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How Will The iPad Fare In Healthcare?

Image representing iPad as depicted in CrunchBaseThe first iPad reviews are out, and they’re very positive. Here’s a selection of the reviews (compiled by MacRumors):

And here’s a roundup of recent medical blogs commentary on the iPad:

iMedical Apps has a nice review of how 5 medical apps might appear on the iPad, including the Blausten Human Atlas, Visual Dx Mobile, Procedures Consult, OsiriX and eFilm, and Papers.

The Unofficial Apple Weblog features a review of Carter’s Encyclopedia of Health and Medicine, an app designed specifically for the iPad. (This is not an eBook, but a full app with searchable interactive skeletons, etc.)

CareCloud, a new cloud-based EHR, plans to have an iPad version. Epic already has an iPhone app and presumably will have an iPad version available. Allscripts is rumored to have an upcoming EHR for the iPad. (No word on whether other EHRs plan on having an iPad app. If you have any information, please post a comment.)

According to Macworld, 1 in 5 doctors plan to buy an iPad. The Practice Fusion Blog has a discussion of other iPad-related surveys of doctors and healthcare professionals.

Healthcare Technology Online has a discussion of the pros of cons of the iPad in healthcare. Read more »

This post, How Will The iPad Fare In Healthcare?, was originally published on by Joshua Schwimmer, M.D..

Google Study: How Do Physicians Use The Internet?

Google Inc. In November 2009 Hall & Partner published a study sponsored by Google titled “Connecting with Physicians Online.” (Here’s the webinar on YouTube and here’s the PDF of the presentation.)

The study’s aim was to better understand how physicians use the internet in their clinical practices. As you’d expect from a study sponsored by Google, it was particularly focused on how physicians use search.

The study surveyed 411 physicians from a range of specialties (PCPs, endocrinologist, cardiologists, psychiatrist) and with a range of experience (2 – 30 years in practice) on their use of the internet in clinical practice. Additionally, various clinical scenarios were presented designed to mimic actual situations the physicians might encounter. Read more »

This post, Google Study: How Do Physicians Use The Internet?, was originally published on by Joshua Schwimmer, M.D..

Finding Health Care Professionals on Twitter

My social Network on Flickr, Facebook, Twitter...Image by luc legay via Flickr

A little over a year ago, before Twitter was the tech/pop culture phenomenon it is today, doctors like myself had a problem: how do you identify other health professionals on Twitter? (At the time, there must have been at least dozens. Dozens.)

This was the first solution. In retrospect, it was hilariously cobbled-together:

This is a feed containing the conversations of all known doctors and medical students who use Twitter: (If that doesn’t work, you can try the original feed from Yahoo Pipes instead.) Technical details, for those interested: I used this list of doctors/medical students on Kidney Notes, ran each person’s Twitter feed through Yahoo Pipes, then burned a FeedBurner feed.

When FriendFeed debuted, I created “The Doctor’s Room,” which was populated by both Twitter feeds and RSS feeds of physicians. Unfortunately, the “room” feature was poorly designed by FriendFeed (which has since been acquired by Facebook). Like the Yahoo Pipes experiment, the FriendFeed room was an educational failure. Read more »

This post, Finding Health Care Professionals on Twitter, was originally published on by Joshua Schwimmer, M.D..

Medicine & Information Overload

index medicusImage by Nuevo Anden via Flickr

The growth of medical knowledge is difficult to visualize. One classic representation is the Index Medicus — a comprehensive index of medical journal articles — whose bound copies filled the shelves of medical libraries for 125 years. In 2004, however, the National Library of Medicine decided to stop publishing the Index. The first reason was practical: the Index Medicus had grown from 82 pounds in 1985 to an estimated 152 pounds in 2004. The second and more important reason was the widespread availability of the search engine PubMed — an electronic database of medical literature available for free via the Internet — which made the printed index obsolete. Compared to the Index Medicus, PubMed was more convenient, could be searched more easily, could be updated more quickly, and certainly weighed less. Copies of the Index Medicus are now a historical curiosity; many physicians now search the medical literature exclusively through PubMed.

The story of the Index Medicus and its successor, PubMed, illustrates three ideas.

First, the quantity of new medical information is more than any single physician can absorb, and keeping up to date with this expanding body of knowledge is challenging. As of April 2009, for example, PubMed contained information on 18,782,970 citations in the medical literature and was adding over 670,000 new entries per year. Doctors must not only absorb this flood of new ideas about treating, diagnosing, preventing, and understanding disease — deciding which information is relevant and which is not — but also learn how to apply and explain this knowledge to the patient sitting with them in the exam room or laying ill in a hospital bed.

Second, in parallel with this unprecedented expansion in medical knowledge, new media and technologies have emerged — of which PubMed is one example — which has made the task of searching, organizing, and retrieving relevant information easier. Potential sources of information for physicians include not only printed journal articles like those indexed in PubMed, but lectures, case conferences, and newer Internet resources such as reference tools (e.g., UpToDate), discussion groups, online expert systems, clinical resource tools, and podcasts.

Third, the expansion of medical information and proliferation of new technologies has required physicians to develop new skills and strategies to keep their knowledge current. Often, the availability of new knowledge overwhelms physicians’ ability to process it, a condition known as information overload. In physician’s offices, one symptom of information overload is the common spectacle of unread piles of medical journals stacked up on every available horizontal space.

While many medical schools now require classes on searching the medical literature and evidence-based medicine, few resources have been available designed to teach physicians how to learn and practice medicine more efficiently. (That’s why, over two years ago, I started writing The Efficient MD blog.)

Since then, I’m glad to report that online resources for physicians have proliferated. Ways of improving efficiency and reducing information overload are now common topics on medical blogs. For example, see recents posts in Life in the Fast Lane, Clinical Cases and Images, and Musings of a Distractible Mind.

Thanks for reading!

(Much appreciation to Jacque-Lynne Schulman, Stephen Greenberg, Margaret Vugrin, and Dean Giustini for helping me with an updated estimate of the weight of the Index Medicus. Any inaccuracies in this post are, of course, my own.)

(This post is also published on The Efficient MD blog.)

This post, Medicine & Information Overload, was originally published on by Joshua Schwimmer, M.D..

Medical Apps For The iPhone: Diagnosaurus, ICD9 Consult, and WellAdult

As of this writing, there are over 400 medical applications in the iTunes App Store. Whether you’re a health care provider or patient, and whether you have an iPhone or iPod Touch or not, it’s worth exploring the impressive range of applications available for this new mobile platform. (Later this year, when iPhone 3.0 is introduced, these applications will be able to interact directly with compatible medical devices, like glucometers and blood pressure monitors.) Here’s a brief introduction to three medical apps in the iTunes App Store.

Diagnosaurus. Many medical specialties—and Internal Medicine in particular—require working through a “differential” of possible causes of  a patient’s clinical presentation. Diagnosaurus ($.99) provides a polished interface for searching differential diagnoses for over 1000 conditions, divided by organ systems, symptoms, and diseases. As a bonus, at the end of each list is provided a list of links to related differentials. For example, “acute hepatiis” and “cholestatis” are listed at the end of “AST/ALT increased.” Much like Wikipedia, you can spent half an hour browsing and clicking through links. For $.99, it’s a steal.

ICD9 Consult. Health care providers must frequently scramble to come up with ICD9 codes for unusual or complex diagnoses in order to bill appropriately. ICD9 Consult ($29.99) is an excellent solution for those moments when you don’t have time to consult a thick book or spend time seaching online for the right code. It allows you to easily search through the different codes or browse by type of disorder (infections, circulatory, respiratory, etc.) or procedure. At $29.99, it’s not cheap, but if it saves you enough time, it’s worth it.

WellAdult. The guidelines for optional clinical preventive services for adults—when to perform cholesterol tests or colonoscopies, for example—are scattered among many different expert organizations and are sometimes contradictory. WellAdult ($2.99) provides an easily navigatable database of recommendations from all major organizations for adults of different ages. Click on “Women Ages 50 – 64,” for example, and you can easily compare the reommendations of different organizations for testing lipids, blood pressure, vaccinations, and cancer screening. For $2.99, this app is well worth it.

*This post, Medical Apps For The iPhone: Diagnosaurus, ICD9 Consult, and WellAdult, was originally published on by Joshua Schwimmer, MD.*

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