Don’t miss the boat on medical apps

There are many reasons why physicians should be using medical apps. Chief among them: “It’s easier to use your phone than to reach for a book,” commented Dr. Chandi Chandrasana, an Ottawa-based family doctor and an OntarioMD peer leader.

What’s more, there’s a ton of expertise built into apps. They can be used for everything from medication checking and journal-article lookups to visual anatomy and ‘best practices’ for various conditions.

As Dr. Chandrasana noted at last fall’s OntarioMD Every Step conference, “If you’re not using them, you’re missing the boat.”

Dr. Chandrasana led a session called “Medical Apps for Physicians and Patients”, which was filled to overflowing. Right away she warned, however, that apps are of wildly varying quality, and it takes skill to separate the wheat from the chaff. It’s important to view them with a critical eye.

“Look at an app like a journal article,” she said. “Ask yourself who wrote it, or who developed it, and find out what other apps they have developed.” This is akin to discerning whether an article has been written by a credible source.

Next, make sure to find out when the last update was. If the app hasn’t been updated for 10 years, don’t download it, she cautioned.

Another important feature is privacy – how private is the data you’re entering?

Dr. Chandrasana then commented on a number of popular medical apps and discussed their pros and cons.

One of the most popular apps for doctors, she noted, is RxTx mobile, which is provided by the Canadian Medical Association’s subsidiary Joule, at no charge to members. It’s produced by the Canadian Pharmacists Association (CPhA), and it contains much of the data found in the huge, printed volume known as the Compendium of Pharmaceuticals and Specialties (CPS). “It’s a smaller CPS at your fingertips,” said Dr. Chandrasana.

RxTx is available through online, mobile and integrated EMR channels, and offers a compilation of more than 2,000 fully bilingual, Health Canada approved, Canadian product monographs and images for drugs, vaccines and natural health products.

The app has condition-based drug tables that are formatted for quick access to dose, adverse effects, drug interactions and relative costs. It runs on iOS and Android devices.

An important feature for Canadian physicians is the availability of Health Canada advisories. These advisories appear in both general search returns and the actual product monograph.

RxTx is now used by more than 17,000 Canadian clinicians. “They include, but are not limited to, physicians, pharmacists, nurses, residents and medical students, as well as dentists and dental hygienists,” said Lyndon McPhail, director of product management for the Canadian Pharmacists Association.

“In January, we launched a major upgrade to RxTx Mobile; which now includes the full content from our Compendium of Therapeutic Choices (CTC) and Compendium of Therapeutics for Minor Ailments (CTMA), said McPhail.

He explained this additional content provides “critical information on what a clinician needs to know about a given condition, through Canadian guidelines and evidence-based steps to treat the condition.”

This therapeutic content, he said, has been one of the most requested features over the past few years.

While the CPS and drug tables in the RxTx app are complimentary to members of the CMA, use of the therapeutic content will be available at a member-discounted fee, McPhail said. Nevertheless, there will be several months of free usage, to show clinicians the benefits of the new content at the point of care.

Some other apps that Dr. Chandrasana mentioned:

• UpToDate, $519 Cdn. A strength is that it mirrors the comprehensive website, but in an app form. On the other hand, it contains U.S. data.
• DynaMed Plus, $395 US or complimentary to CMA members. It includes bullet format evidence-based recommendations, Micromedex drug content, and coverage of Canadian and international guidelines.
• Epocrates, free. It’s popular, and contains information on thousands of prescriptions, generic and OTC drugs, including an interaction check for adverse reactions between up to 30 drugs at a time. However, it uses U.S. content.
• Visual anatomy, free. It’s great to have a skeleton in your pocket. The app can be a little hard to use at times, said Dr. Chandrasana, and there are ad links. There’s a better version, called Visual Body, but there is a cost to it.