 | Viet Tran @drvtran Presented at the 32nd Australasian College for Emergency Medicine Annual Scientific Meeting Welcome, I'll be your "App-physician" today. I'm hear to cure your App-besity (you know, those pages of apps that you never use) and your App-orexia (I'm looking at you mum - you can do more than just make phone calls!) Join me on this app-intervention. |
I treated Mavis the other day - a lovely dottery questionably independent 80yo lady who was brought in by ambulance having suffered from an unheralded syncopal episode (whilst sitting no less). She never really grew fond of any particular GP and so it goes that she took it upon herself to administer a cocktail of individually useful but collectively harmful medications. Medication rationalisation I hear you say?
Our apps are much like Mavis' armatorium - some of us have apps that we download which loosely does what we want it to, and over time accumulate them on our devices to allow them to collect digital dust and dilute our intention to use even the useful apps. App rationalisation I hear you say?
Our apps are much like Mavis' armatorium - some of us have apps that we download which loosely does what we want it to, and over time accumulate them on our devices to allow them to collect digital dust and dilute our intention to use even the useful apps. App rationalisation I hear you say?
Overview
- App Rationalisation
- Apps in the wild
App Rationalisation
What I want is for you to recognise the disconnect between having apps and using apps. And to do that we need to answer the question "How can we become more effective with our apps"?
Principles for Effective App Use
We can break this answer into 4 themes:
Principles for Effective App Use
We can break this answer into 4 themes:
- Purpose: Productive
- Be Picky
- Learning Curve
- Operator Dependant
 1. Purpose: Productivity All apps have a purpose whether its to tweet, calculate risk, check your email, the weather, your finance, the news…the list goes on. It goes on so much so that Apple® have coined the addictive term "There's An App For That". And this is true…there probably is an app for that. But it makes no mention of how purposeful that app is. There's no point having "an app for that" if it is unreliable, clunky, frustrating to navigate and apply. What we're missing is the bigger picture. Because its not the size of the app store that matters… So what is the bigger picture? Patient safety through Productivity. Apps, smartphones, technology - the whole point of this from the start was to create new ways to remain productive. Don’t lose the bigger picture. |  2. Choose Wisely All that glitters is not gold. The path to app-besity is from over indulgence. Its far too easy to download apps. Portion Wisely! So how do you work out if something's useful or not? There are a few guides:
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 3. Learning Curve In this day and age technology doesn’t come with instruction manuals - well they do, but like product information leaflets that come with medications - not many people read them. We live in a world of trial and error when it comes to this technology, and apps are no different. So there is a learning curve, and at the far left of this curve you may think that an app is useless, but someone using the same app on the far right of the curve will find it useful. And using your paediatric calculator for the first time in a resus probably breaks the 1st principle of effective app use. |  4. Operator Dependant This principle goes hand in hand with the learning curve. Like ultrasound, fascia iliaca blocks, intubations etc, Apps are also user dependant, quite often relative to where you are on the curve. If an app does not seem productive, look at the operator…because unless you're a developer, you can't change the app. With these principles in mind, lets take a look at apps in the wild. |
Apps in the Wild
In medicine there are 3 types of apps:
- Point of Care
- Medical Education
- Medical Productivity
POINT OF CARE
Medical Calculators
 | Mediquations (iOS & Android) AU$7.99 Has the most number of critical care related calculators and regularly updated with good reviews within and without the app stores Tip: The "info" tap on each calculator links to the paper(s) it was developed from |
 | MedCalX (iOS only) AU$7.99 Has the same calculators as Mediquations with the added feature of personalised "Formulas" eg putting Well's criteria and PERC score in the same folder for easy access. Also links to original articles. |
 | PediStat (iOS & Android) AU$4.99 Paediatric calculator. There are a few out there - i'm familiar with this one and know how and where to access what i want when i need every ounce of my cognition. The take home message for these sorts of apps are to be familiar with them - much like the drugs that you might choose to use to intubate with. |
Drug References
 | DrugDoses (iOS & Android) AU$22.99 (PICU Guidelines $7.99) Continually updated electronic version of the paediatric drug doses "bible" otherwise known as Frank Shann. |
 | iMims v2.0 (iOS & Android) Free with institutional subscription The popular electronic drug reference accessed from computers. v2.0 brings with it multiple unwelcome features and a few that are - i'll leave it to you to work out which is which. See below on how to access it via your institution. |
 | Toxicology Handbook (iOS & Android) AU$87.99 via iBooks or included with purchase of hardcopy for AU$95RRP Inkling is an online app book store and reader similar to iBooks. It excels in that most medical hardcopy text have an included serial for the online version. |
 | eTherapeutic Guidelines (iOS & Android) $14.99 for iOS and AU$345 for a yearly miniTG subscription iSilo is an archaic document reader for their own proprietary format. miniTG has for many years used this format to deploy their app. This convoluted and archaic system along with the institution subscription structure prevents most institutions purchasing the 'smartphone compatible' version. |
| A note on institutional subscriptions Around Australasia, particulary in the public sectors, most will give you an "enteprise" subscription to the portable equivlanet of the computer based references. Below is a list of the places to look for instructions to access these subscriptions. Note that they are controlled by your health librarians - so if you're still not sure how to find/install etc just ask your friendly librarian!
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General References
 | Royal Children's Hospital Guidelines (iOS & Android) Free An app version of the RCH guidelines, kept up to date and easy to navigate. Tip: RCH also have a patient information app called "Kids Health Info" |
 | EyeManual (iOS & Android) Free An app version of the popular NSW Eye Manual. Tip: The "reference" tab includes a 'how-to' for the slit lamp and practical advice like how/when to apply an eye pad |
 | DIP: Diagnostic Imaging Pathways (iOS & Android) Free An app version of the popular Western Australian Radiology Team. |
 | Essential Anatomy This is the one that i've been used to and have used as a tool prior to calling orthopaedics or plastics to look like a #master. Like PediStat i would suggest you have a look at what's out there and commit yourself to learning and using it if you want it to obey principle #1 |
 | UpToDate (iOS & Android) Institutional Subscription We all know it so i wont discuss it. Not as prolific with regards to how many institutions actually have the smartphone subscription add-on. |
Unitaskers
 | EyeMD (iOS only) Free A unitasker to its core - but it does it well. Visual Acuity on a c-spine cautioned patient has never been easier. Note that there are numerous studies out there questioning they comparison to traditional VA - but at least you can say VA "grossly" intact. |
MEDICAL EDUCATION
#FOAMed
 | FaceBook enough said |  | Twitter Other's available |  | FlipBoard RSS aggregator |  | Feedly RSS aggregator |
 | OverCast (iOS only) Free A podcast aggregator with 2 unique functions: 1. Speed Up: increase the speed of a podcast 2. Smart Speed: cuts out the silence/pauses on the run = shorter podcasts |
 | WikEM (iOS & Android) Free The app version of the website |
Celebrity
 | Emergency Medicine Australasia (iOS - Android coming soon) Free for ACEM members EMA app that allows you to search and download editions or just articles from past/present future. |
 | NEJM (iOS only) Subscription Similar to the EMA concept but you need a paid subscription to NEJM (not an institutional one) |
 | Radiopedia (iOS only) Free with many in-app purchases The mobile version of the website. The downloaded version is "freemium" in that you get a limited number of images and need to buy "systems". The costs can add up. |
Productivity
Document Handlers
 | ReadCube (iOS & Android) Free Powerful app. If you have an affiliated university log in (most Australian Universities are) you can search pubmed within your browser, download articles and file them whichever way you want. You can also annotate, highlight and add notes to articles. ReadCube also has a desktop (Windows & Mac) app to sync across to your laptop. |
 | Papers 3 (iOS only) Free Born many years prior to ReadCube and is frequently updated. Navigation functions and layout differ subtly to ReadCube but still offers the same university input and in app browsing and downloading of publications. The caveat is that the laptop app is about $50! |
 | EndNote (iOS only) Free Similar to ReadCube and Papers 3 but nowhere near as powerful |
 | Mendeley (iOS & Android) Free Half way in terms of functions between Papers 3 and EndNote |
Note Takers
 | OneNote (iOS & Android) Free Powerful note taking app that allows you to have different notebooks. Within each notebook are chapters and within each chapter you can have multiple titles. Syncs across all your devices and even online. Can capture typed notes, generate checklists, record voice to note and take pictures to note. |
 | Evernote (iOS & Android) Freemium Similar to OneNote but without the "chapters" level. Also uses a freemium model in that ads are prolific and certain limits regarding monthly upload, note taking quotas. |
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