Earlier this year, we put together a list of what we thought were the best medical apps for healthcare providers. Now at the end of 2018, we’re augmenting that list to give you a full picture of what we think are the must-have medical apps for those in primary care.
Quick reference for common obstetric emergencies
Many of us in family medicine practice full-scope — including obstetrics and urgent/emergent care. Routine vaginal deliveries can quickly deteriorate into one of many frightening obstetrical emergencies. Recent information from the CDCshows a sobering statistic that maternal mortality in the U.S. is increasing rather than decreasing. The number of reported pregnancy-related deaths in the U.S. steadily increased from 7.2 deaths per 100,000 live births in 1987 to 18.0 deaths per 100,000 live births in 2014. The three most common causes of maternal mortality worldwide and in the U.S. have not changed: postpartum hemorrhage, venous thromboembolism, and severe hypertension of pregnancy. The Safe Motherhood Initiative (SMI) is an initiative of the American College of Obstetricians and Gynecologists (ACOG) District II in New York State. This group links hospitals across the state together and provides healthcare bundles and education aimed at reducing mortality from these three most common lethal pregnancy complications.
ACOG DII SMI is a combination of expert opinion, ACOG position statements, and algorithms supported by evidence-based medicine, clinical practice guidelines, and standard of care medical practice. The app contains easy to follow checklists, algorithms, and teaching slides targeted to the three most common causes of maternal mortality.
Screening and assessment of mental health conditions
Mental health conditions are exceedingly common and costly in the U.S. medical system. Recent statistics from the CDCestimated that they account for 60 million visits to primary care and 6 million ER visits annually. Depression alone accounts for more than 10% of all primary care visits. These conditions result in a sobering 44,000 suicide deaths per year in the U.S.
Screening for these conditions is commonly performed in most primary care practices with supporting recommendations from the U.S. Preventive Services Task Force (USPSTF) for conditions such as depression, alcohol abuse, etc.
Psych on Demand is an app by a board-certified psychiatrist that puts all of the most common (and some uncommon) screening instruments in one user-friendly app. The app contains more than 35 instruments covering disorders including depression, post-traumatic stress disorder (PTSD), attention deficit-hyperactivity disorder (ADHD), anxiety, bipolar disorder, and many others.
It’s an exceptional value for all who screen and treat mental health disorders.
The wait is over!
Type 2 diabetes remains a global epidemic. According to a 2017 CDC report, over 100 million Americans have prediabetes or diabetes. Diabetes was the number seven leading cause of death in 2015. The World Health Organization (WHO) published a report showing a quadrupling of the prevalence of diabetes since 1980 worldwide. According to the CDC, 1 in 4 with diabetes do not know they have the disease. Diabetes creates a significant burden on morbidity and mortality and per the ADA, came at a cost of $327 billion in 2017 in the U.S. alone. The ADA app had not been updated since the release of the 2014 standards. In June, the app was updated to the 2018 ADA Standards of Care and completely redesigned — finally. The latest version of the app includes detailed information on diagnosing and treating diabetes, lifestyle and nutrition recommendations, and specific guidelines from lipid management to retinopathy treatment.
ADA Standards of Care is well-referenced and provides content any medical student or seasoned attending could benefit from having available at the tips of their fingers. The app contains hyperlinks to references, comprehensive PDFs, and links to online ADA articles.
Teaches the Epley maneuver for vertigo on your smart device
“I’m dizzy, doctor!” Those were the words of a patient I saw in clinic recently. Upon further questioning, it was clear this patient had vertigo. The question was what type? Luckily, a good patient history and physical exam can both make a solid diagnosis and in some cases, treat the patient. Primary care providers must know how to properly perform the Dix-Hallpike maneuver to help make a diagnosis of vertigo, especially the most common form, benign paroxysmal positional vertigo (BPPV). Luckily, the vast majority of vertigo cases seen in primary care are due to BPPV, and this very disturbing condition (for the patient) can be effectively treated in nearly 90% of the cases by proper performance of the Epley maneuver.
An enterprising ENT physician and inventor in Canada created a unique solution to BPPV. He created an app called DizzyFix for providers to teach proper diagnosis and treatment of BPPV using the Dix-Hallpike and Epley maneuvers, and the DizzyFix device that patients can place on any “ball cap” to guide them through the Epley Maneuver at home.
Ensures your patients receive the correct pneumococcal vaccines at the right time in the right sequence
One of the most common tasks during clinic is to ensure my patients are up to date on their vaccinations. In 2015, the CDC/FDA/Advisory Committee on Immunization Practices (ACIP) introduced the new pneumococcal conjugate 13 valent vaccine (PCV13) for use in adults in addition to the pneumococcal polysaccharide 23 valent vaccine (PPSV23). For many of our clinic’s nursing staff, residents, and faculty, the transition caused some confusion. The guidelines have been revised slightly since then with the most current pneumococcal vaccine guidelines published in November 2018. Despite updates to existing “shots” apps such as Shots by STFM, CDV Vaccines, and ACP Immunization Advisor, the process can still be challenging to explain to patients and ensure immunizations are given at the right time and in the proper sequence.
Recently, the CDC entered the pneumococcal vaccines fray with their own app to help providers — CDC PneumoRecs. This app covers both infant/child as well as adult pneumococcal vaccines. The app uses a patient’s date of birth (DOB) to calculate which vaccines the patient requires, when, and in what sequence based on age and risk factors.
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