Technology in Medicine

Gil C. Grimes, MD

Scott & White Memorial Hospital and ClinicTexas A&M University Health Science CenterScott & White Memorial Hospital and Clinic

Texas A&M University Health Science Center

Outline

• Handheld devices and medicine

• Podcasts

My Biases• I use Windows based

products• I use an iPac• I have used Palm in

the past• I love portability• I love not needing

internet access• I like listening to

Podcasts while doing chores

PocketPC Devices

Why Do I Need a Handheld?

• Fast access to a large amount of info

• Medical math/ calculating drips, etc.

• Protocol, recommendations, formularies

• Use EBM at the bedside

• EMR (electronic medical record)

• Wireless access to WWW

• E/M, CPT coding

Why Do I Need a Handheld?

• Medical references

• Billing, scheduling, reminders

• Electronic prescribing

• Medical documents/ internet content

• Getting rid of yellow stickies/ database

• Software for RNs

Why Do I Need a Handheld?

• Portable

• Calendar, contacts, email, task list, phone numbers, pager numbers, passwords

• Amazing storage capacity, advanced networking, encryption capability

• Procedure logs

• Dictation

Medical Uses

Patient Care– Medical Calculators– Pregnancy Calculators– EBM Tools– Immunization

Schedules– Medical Texts– Prescriptions– Dictation– Medical Records

– Drug References– Antibiotic Guides– Treatment Protocols

– Clinical Decision Tools

– Coding

Medical Software

• Drug References– ePocrates Rx– Johns-Hopkins ABX Guide– LexiDrugs– Sanford Guide– MicroMedex– Pocket PDR– Tarascon Pocket Pharmacopia

Medical Software, Cont.

• Texts and Reference Materials– Washington Manual– Outlines in Clinical Medicine– 5 Minute Clinical Consult– Harrison’s– Immunization Schedules– ER References

Medical Software, Cont

• Clinical Calculators– MedMath– MedCalc– MedRules– Archimedes– ATP-III– ABG Pro– STAT Coder– STAT Cardiac Risk

– Preg Wheel– Many More

Medical Software, Cont

• Evidence Based Medicine Tools– Essential Evidence Plus– DynaMed– EBM Tables– Up to Date– JFP Poems

Medical Software, Cont.

• Prescribing/Dictation– Allscripts– ePhysician– Medical Manager (WebMD)

Commercial Web Sites

Reviews/Advice/Downloads• CollectiveMed.com• Handango.com • HandheldMed.com• MedicalPocketPC.com• PDAcotex.comTalking with health prof• Doctor Palm• PDAMD.com• Wireless Medical

Applications• Ectopic Brain• EMBI.NET

Educational Sites• Dalhousie University• University of Arizona• Children’s National

Medical Center• University of Minnesota

Databases• Handbase.com

USPTF AHRQ tool

Essential Evidence PlusWindows 95/98/NT/ME/2000/XP/Vista, PocketPC, Palm and

Web

Bayesian diagnostic test / H&P calculator >2000

Basic drug info by class and cost for 1200 drugs

Key evidence-basedtreatment guidelines

Cochrane Databaseof Systematic Reviews:over 1500 abstracts

140 clinical predictionrules

www.InfoPOEMs.com

2400+ short research synopses (400 added per year)

5 Minute Clinical Consult

Photo Atlas >500 photos

Saving Time By Downloading Other’s Databases

www.ddhsoftware.com/gallery

Considerations

Palm OS• More software• More intuitive interface• Longer battery life• Smaller, compact design• $100 to $600

Pocket PC• Faster, more powerful

processors• Higher-end software• Better screen resolutions• Better wireless capability• Increased security features• Better integration with

Word, Excel, Outlook, and Power Point

• $180 to $700

Should you Get an iPhone

• Software available?– ePocrates

• Web-based programs?– ePocrates– DynaMed– Essential Evidence Plus– Many others

Practical Applications

• Useful Websites– Ectopic Brain http://pbrain.hypermart.net/– The Palmdoc chronicles http://palmdoc.net/– FSU Handheld website

http://med.fsu.edu/library/PDAsoftware.asp– Meister Med http://www.meistermed.com/index.htm– EMBI.NET http://www.embi.net/content/view/20/110/– Skyscape http://www.skyscape.com/index/home.aspx– Handheldmed

http://www.handheldmed.com/Site.New/Pages.php?p=welcome

Podcasts

Podcasting, (noun) a term that describes the technology used to push audio content from websites down to consumers of that content, who typically listen to it on their iPod or other audio player that supports mp3.

Podcasts

• These are asynchronous– The broadcaster creates the podcast– The user downloads the podcast– The user listens whenever they desire

• Think of this as TiVo for audio broadcasts

Podcasts

• Why do I care?– CME is available– Numerous journals produce audio reviews of

their current issue– Numerous grand rounds available– A sense of community

Podcast Reception

• Equipment– Internet accessible computer– Some form of Media Player

• MP3 Player• iPod• Software for your computer

• Software to subscribe and manage podcasts– iTunes– Juice– Google returns 4 million hits– 90% are free

Making it work

• Find a Podcast– University of Hawaii Page

• Using iTunes click and go

• Using others may take a little more work

• Synching it up

Questions?