Keith Sinusas, MD Associate Director Middlesex Hospital Family Medicine Residency
Dr. Bones McCoy in
the original Star
Trek TV series with
his tricorder
It is estimated that 72% of U.S. physicians
use a smartphone
The number has climbed rapidly from
50% in 2007, then 62% in 2009
It is projected that the number will hit
81% in 2012
However, it is unknown how many are
using it for more than just a phone
Discuss the smartphones currently available
Report on ratings of the smartphones and the cellular service providers
Describe where to get smartphone apps List the top 10 apps for the family
physician List some other interesting medical
applications Review the next big wave: the iPad
iPhone – 55%
Blackberry – 22%
Android – 15%
Palm – 4%
Windows – 3%
Unknown – 1% iPhone
Blackberry
Android
Palm
Windows
Unknown
iPhone – will remain solid
Android – climbing steadily
Blackberry – falling quickly
Palm – R.I.P.
Windows – has a chance of surviving
What should you do when shopping for a
smartphone?
Coverage is always an issue “Can you hear me know?”
Existing contract might limit choice
Data service • Good data service is critical to when searching
such as in Google or in MDConsult
• Many medical smartphone apps reside entirely on the phone so data service is less critical
• 3G vs. 4G – currently the difference is not too great regarding speed
Provider Boston
Overall
Score
(1-100 scale)
Boston
Data
Rating
(1-5 scale)
New York
Overall
Score
(1-100 scale)
New York
Data
Rating
(1-5 scale)
Verizon 76 3 72 4
Sprint 73 n/a 69 3
T-Mobile 70 n/a 69 n/a
AT&T 60 1 57 1
Phone choices are often limited by each
wireless provider
Until recently the iPhone was only
available on Verizon
The following tables are based on
information from Consumer Reports
Phone Cost
Over-
all
score
Dis-
play
Ease
of use
Phone
rating
Web
rating
Cam.
rating
Batt.
life OS
Samsung
Infuse 4G $200 79 5 5 4 5 4 5
Motorola
Atrix 4G $100 76 5 5 4 5 3 5
HTC
Inspire 4G $100 74 5 5 4 5 3 3
Samsung
Captivate $50 74 5 5 4 5 3 4
Apple
iPhone 3GS $50 68 4 5 4 4 3 3
Blackberry
Torch $50 66 4 5 4 4 3 3
Phone Cost
Over-
all
score
Dis-
play
Ease
of use
Phone
rating
Web
rating
Cam.
rating
Batt.
life OS
Motorola
Photon 4G $200 77 5 5 4 5 3 3
Samsung
Epic 4G $100 72 5 5 4 5 2 3
HTC
Evo 3D $200 72 5 5 4 5 3 3
HTC
Evo 4G $50 70 5 5 4 5 2 3
Samsung
Nexus S 4G $30 70 5 5 4 5 3 3
Phone Cost
Over-
all
score
Dis-
play
Ease
of use
Phone
rating
Web
rating
Cam.
rating
Batt.
life OS
Samsung
Galaxy S 4G $100 78 5 5 4 5 4 5
T-Mobile
G2X $150 76 4 5 4 5 4 4
HTC
Sensation 4G $200 75 5 5 4 5 4 4
Samsung
Vibrant $150 75 5 5 4 5 3 4
T-Mobile
Sidekick 4G $100 75 4 5 4 5 3 5
Blackberry
Bold 9780 $130 63 3 4 4 4 3 4
Phone Cost
Over-
all
score
Dis-
play
Ease
of use
Phone
rating
Web
rating
Cam.
rating
Batt.
life OS
HTC
Thunderbolt $250 74 5 5 4 5 4 3
LG
Revolution $200 73 5 5 4 5 3 3
Samsung
Droid Charge $300 73 5 5 4 5 3 2
Motorola
Droid 3 $200 73 5 5 4 4 4 4
Motorola
Droid X2 $200 73 5 5 4 4 4 4
Apple
iPhone 4 $200 71 5 5 4 4 3 3
iPhone • Has the largest selection of applications available at the iTunes
App Store
• There are >4,000 medical apps
• Seemless integration with a Mac computer, but still can be used with a PC
Android • Has a smaller selection, 1,000 medical apps
• However, most of the good medical apps are available for Android
Blackberry
• Very limited selection of medical apps
• This seems to be preferred by business users because of the tighter security features
• The keyboard is also a plus for many users
• This one is marginal for use by doctors
iPhone http://www.google.com/search?sourceid=navclient&ie
=UTF-8&rlz=1T4RNWE_enUS331US335&q=itunes
Android
https://market.android.com/apps/MEDI
CAL
Blackberry
http://appworld.blackberry.com/websto
re/category/78?lang=en
Click on the App
Store
Search for app by
name
Click on Install
Enter iTunes
password
Even though the
app is free you
have to open an
iTunes account
and enter a credit
card number
Skyscape now
appears on your
homescreen
Tap on it and you
are ready to use it
Your Skyscape
home page will
open and you are
ready to use it
The process is very
similar
Tap on Applications
and run a search
Connection to the 3G or 4G • Using it depends on signal
strength
• It is also costly, since you pay by the MB of data transfer
Connection to local wireless • You need a local wireless
network and the password to connect
• It costs you nothing to work on it
• It is usually faster than 3G/4G
MediBabble Medical translator which
asks the questions for you Cost – Free, includes Spanish Also available
• Chinese – Cantonese and Mandarin • French • Haitian Creole • Russian
It helps you ask the questions, but can’t help you understand what they say
ICD-9
Quick way to find ICD-9 codes
Cost - Free
AFP by topic
Complete listing of all articles
in American Family Physician
in the last several years
Great if you remember there
was an article on a specific
topic, but also easily
searchable
Cost - free
PubMed Mobile
Searches all of the National
Library of Medicine
Some articles are full text
Most articles have the abstract
MD Consult Excellent search engine for
medical info • Full text of several major textbooks • Full text of the Clinics series • Journal articles • Patient ed info
Its not really an app, it is a database accessible on Internet
Cost – free for most with a U Conn affiliation, otherwise there is an annual fee of $395
AHRQ ePSS
Complete listing of all the
recommendations of the U.S.
Preventitive Services Task
Force
Easily searchable
Cost - free
AAA screening
CDC Vaccine schedule
Complete schedules for
children and adults
Catch up schedules also
included
Cost – free
There is a similar app from
STFM which is just as good and
is also free
Medscape
Searchable database with • Medications, including OTCs and
herbals
• Disease information
• Procedures
Cost - Free
MedCalc
Catalog of >200 medical
formulas, such as • BMI
• Peak flow
• Framingham heart risk
• Units converter (e.g. lbs to kg)
Cost - free
Epocrates Easy to search database of
prescription medications Info on
• Dosing
• Adverse reactions
• Drug interaction
• Cost
• Pill pictures
Cost - Free
This is the most essential smartphone
app and it is available on all platforms
I use it many times everyday
Upgraded version at cost of $199/yr and $299/2 yrs
Includes • Basic Epocrates • Disease information from BMJ • Billing codes • Inf Dis guidelines • Alternative medicine info • Calculators
It is expensive, but it might be worth it For me, free version of Epocrates plus free
Medscape gets you a similar package
DueDateCalc EFM Guide Qx Calculate ABFM Exam Prep Micromedex Procedures Consult NEJM eePlus Mobile Skyscape Sanford Guide to Antimicrobial therapy Hopkins Inf Dis manual
Eye exam • Eye charts
• Color blindness exam
Ophthalmoscopy • Device connects to iPhone camera
• Records image of retina
A phone
As a phone they actually are not quite as
good as dedicated phones, but still
adequate
Since they are connected to a computer,
you can enter contacts via data files
A pager
It is possible for a paging system to just
contact you with text messages on your
phone
Study reported in Journal of Hospital Medicine – 2010
Toronto General Internal Medicine inpatient service gave Blackberries to all the residents
Instead of beeping, they were texted or e-mailed
The residents all preferred it to the old system
The nurses found that it reduced the time required to contact the resident from 27.6 to 11 minutes
Clinicians can e-mail
or text photos as a
consultation
Recent case of shingles
texted to me at home
while on call to help in
decision making to
admit or not
Track 3 Diabetes Planner • Tracks blood sugars
• Tracks medication, especially
insulin dosing
• Calorie counter
• Exercise log
• Restaurant planner – e.g. you can find out the
calories in a Big Mac or a Subway turkey
footlong
Meta-analysis in Diabetic Medicine
reported in 2011
22 Clinical trials in which mobile phones
were used by patients and clinicians to
monitor care • Reduced Hgb A1C by 0.5%
• Seemed more effective in Type 2 compared with
Type 1
iPregnancy • iPhone app with information about pregnancy
• Tracks OB visits
• Posts information on Twitter and Facebook
• Baby name lists
Text for baby • Serviced sponsored by Johnson & Johnson
• Weekly text messages are sent to a pregnant woman with information about what she should do at a given week of pregnancy
• Text message fees are waived for this service
The iPad
This year Yale University School
of Medicine “gave” each of its
students an iPad • iPad2 (64 GB WiFi/3G) plus
keyboard and apps worth a total
of $900
• All texts will be on iPad
• Claim to be going green
to eliminate paper
Perhaps next year’s CAFP will include a
lecture on tablet computers
I welcome your questions I am also interested in
learning about how you use your smartphone
Do you have any other favorite apps to share with the audience?
Please return your ARS clicker