk than type in my notes.
What are your favourite apps? Do you recommend any that you think are truly amazing? I welcome any comments and hope that you find these apps useful. Perhaps I will see you at one of my talks someday!