1. Mobile Device Apps: What to Have at Your Fingertips Ryan B. Jacobsen, PharmD, BCPS Clinical Pharmacy Specialist & Clinical Coordinator Clinical Assistant Professor University of Iowa Hospitals & Clinics and College of Pharmacy

2. Disclosure Dr. Jacobsen reports no actual or potential conflicts of interest associated with this presentation Dr. Jacobsen indicates that off-label use of medication will not be discussed during this presentation

3. Objectives Review the most popular software applications (APPs) for clinical practice Review some popular software applications (APPs) for patient engagement

4. Outline Background on APPs and handheld technology Clinical practice (“Point of Care”) APPs Patient engagement/education APPs

5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4029126/pdf/ptj3905356.pdf

6. Demand for Access Communication: voice calling, video conferencing, text, email Hospital Information Systems: electronic health records, clinical decision support systems, laboratory information Informational resources: textbooks, guidelines, medical literature, drug references Clinical software applications: disease diagnosis aids, medical calculators, risk stratification Mosa AS, Yoo I, Sheets L. A systematic review of health care apps for smartphones. BMC Med Inform Dec Mak. 2012 Jul;12:67

7. Mobile Platforms Android Apple (iOS) Windows (Microsoft) Other

8. http://www.idc.com/prodserv/smartphone-os-market-share.jsp

9. Health Care Professionals 87% use smartphone or tablet at work ~80% of physicians use iPhone ~66% of physicians own tablet & 54% use in practice 80% of physicians age 55 & older use smartphone Chase J. Ipads and other drugs. Medical Marketing & Media: The Interactive Guide. 2013:10-11.

10. APPs Software applications (APPs) Not all of them are available in all platforms or operating systems Some are free, some cost $$$ Some are: GreatOkayFun/entertainmentBad

11. Limitations... A word of caution Lack of oversight with respect to standards and content Security and patient privacy Impact on provider-patient relationships Impact on education Diagnostic or therapeutic efficacy claims Blurred lines between personal and professional use Best approaches to use

12. Android OS Numerous APPs<Apple iOS Often lag behind Apple iOS but improving Most of the popular medical APPs are available play.google.comwww.imedicalapps.com

13. Apple iOS iPhone, iPad, iPod touch Very popular among healthcare professionals >1.2 million APPs Apps for Health Care Professionals on iTunes

14. Nursing Apps Imaging Apps Patient Education Apps Personal Care apps Reference Apps Medical Education Apps EMR and Patient Monitoring Apps iTunes

15. http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ConnectedHealth/MobileMedicalApplications/ucm255978.htm

16. App Title Category:Platform:Cost:Pro’sCon’s Please feel free to share your experience with any of the APP’s throughout this presentation

17. UpToDate Category: Medical Reference Platform: iOS, Android Cost: $495/year (*free with institutional access) Pro’s: comprehensive (10,000 conditions), evidence-based, “up to date” Con’s: $$$, updated quarterly *http://www.imedicalapps.com/2013/07/uptodate-free-iphone-ipad-hospital-subscription/

18. Medscape Category: Medical Reference- multipurpose Platform: iOS, Android Cost: Free Pro’s: clinical reference (4,400 conditions), drug info, interaction check, medical news, CME Con’s: some user info may be shared with Pharma, not the most up to date, advertisements

19. Epocrates Category: Drug Reference & More Platform: iOS, Android Cost: Rx (free), Pro ($99/yr), Essentials ($159/yr), Essentials Deluxe ($199/yr) Pro’s: Drug Interaction check, Pill identifier, Drug info, easy to use, multiple features Con’s: “free”-some adds (Pharma), $$ for added features

20. Epocrates Rx-Free: Drug interactions, Pill ID and pictures, Drug Info, Formulary, Pricing estimates, Calculators, Tables, AHRQ ePSS, BMI tool Pro: Infectious Disease treatment guide, Brand Name OTC drugs, Alternative Meds, IV compatibility checker Essentials: Disease monographs, High-res disease images, hundreds of diagnostic and lab tests Essentials Deluxe: ICD-9 Codes and CPT codes, Medical Dictionary

21. LexiComp Category: Drug reference (primarily) Platform: iOS, Android Cost: $175-$215 or >> Pro’s: comprehensive medication reference, trusted resource Con’s: $$$

22. Omnio Category: Multipurpose Platform: iOS, Android Cost: Base software Free. Add- on references for $$. Pro’s: multiple popular references available for purchase, one App for all-in- one functionality, customizable Con’s: interface takes practice, can get expensive

23. Johns Hopkins ABX Guide Category: Infectious Disease Platform: iOS, Android Cost: $29.99 Pro’s: Uses same IDSA treatment rec’s as Sanford, detailed info-signs, symptoms, labs Con’s: $$

24. Qx Calculate Category: Medical Calculator Platform: iOS, Android Cost: Free Pro’s: user interface, free Con’s: sometimes too fancy

25. Kidometer Category: Pediatric reference Platform: iOS Cost: $4.99 Pro’s: reference of age-based norms Con’s: last updated 2012, only iOS Alternatives: PediQuikCalc, PediSTAT, Pediatric Quick Reference

26. Pediatric Quick Reference Category: Pediatric quick reference Platform: Android only (was pulled from iOS) Cost: Free Pro’s: dosing meds, easy to use Con’s: double-check dosing

27. ASCVD Category: Risk calculator Platform: iOS, Android Cost: Free Pro’s: simple, easy to use, patient education, statin intensities, guideline info Con’s: “controversial” risk calculator

28. CORE Category: Clinical Orthopedic Exam (CORE) Platform: iOS, Android Cost: $39.99 Pro’s: very descriptive, exam signs, special tests for each joint, link YouTube videos Con’s: $$

29. VisualDx Category: Dermatology Platform: iOS, Android Cost: $199.99 essentials; $299.99 complete Pro’s: search by topic, variety of pics, handy Con’s: $$$

30. PreopEval14 Category: pre-op evaluation tool Platform: iOs Cost: Free Pro’s: easy to use, evidence-based Con’s: not on Android

31. Eye Emergency Manual Category: Eye reference Platform: iOS, Android Cost: Free Pro’s: a lot of content, easy to use Con’s: ?

32. CDC Vaccine Schedules Category: Immunization reference Platform: iOS, Android Cost: Free Pro’s: up to date, useful info Con’s: interface

33. AHRQ ePSS (electronic preventative services selector) Category: Screening tool Platform: iOS, Android Cost: Free Pro’s: easy to use, links to A LOT of info Con’s: links to A LOT of info

34. Patient Engagement APP’s Medication reminders/adherence Diaries: diet, activity, pain, other Education Disease management Wearable Biometrics FitBit, FuelBand, iWatch Glucometers, home blood pressure Evidence is needed to guide whether or not improvements in patient outcomes

35. MyFitnessPal Category: Calorie counter, weight loss tool Platform: iOS, Android Cost: Free Pro’s: easy to use, great features, web & mobile access Con’s: ?

36. Healthy Children Category: Patient Information Platform: iOS, Android Cost: Free Pro’s: Developed by American Academy of Pediatrics, simple to use Con’s: App is somewhat “buggy” or slow Register on website then log in. www.healthychildren.org

37. Change Talk: Childhood Obesity and Motivational Interviewing Category: training & patient education Platform: iOS, Android Cost: Free Pro’s: innovative, important topic Con’s:

38. The Future is Now iPhone Otoscope

39. The Future is Now Wireless blood pressure monitor

40. The Future is Now Wireless Scales

41. J Med Internet Res 2015;17(4):e101 n=348 30 day hospitalization rate vs. control: Hazard ratio=0.52,P=0.01 Mortality rates vs. control: Relative Risk=0.33,P=0.04

42. The Future is Now Diabetes management

43. The Future is Now http://www.imedicalapps.com/2015/01/new-study-shows-innovative-use-smartwatch-diagnosis-tremors/

44. “10 best medical apps released in February & March” IM Essential Flashcards Pepid Elements ACEP Toxicology Section Antidote App CDC Tickborne Diseases Chest X-Rays Free OB Wheel FDA Drug Shortages TriagePicDementiAssist Hip Decide http://www.imedicalapps.com/2015/04/best-health-medical-apps-february-march/10/

45. Other APPs Dynamed AGS iGeriatrics Chronic Pain Tracker AF Guide (Afib) MediBabbleGenerics Micromedex QxMD Read Journal Club MedPage Today DropboxEvernoteOthers?

46. Don’t let technology be a replacement for good patient interaction and human touch but rather utilize it to make you a better health care professional and to help your patients better achieve their health care goals.