PDAs and Smartphones: Clinical Tools for Physicians

Andrew E. Craig, MSN, FNP-C


October 09, 2009

In This Article

Clinical Software

Once you've purchased your handheld, you'll want to either download or access programs and applications that can help you in your practice. Software available includes drug references, clinical references, medical calculators, and others.

Drug Reference: One of the most popular types of handheld software, this allows you to look up drugs on your handheld device. Dosing, side effects, drug interactions, and drug prices can be reviewed. Some programs even offer color pictures of pills and allow you to filter drug choices by a particular insurance formulary.

Say you're talking with a patient, and he wants to know if the new medication he's being discharged with is covered under his insurance or whether it will interact with his blood thinner; with a handheld computer, you can answer that question in a few seconds without leaving the bedside.

Some of the many programs available include:

Lexi-Comp, which offers a number of products for PDAs or smartphones. Products within the suite include Lexi-Interact, a drug interactions database. Other products provide information on drug dosing and dosage forms, indications/contraindications, a toxicology database, and a medical dictionary.

The Sanford Guides, which provide guidelines and recommendations for treatment of infectious diseases. Both The Sanford Guide to Antimicrobial Therapy and The Sanford Guide to HIV/AIDS Therapy are available.

Epocrates, which includes drug monographs, a drug interaction checker, formulary information from many health plans, CME, and medical news. Additional modules available for a cost include a disease review database, symptom checker, and an herbal medicine reference.

Johns Hopkins Antibiotic Guide (ABX Guide), which contains information on diagnosis, drugs, pathogens, management, and vaccines. Helps confirm diagnoses and helps identify the right antimicrobial to prescribe.

Medscape for the iPhone, which contains over 6000 generics and brands, including herbals and supplements; interaction checker; and continually updated drug database including notifications of important prescribing changes. It can check for drug-drug interactions, or interactions between drugs, herbals, and supplements, allowing for inputting up to 30 entries at once.

General clinical references also abound.

The 5-Minute Clinical Consult contains comprehensive and structured information covering over 700 medical conditions. Key terms are hyperlinked; so if I'm reading about diabetes and the article mentions hypertension, I can jump directly to the article that discusses hypertension by tapping my finger on the word.

Harrison's Principles of Internal Medicine is one of the best-selling medical textbooks worldwide. You can buy this in electronic format from a variety of software vendors like Unbound Medicine and Skyscape or access it online at www.accessmedicine.com.

UpToDate is an evidence-based, peer-reviewed information resource, used by clinicians, medical students, and academic medical centers for answers to their clinical questions.

Medical calculators are also quite helpful, and there are many available. These make medical calculations a breeze; you can calculate everything from drip rates to BMI, predicted peak flow to the Parkland formula, pregnancy due dates, and much more. You may find these as standalone programs (some, like MedCalc, are even free!) or they may be packaged along with drug and clinical references into one big clinical program suite.

CME -- Continuing education is offered on handheld devices as well. The Prescriber's Letter has a PDA version, and some of the clinical suites and software vendors offer CME as either part of the suite or an add-on. Medscape for iPhone and iPod touch enables you to take CME courses on your handheld, and it keeps track of your CME courses taken.

In addition to accessing EMR, Dr. Jones uses several clinical tools on his PDA. He's a fan of 5 Minute Clinical Consult (5MCC) for primary care and is actively involved in creating the second edition of 5MCC for sports medicine, which will be the first edition of that title to be offered in an electronic version. While Dr. Jones has many years of experience, he says having a clinical reference available at his fingertips is extremely helpful. "There is so much in medicine to know, it's challenging to be able to recall in an instant everything you've learned over the years. This helps," he says. "Having the information available in bullets is fast and easy to access." He humorously refers to his PDA as his "peripheral brain."

Dr. Jones uses the Epocrates and Tarascon drug references. He finds this particularly helpful for answering drug questions from a patient regarding if a medicine comes as a tablet or a capsule, or whether it's available in a particular strength.

Dr. Jones gives this advice to physicians considering acquiring a handheld device for clinical use: "Yes, get one. Do it! It's timesaving, it saves me trips to the bookshelf, and all the information I need is only a few clicks away."


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