Clinical Reasoning, Mobile Computing, Point of Care Tools: Medical Knowledge in Your Pocket

This month, the second-year medical students at UCHC are in the process of selecting and purchasing their mobile computing devices (PDAs or SmartPhones) in preparation for the beginning of their clinical clerkship year when they’ll be using them to keep a log of patient encounters, check for drug interactions, calculate laboratory test results, look up point-of-care medical/reference facts or other essential activities like checking email and sharing files.

I’ve noticed that quite a few of the first-year medical students are already using PDAs, Blackberries and iPhones, thus getting ahead of the learning curve.  Several are already using EpocratesRX, a basic mobile drug reference resource available at no cost from Epocrates.com.

Other free downloads popular with medical students are Diagnosaurus 2.0, a differential diagnosis tool from McGraw-Hill, and Archimedes, a medical calculator, provided by Skyscape.

A desirable feature when evaluating potential new library subscription products is the availability of a mobile computing version.  Examples of highly-useful clinical resources which come with a mobile version are DynaMed, Essential Evidence Plus, Lexi-Comp, Micromedex, MD-Consult/First Consult, and two integrative-complementary-alternative medicines resources, Natural Medicines and Natural Standard.

These last two resources are especially important when clinicians need to determine potentially hazardous drug interactions between “over-the-counter” homeopathic or dietary supplements and allopathic prescription medicines.

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It is a rapidly changing world of devices, products, access, cost (and choices).  To review more of what is available in hand-helds for medical applications, visit a few pages* written for UCHC students by library staff :

• A good place to start: Lyman Maynard Stowe Library Mobile Computing Page
• UCHC Computer Education Center: PDA Faqs and Product Comparisons
• Software Recommended for UCHC Students
• Software for Practicing Evidence Based Medicine
• Discussion on Smartphones
• Basic Tutorial on How to Sync
  

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Wikipedia.org has a page about Open Source Healthcare Software.

Recently I came across a free clinical calculator site which anyone can use: MD+Calc.  Thanks to Graham Walker for putting this site up. Below is a screenshot of the topic page “Endocrine/Metabolic“:

Image/Source credit: http://www.mdcalc.com/ – All rights reserved – Copyright 2010

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Finally, here is a brief list of other free clinically-oriented sites**:

• MedCalc 3000
• Martindale’s Calculators Online Center
• The Medical Algorithms Project (Registration to log-in – recommended)
• GlobalRPH.com
• MedCalc
• Andrew Yee’s Medical Eponym Page (updated Aug 2009)
  

• Medical Calculators Page – Weill Medical College – Cornell Univ.
• Johns Hopkins ABX Guide and also see POC-IT (Point of Care Guides).  Registration and log-in is required to view the full content of the site – just go ahead and do it, as there is a great deal of information here.
• University of Washington – Health Links PDA and Mobile Resources

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* Note: Access to the clinical subscription databases described here is limited to UCHC students, staff and faculty.

** These links are provided for educational use only – not for clinical decision-making in the care of actual patients.

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