There's an App for That!

Medical Applications for Mobile Technology are Burgeoning

With mobile technologies advancing, so too are medical uses of those technologies – and the ride has just begun, predicts one expert.
 
"The medical applications are growing very rapidly. We can't keep up," said Felasfa M. Wodajo, MD, a senior editor with iMedicalApps.com, a website founded by a medical student and staffed by students and physicians who provide commentaries and reviews of mobile medical technology and applications. Their reviews are based on their own experiences in a hospital or clinical setting. Launched just nine months ago, the site already boasts 30,000 users daily, and that number is climbing.
 
Most of the applications reviewed by the iMedicalApps team were written for Apple's iPhone OS platform, while more applications for the new iPad are emerging. Wodajo said the reviewers would be interested in reviewing other platforms, but there are few options on the market. The Apple is "far and away" the platform that offers the most applications and the most flexibility, he said, adding that "it won't be that lopsided forever" as other platforms such as the Android gain users.
 
Meanwhile, Wodajo said apps for the iPhone "are just exploding and in just a two-year span of time. This is incredibly fascinating."
 
Wodajo, medical director of musculoskeletal oncology at Virginia-based Inova Health System, said the key to a successful app is its ability to meet a specific need, and that's why many apps target specialties. For example, a popular app in his specialty is Musculo, developed by a company called Modality. Musculo is actually a series of four apps featuring anatomical drawings of the late Frank Netter, MD. Other Modality apps are geared to general anatomy, head and neck anatomy and neuroanatomy. Wodajo said the application is an effective tool during patient consults, especially on the larger screen of an iPad. "It's very impressive as a desktop application, too," he added.
 
For dermatology, there's VisualDx Mobile, an app that combines physician-reviewed clinical information with thousands of medical images that show variations of a disease through age, stage and skin type. Wodajo noted that such an app is valuable to physicians in rural areas, where a dermatologist may not be available. In fact, many of the mobile applications are a boon for rural medicine, he said. There are targeted apps for otolaryngology, urology, gynecology, pediatrics and a host of other specialties, as well as apps for nurses, radiologists, dieticians and even midwives.
 
For more general medical apps, Wodajo praised the mobile version of the drug reference Epocrates. "It's a standard-bearer and has been out since the Blackberry days. It works beautifully on the iPhone, and they've just come out with the iPad app," he said. In March, the Agile Partners company updated the venerable Merck Manual, all searchable and navigable, for the iPhone, iPod Touch and iPad. MedPage, Medscape and WebMD are available as apps, too.
 
Mobile apps are also useful for teaching, and textbook publishers are getting in on the act. Wodajo cited a series called Procedures Consult as an example. Procedures Consult blends high-quality video, illustrations, animations and text to help physicians, medical residents and students prepare for, perform and test their knowledge of the most common medical procedures encountered in a clinical setting. "That's very hard to communicate via a textbook. It's a portable, video library of procedures and examinations, and it's a great opportunity for teaching," Wodajo said.
 
Another example is the Clinical ORthopedic Exam (CORE) application, a reference for clinicians from multiple disciplines. CORE offers a database of almost 250 clinical tests to help diagnose musculoskeletal and orthopedic disorders. It offers descriptions on how to perform each test, video demonstrations and links to supporting medical references via abstracts in PubMed, the service of the U.S. National Library of Medicine. In fact, PubMed on Tap for the iPhone and iPad is searchable via key words. "I'm walking around with hundreds of PDFs of relevant literature in my field. It's very valuable," Wodajo said.
 
Academic medical centers are also developing their own mobile apps. A new Vanderbilt University Medical Center application for the iPhone allows anesthesiologists and other clinicians to remotely monitor patients, check vital signs, communicate with other providers and literally peer into operating rooms during surgeries. Expanding on an in-house desktop program called Vigilance, the new VigiVU app allows clinicians to monitor up to four patients simultaneously.
 
Anesthesiologist Brian Rothman, VUMC associate director of Perioperative Informatics, said the app enhances proactive decision-making, makes communication between team personnel more efficient and can improve patient care. With the iPhone app, communication between clinicians during urgent situations is no longer reliant on outdated paging systems. "Why are we disconnected from our patients when current technology can bring them to us?" Rothman asked.
 

iMedicalApps.com is looking for clinicians, residents and medical students who are good writers and interested in mobile technology in medicine to use and then write reviews of applications. "Please join us. We'd love to have you on board," said Felasfa M. Wodajo, MD, senior editor. To contact the site, visit iMedicalApps.com and click on "contact."

Making quick headway in the medical field is the iPad, which Wodajo believes "has a lot of potential in medicine. It's going to be very important. Of course, the proof will be in the pudding, but it's the perfect form factor (physical style) for so many things. … That form factor is an important distinction. The iPhone gives you mobility, but the iPad gives you a much more complex interface." That interface will drive development of new and unique apps designed to take advantage of the iPad's characteristics. Wodajo added that he does most of his reading now on his iPad – and it fits easily into the pocket of a lab coat.
 
"It's hard to compare the iPad to something because it's the first of its class. It's thin, light and can hold a huge amount of text, video and other information, and it's incredibly easy to manipulate," Wodajo said. He pointed with excitement to the app Dr. Chrono, the first iPad-only electronic medical record. "That's the bleeding edge right there," he said.