Medical Apps for Physicians

The CDC, ACC and University of Toronto help physicians motivate patients, make better decisions and refresh their techniques.

By Iltifat Husain, M.D. | Fall 2017 | Tech Notes


In this edition of Tech Notes, we’ll cover a medical app from the Centers for Disease Control and Prevention (CDC) essential for the current opioid epidemic, an app from the American College of Cardiology, and an app that helps providers do quick and minor procedures at a patient’s bedside.

CDC Opioid Guideline: Motivating behavior change

CPC Opioid Guideline

Price: Free Apple: Android:

Every health care provider is currently aware of the opioid epidemic that is gripping our nation. Many of us see this on a daily basis with patients who come in for overdoses. It has become common to administer naloxone to patients who come into the emergency room with decreased mental status. Per the CDC, overdose deaths involving opioids, including prescription opioids, have quadrupled since 1999.

To help physicians manage this crisis, the CDC released the “CDC Guideline for Prescribing Opioids for Chronic Pain” in 2016. These guidelines were meant to help physicians treat chronic pain in patients who are outside of active cancer therapy, palliative care and end-of-life care. The guidelines address when to initiate opioid therapy, the types of opioids to choose, and how to assess the risks and harms of prescribing opioids.

At the end of 2016, the CDC released a medical app dubbed CDC Opioid Guideline, an app that condensed the recommendations the CDC had made earlier in the year pertaining to chronic opioid management. The app itself offers some great features. One of the favorites is the morphine equivalency calculator and a subsection that explains how to perform motivational interviewing with chronic pain patients.

I can’t overemphasize the importance of the app’s motivational interviewing section. It gives physicians the opportunity to use evidence-based techniques for behavior change. The techniques have been proven to reduce the risk of opioid misuse, increase patient motivation to change, and decrease depression in the setting of opioid use.

This app is a must-have for primary care physicians and other physicians who prescribe opioid therapy on a daily basis.

Key ways to use this app: If a patient presents with chronic pain, use the app to determine if their medication dosing should be changed, or if they are at risk for opioid addiction. Use the morphine equivalency calculator to determine conversions for opioid therapy. Use the motivational interviewing section with patients. It’s a patient-centered approach to causing behavior to change.

DAPT Risk Calculator: Help deciding on treatment

DAPT Risk Calculator

Price: Free Apple: Android:

The American College of Cardiology (ACC) is one of the most active medical societies in the mobile space. The DAPT Risk Calculator is one of their latest medical apps and continues the association’s trend of producing useful and free medical apps.

Duration of Dual Antiplatelet Therapy (DAPT) is a big deal for patients who undergo cardiac catheterization procedures. While the length of DAPT after bare metal stents and drug eluting stents is well established, guidelines aren’t as clear on what to do after 12 months.

Serious harm can arise from continuing antiplatelet therapy, such as gastrointestinal bleeds. The DAPT score, developed from the DAPT study randomized trial data, helps physicians determine whether or not anticoagulation therapy should be continued based on a patient’s comorbidities and stenting characteristics.

Though there are online calculators for this, having it available at the point of care provides ease of use and helps you go over the score with the patient as well.

Key ways to use this app: This app helps family physicians and cardiologists decide whether or not to continue antiplatelet therapy after 12 months.

Proceducate: Refresh your skills


Price: Free Apple: Android:

Having a medical app that helps with you with both learning and refreshing your medical procedure skill set can be very useful. Proceducate is a medical app that fills this role. The app is focused on procedures encountered in the primary care setting and would also be useful for urgent care providers and emergency medicine physicians.

The great thing with the videos and explanations is how abbreviated they are, enabling them to be used at the point of care to refresh on anatomy or key parts of the procedure. The app is part of a research study at the University of Toronto that is looking at how to best integrate mobile applications in learning and teaching.

Proceducate isn’t a great app to use if you’re just learning a procedure; for that, you need formal training and to see several being done. But it’s a great tool to use if you have already learned a procedure and want to reinforce and learn some of the finer points, or if you need to refresh your memory on a key part. The following are key procedures discussed within the app: suturing, cryotherapy, biopsies, toenail management, aspiration/injections, IUD insertion, speculum exam and perineal laceration repair.

For almost every procedure, there is a short video along with the following information: indications, risks, equipment needed, detailed review of the procedure and various steps, complications, and references to where the procedure steps were sourced.

Key ways to use this app: There is often not just one way you can do a procedure. Use this app to learn a variation on a technique or to refresh your memory of any key part.

Iltifat Husain, M.D., is editor-in-chief and founder of, the leading physician publication on digital medicine. He’s also assistant professor of emergency medicine and director of medical app curriculum at Wake Forest School of Medicine.



Fractures, Fevers, and Helping Patients Understand Your Choices

Summer 2017 | Tech Notes


In this edition of Tech Notes, we’ll cover three useful medical apps for daily practice: two for physicians, and one to share with your patients.

OrthoFlow: Fracture management


Price: $4.99 Apple; $5.99 Android. Apple: Android:

OrthoFlow is almost like having an orthopedic surgeon in your pocket. It’s especially helpful in primary care, urgent care and emergency room settings, where a lot of basic fracture management occurs.

OrthoFlow’s introductory screen shows a full human skeleton. Simply tap until you localize the affected bone. Once you’re done with this quick process, the app asks questions about displacement, neurovascular function and more. Then it provides specific recommendations, such as which type of splint to use and what key details to discuss with your orthopedic surgeon.

Key ways to use this app. If you are a primary care, urgent care or emergency medicine provider and your patient’s X-rays show a fracture, this app will help you determine fracture management. If you are an orthopedic surgeon, the app’s appendix will provide you with detailed information on necessary surgeries and items to discuss in morning fracture rounds.

Step-by-Step Febrile Infant: Validated Step-by-Step Approach

Febrile Infant

Free. Apple:

Step-by-Step Febrile Infant is yet another helpful app from Dr. Joshua Steinberg. Steinberg has created more than 15 medical apps, and this one is a great example of turning validated research into an easy-to-use app.

The app is based on the Step-by-Step Approach, a clinical evaluation protocol that helps physicians decide on care for febrile infants.

A validation of the Step-by-Step Approach was published in Pediatrics in July 2016. The app not only recreates the study’s findings and suggestions but also offers several sections that explain the study further.

A word of caution: Since the Step-by-Step Approach is a deviation from traditional practice and management of a febrile infant, make sure you understand your local practice and standard of care before using the app.

Key ways to use this app. If you are an emergency physician or pediatrician who cares for febrile infants, this app can help you understand the validated Step-by-Step Approach. If the Step-by-Step Approach has become the standard of care in your area, this app can help suggest management of care.

Making Healthy Choices: Explaining treatment decisions

Health Choices

Price: Free. Apple:

When patients come in with very specific expectations for care, it can be difficult to convince them that a particular test or a round of antibiotics is unnecessary. That’s where the Making Healthy Choices app comes in.

In the app, patients can drill down to specific procedures, tests and medicines to learn more about the indications for each of these. This helps them understand why you are—or are not—recommending a certain course of action.

One of my favorite features is the “Questions to Ask” section, which gives patients important questions to ask when a physician recommends a procedure.

Key ways to use this app. If a patient or a family member doesn’t understand your recommendations, encourage him or her to download the app and read about a particular procedure, test or medicine.

Iltifat Husain, M.D., is the editor in chief and founder of, the leading physician publication on digital medicine. He is also an assistant professor of emergency medicine at Wake Forest University School of Medicine.



Evidence-based apps take on gout, drug dependence and smoking

These three apps help physicians diagnosis gout, employ the SBIRT method and give patients the tools they need to quit smoking.

By Iltifat Husain, M.D. | Spring 2017 | Tech Notes


In this edition of Tech Notes, we’ll cover three great evidence-based apps: one for determining whether a patient is suffering from a gout flare or something more serious, one for screening for substance abuse, and one that may help your patients quit smoking. All three apps are free to download.

Gout Diagnosis

Gout Diagnosis

Price: Free iTunes: Android: Not available

When a patient presents with joint pain, there is always the concern that an acute infection is the cause of the pain. Often a physician will perform a joint fluid analysis by doing an arthrocentesis of the joint—a procedure that can be very painful—even though he or she suspects gout is the etiology of the symptoms. The Gout Diagnosis medical app utilizes evidence-based algorithms that are straight from the literature to help physicians determine without a joint fluid analysis whether gouty arthritis is the source of a patient’s pain.

This medical app is based off research by Hein Janssens, M.D., and Jaap Fransen, Ph.D., et al. (Their original paper is called “A Diagnostic Rule for Acute Gouty Arthritis in the Primary Care Without Joint Fluid Analysis.”) With the permission of the authors of the original study, Joshua Steinberg, M.D., a prolific physician app developer, turned their decision algorithm (which has been validated in the literature and is widely used) into a point-of-care medical app.

The Gout Diagnosis medical app is very easy to use at a patient’s bedside. It offers you seven Yes or No fields, six of which can be answered just by talking to the patient. The decision algorithm then gives you a score along with recommendations about whether or not a joint aspiration may be necessary.

The app is free and easy to use. Unfortunately, it is not available for the Android platform right now. (In the past I’ve asked Steinberg and other medical app developers why they often don’t create analogous Android versions, and they’ve said they see tremendously fewer downloads on Android than iOS.)

Key ways to use this app. Use the app to determine if a gouty flare is causing joint pain or if an arthrocentesis should be performed. You can also use it to learn more about the original research by Janssens and colleagues and how it can be applied in clinical practice.



Price: Free iTunes: Android: Not available

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based method to help identify and reduce dependence on alcohol and illicit drugs. Given the current opioid crisis, this methodology has been gaining huge traction in the clinical arena.

Though specific SBIRT training is available, it would be difficult to learn the method simply through reading about it. The SBIRT app, however, provides a great means for learning how to use the method.

Created in partnership with the University of California San Francisco (UCSF) and the Substance Abuse and Mental Health Services Administration (SAMHSA), the app not only takes you through the steps of SBIRT but also provides the evidence behind the methodology and offers informative content (such as in the Epidemiology section) to foster an understanding of the opioid crisis and other substance abuse problems plaguing the general patient population.

One of the coolest features of the app is the video modules included. These video modules (found in the Key Resources section) show you examples of SBIRT evaluations and help you understand how to use the approach with your patients.

Because the app has screening sections built in, it can be used at the point of care with patients, so even if you don’t have extensive training with the SBIRT process, you can use the app at a patient’s bedside. It even gives you scripts to help you ask key questions of your patients.

The medical app also has questions at the end of the app that allow you to track your progress with SBIRT. You are able to denote your comfort level with the process and do self checks to see if you are mastering the technique.

Key ways to use this app. You can use this app to learn the SBIRT methodology, to go through the SBIRT process at a patient’s bedside and to learn more about substance abuse and how it’s affecting your patient population.



Price: Free iTunes: Android:

Apps to help patients quit smoking have been around since the launch of the smart phone. Not all are created equal, however, and not all use evidence-based techniques in their processes.

QuitGuide is a free smoking cessation app launched by the National Cancer Institute. It’s great to see a medical app from such a reputable source, and unlike several of the currently popular smoking cessation apps in the App Store, this one follows the practice recommendations for smoking cessation from the Tobacco Control Research Branch. Though the app has been around for a while, there have been many iterations over the years that continue to improve its overall functionality.

Some of the key highlights of QuitGuide are its ability to integrate social networks (such as Facebook) into the decision to quit smoking. Users can even post custom messages about why they want to quit smoking. The app also has a personal, customized touch to help patients with smoking cessation.

Key ways to use this app. This app is a great resource for educating patients on why they should quit smoking. If patients are ready to quit smoking, consider prescribing this app to them.



Decision tools and medical calculators to use at the point of care

These three apps help you make informed decisions about imaging, diagnoses, treatment and more.

By Iltifat Husain, M.D. | Fall 2016 | Tech Notes


In this edition of Tech Notes, we’ll cover three great medical apps that can make you into a more efficient physician: MDCalc, Ottawa Rules and SmartIntern Sepsis. Each of these apps is focused on helping health care providers practice evidence-based medicine. In addition to providing a wealth of information, these apps can be used quickly at the point of care. All of these apps are also free to download and use.

MDCalc: Medical Calculators, Scores, and Clinical Decision Support


Price: Free. App Store Link: Android Link: Currently not available

It’s hard to find a practicing physician who hasn’t been to The popular physician-run website is a go-to for finding medical calculators and clinical decision tools. Thanks to a recent release, the website is now available as an app, also called MDCalc.

This app is now a must-have for any physician; it provides access to nearly every type of medical calculator or decision tool. Although popular clinical decision apps such as Medscape, UpToDate and DynaMed also have their own calculators, MDCalc makes the process much easier because it lets you enter data into decision tools with just one click.

What further separates MDCalc from other medical calculator apps is the amount of evidence-based medicine it teaches. Every clinical decision tool within the app has a section dedicated to the evidence behind the actual equation. Some clinical decision calculators within the app—such as Wells’ Criteria—even have direct quotes from the tool’s creators.

The app is currently free, but in the past the developers have mentioned in its App Store description that they may charge for it in the future.

Ways the app could improve. Unfortunately this app is currently unavailable on Android.

Key ways to use the app. You will no longer need to search for decision tools on Google or on the actual website. The app loads quickly, and you can use its search function to find the clinical decision tool or medical calculator you want. I would also recommend using this app to learn more about clinical decision tools. If you’re a physician new to the iPhone, this is definitely the most important medical app to download.

Ottawa Rules

Ottowa Rules

Price: Free. App Store Link: Android Link:

In medical school every physician gets taught the decision tools related to the Ottawa rules, which include C-spine, knee and ankle rules. Instead of having to look up these clinical decision tools online, you can now access the Ottawa rules from this free app provided by the Ottawa Hospital Research Institute itself.

Though the app can be used simply to access the tools, it’s much more than that. The app also has videos and commentary that provide a wealth of information about the rules. The videos in particular are a great touch because they explain in great detail the nuances behind the rules.

Ways the app could improve. Overall the app is slick, but it would be helpful if it gave you access to the criteria more quickly. Right now it’s faster to use the MDCalc app or another medical calculator’s decision tools at the point of care. The Ottawa Rules app does, however, contain a wealth of valuable information that still makes it a critical download for those who use these tools.

Key way to use the app. At this time the best way to use this app is for educational purposes. The app is free to download. There are some great figures and algorithms included, and the videos, though not flashy, provide contain great content.

SmartIntern Sepsis

SmartIntern Sepsis

Price: Free. App Store Link: Android Link: Not available.

Earlier this year a consensus group published changes to the definition of sepsis in the Journal of the American Medical Association (JAMA), calling for a move away from systemic inflammatory response syndrome criteria in favor of the sequential organ failure assessment score. Also known as “Sepsis 3.0,” this is the first set of new guidelines since 2003.

The SmartIntern Sepsis app takes the new sepsis guidelines and puts them into easily understandable formats. It also has built-in calculators. In addition, the app has educational aspects to it, helping health care providers better understand the new guidelines. There is some controversy surrounding the Sepsis 3.0 guidelines, so it would be prudent for health care providers to read the JAMA study in detail.

Ways the app could improve. Though this app isn’t as popular as MDCalc, it, too, is not available for Android devices.

Key ways to use the app. If you are trying to implement the new Sepsis 3.0 guidelines, this app will help you calculate scores and learn the new algorithms. This app is focused on emergency medicine physicians, critical care physicians and hospitalists.

Iltifat Husain, M.D., is the editor-in-chief and founder of, the leading physician publication on digital medicine, and an assistant professor of emergency medicine at Wake Forest University School of Medicine.



Two of the best medical apps of 2016 (and one just for fun)

This issue’s app reviews include a prescription saver, a daily aspirin decision tool and a vein seeker not yet ready for clinical use.

By Iltifat Husain, M.D., founder of | Tech Notes | Winter 2017


In this edition of Tech Notes, we’ll cover GoodRx’s new app for physicians; a critical app for primary care physicians related to daily aspirin use; and an app that helps you see veins using just your iPhone’s camera. Each of these medical apps is free to download and easy to use.

Aspirin Guide Simplifies the aspirin decision-making process

Aspirin Guide

Price: Free iTunes: Android:

For any physician or provider who has to determine whether or not to start a patient on daily aspirin for primary prevention of cardiovascular disease, Aspirin Guide is the most important app you will use.

It’s one of the best medical apps released in 2016 and is a must-have for primary care physicians and cardiologists. It’s from researchers at Harvard Medical School and helps health providers decide which patients are candidates for the use of low-dose aspirin.

The decision to start patients on aspirin is much easier for secondary prevention of cardiovascular disease; it gets complicated when it comes to primary prevention due to the consequences that can arise, such as serious bleeding events.

The U.S. Preventive Services Task Force (USPSTF) gives various grades of recommendation for use of aspirin in primary prevention for cardiovascular disease and colorectal cancer. The determination isn’t based just on age, but also various medical calculators the USPSTF wants providers to use.

Aspirin Guide simplifies the decision-making process. The app can be used at the point of care with patients. It does all the backend work of calculating risk scores based on your various inputs. Aspirin Guide also can email the results to your patients so that they can see why there was a decision to start on daily aspirin or not.

The app is available for iPhones and Android and is available as a web app as well.

Key ways to use this app. Use this app to determine if your patients should be on daily aspirin use for primary prevention of atherosclerotic cardiovascular disease (ASCVD). Use it to calculate 10-year cardiovascular disease risk score, and use it to email a summary of the decision-making process.

GoodRx For Doctors Helps your patients save money on prescriptions


Price: Free iTunes: Android:

GoodRx has been one of the most downloaded medical apps in the App Store for the last few years. It provides coupons for prescription medications and can help patients save money on prescription drugs.

Patients or physicians are able to input a particular drug and dosing and then get a list of pharmacies that offer the lowest price.

GoodRx is particularly useful for patients who do not have insurance, but it can also help those who have insurance save on prescription drugs.

For example, clindamycin can cost my patients paying out of pocket more than $60, but using GoodRx, I can get them the prescription for less than $15.

GoodRx partners with a pharmacy benefit manger (PBM) in order to get lower prices of prescription medications. PBMs are able to negotiate discounts with pharmacies, and they earn a transaction fee for sending customers to a pharmacy.

GoodRx recently released a physician-centric version of their app, GoodRx For Doctors. The app makes GoodRx much easier to use with patients. In the past, I would have had to use GoodRx on a desktop, search for a drug, and print out the coupon for my patient. With GoodRx For Doctors, I’m able to save my favorite prescriptions more easily, and I can easily send my patients a text or email of the coupon right from my phone. When the patient gets the coupon via text on their phone or in their email, it doesn’t convey my personal information.

Key ways to use this app. Use this app if you have patients without insurance or the drug isn’t on the $4 Walmart list. It’s best for patients who have smartphones (otherwise, just print the actual coupon for your patient in clinic). Use this app to look up information on the drug prescribing; there is a decent drug monograph available.

VeinSeek Identifies vein location with an iPhone

Vein Seek

Price: Free iTunes: Android: Not available

Unlike the other two serious apps mentioned for clinicians, VeinSeek is a fun app that only health professionals will get a kick out of. It’s important to note this app should not be used for medical purposes or on any patients.

VeinSeek is a live video processing app that uses your iPhone’s camera and layers of algorithms to show veins on your arm. “Vein seeking” devices have been around for awhile—they use infrared light to show veins. But VeinSeek doesn’t require any add-ons or attachments; it simply uses algorithms to help distinguish veins.

This app is nowhere near ready for primetime, but it shows the power of what a smartphone camera can do when connected to smart software.

Key ways to use this app. As mentioned, you definitely can’t use this app for any type of patient care or any type of medical treatment. But it’s a good proof of concept and an example of how live video processing apps have potential to be used in the medical setting in the future.

Iltifat Husain, M.D., is the editor in chief and founder of, the leading physician publication on digital medicine, and an assistant professor of emergency medicine at Wake Forest University School of Medicine.



Medical apps for STDs, statins and cancer-screening

These three medical apps help physicians treat STDs, reveal the costs and benefits of screening for cancer and recommend statins based on patient particulars.

By Iltifat Husain, M.D. | Summer 2016 | Tech Notes


This issue’s apps include a great statin management app from the American College of Cardiology, an STD treatment app from the Centers for Disease Control and Prevention, and an evidence-based cancer-screening app. In addition to helping physicians make the best treatment decisions for their patients, all three of these apps are free to download and use.

STD Treatment Tx Guide by the CDC

The CDC isn’t new to the App Store—their STD Tx Guide app has been in the store since 2013. Whereas previous iterations of STD Tx Guide were OK, their most recent version of the app is a must-have for physicians. This version, released in January 2016, contains the most recent updates to treatment algorithms for sexually transmitted diseases.

In addition, the app itself now has key functions that were not present prior. When you open the app, you can go through the conditions immediately. Not only are sexually transmitted diseases listed, but so are other conditions such as sexual assault.

STD Treatment app

Price: Free. App Store: Android:

My favorite feature of the updated app is that the information is now native to the app. Previously, all the information for treatments and conditions had to be accessed online through the app, but now, almost all the information is native. This means you can use the app even when you don’t have an internet connection, and it loads significantly faster than before.

Ways the app could improve. A more thorough “More Info” section for each of the conditions would improve this app. Currently this section has short paragraphs and great references, but more details about diagnosing, managing and caring for conditions would be welcome.

The “Sexual History” section could also be improved if it lost its PDF feel and were instead optimized for mobile devices.

Key ways to use this app. Use this app if you need the latest information on the medication regimen for an STD, if you have a pregnant patient and need to figure out what medication would be OK during pregnancy, or if you have a patient who is allergic to penicillin and needs an alternative treatment regimen.

ePrognosis: Cancer Screening

ePrognosis is a decision support app created by the authors of the popular GeriPal blog in collaboration with health experts at the University of California, San Francisco and Harvard Medical School. This cancer-screening app focuses on colorectal and breast cancer screening for geriatric patients.

One of the key tenets of the app is the understanding that screening and testing can lead to harm. The authors list, for example, some potential harms of colorectal cancer screening, such as severe abdominal pain and the need for hospitalization. These potential harms have been well documented in medical literature, so one goal of the app is to help physicians and patients determine whether screening would benefit them or cause more harm than good.

ePronosis app

Price: Free. App Store: Android: Currently not available

ePrognosis lets you choose colorectal or breast cancer screening or both and then presents you with a standard set of questions. These questions take approximately two to three minutes to fill out. It would be much quicker to flip through the questions while you’re with the patient. For example, one question asks whether the patient has difficulty walking a quarter mile without help from other individuals or special equipment.

Once you go through all of the prompts and questions, you are presented with a meter that ranges from “Harms” to “Benefits.” The meter’s arrow shows to what extent the decision tools within the app recommend screening for that particular patient. My favorite part of the app is the “Learn More” section. In this section you are able to tell your patient their chance of harm if the path of screening or testing is chosen. ePrognosis presents this in an easy-to-explain format with a graph that shows 1,000 units (to represent patients) and highlights how many of those units would experience harm in the first year due to testing. It’s a great graphical representation that makes sense for patients.

Ways the app could improve. It would be great if more data about the decision tools ePrognosis uses were presented in the app. You are able to access information about the decision tools used in the “Information” section, but the “Calculations” section isn’t very detailed and can be difficult to go through. Additionally, there is currently not an Android version.

Key way to use this app. Use this app with elderly patients for whom you are considering colorectal or breast cancer screening. Discuss the results with your patients and show them the graph in the “Learn More” section to help them see how many individuals would be benefitted versus harmed by testing based on their individual variables.

Statin Intolerance by American College of Cardiology

The American College of Cardiology has a great number of medical apps in the App Store. One of my favorites is Statin Intolerance.

This app is useful because the fact that a patient reports muscle aches does not necessarily mean he or she is truly intolerant to statins. If a patient has side effects to the first statin prescribed, cardiologists will often try utilizing other types of statins. Statin Intolerance helps you determine which would be best.

Statin Intolerance app

Price: Free. App Store: Android:

The app has three basic sections: Evaluate, Follow-Up and Compare. The “Evaluate” section is the most comprehensive; this is where you input risk factors, medications, patient demographics and symptoms. This section takes a few minutes to complete and is pretty detailed. In the “Follow-Up” section, you are presented with more specific advice such as titration of meds and other types of statins to use. In the “Compare” section, you can learn significantly more details about statins, such as their half-lives and whether they are lipophilic or not.

Ways the app could improve. The “Evaluate” section could be designed significantly better. Overall this section feels cumbersome to use.

Key way to use the app. If you have a patient who is having side effects to the first statin prescribed, you should consider using this app.

Iltifat Husain, M.D., is the editor-in-chief and founder of, the leading physician publication on digital medicine, and an assistant professor of emergency medicine at Wake Forest University School of Medicine.



Achieving automation through apps

These medical apps support surgeries, reschedule no-shows and ping physician networks for referrals and consultations.

By David Geer | Tech Notes | Winter 2016


As with any other busy professional, physicians are always searching for ways to offload and automate tasks that are not their core business—caring for people.

This issue’s apps, together with input from end-user physicians, merit your consideration.

Product in Action Dashboard

The Luma Health web-based app and service is available at Cost is $250 per provider, per month. A free two-month trial available.

Luma Health fills canceled appointments through patient texts

The Luma Health solution is about as significant as the challenges that it solves. Appointment cancellations and no-shows lead to make-shift approaches to scheduling and rescheduling patients: paper lists, Post-It Notes and Word documents. Not to mention the hours staff members spend calling patients to finalize appointments. This process scales poorly at best. And the larger the practice, the more the chaos.

“Luma Health enables practices to automate appointment workflows and reduce appointment cancellations. It automatically identifies appointment cancellations—filling those slots from a wait list, no phone calls required. The app reschedules canceling patients as well,” says Tashfeen Ekram, M.D., cofounder of Luma Health.

The Luma Health app and service uses secure SMS messages that meet HIPAA requirements. “Our first point of contact reminds patients about their appointment, providing additional pertinent information such as co-pays and pre-appointment instructions,” says Ekram. The SMS message prompts the patient to confirm or cancel. The app pulls the real-time message data from the patient and records it for medical staff to access in a centralized dashboard.

Shahriar Heidary, M.D., is a non-invasive cardiologist in San Jose, California, whose practice is part of the South Bay Cardiovascular Medical Group. Heidary was looking for an easier way to fill canceled appointments for office visits and tests when he found Luma Health.


The web-based OR TRAX platform is accessible from any Internet-capable devide. Apps are also available through the Apple App Store and Google Play. Free to physicians whose facility uses the OR TRAX service.

“I enjoy the fact that it is automated, saving time,” he says. “Multiple users can use it. Patients like the app’s streamlined approach. Receiving a text is easier, and the app can send texts in multiple languages.”

It’s also mobile-enabled. “I am able to use it from my iPhone and my Windows PC,” says Heidary.

For future versions of Luma Health, Heidary would like to see expanded text-based communications that include reminders about a patient’s required exercise time, medication regimens and billing payments.

OR TRAX sends surgical schedules to support the operating room

OR TRAX is an electronic medical standard database that enables providers to send surgical schedules to surgeons and medical device vendor representatives who supply products such as implants, instrumentation and support to the operating room.

“The app is free of any PHI (Protected Health Information) and is only accessible to vendors who are credentialed at the given facility,” says Abram Liverio, COO of OR TRAX.

OR TRAX’s database returns time to health care professionals, strengthens HIPAA compliance, and reduces OR expenses that would result from vendor tardiness. It’s unique in that it transmits this information in real time, notifying surgeons and vendors automatically of case time changes, cancellations and reschedules.

Ira Guttentag, M.D., FACS, is the head team physician and medical director for the Tampa Bay Lightning hockey team. He was looking for a technical solution to keep him abreast of what surgeries he is performing, when and where they will take place and any changes to the cases.

“Prior to adopting OR TRAX, my office staff or PA would coordinate between the surgery centers, the vendor representatives and the hospital staff to set up and change appointments and case times. Then they would relay the information to me,” says Guttentag. OR TRAX automatically notifies Guttentag of changes to procedures and guarantees that the proper vendor representatives, trays and implants will be available at each case time. “I just wait for the notifiers to come in on my updated cases screen,” he says.

Guttentag’s favorite features on the app include the ability to check case times, locations and particulars anytime, with live updates.


PingMD for the web, Android, and iOS comes in four versions, from basic for secure messages to a version with eVisit, concierge and virtual care abilities and services.

Pingmd builds professional networks for referrals and consults

Kenneth E. Grant, M.D., head of gastroenterology at CHOC Hospital in Orange, California, was used to texting, paging and calling his fellow physicians to make referrals, and was interested in a tool to ease the process.

Then he found pingmd, which secures transmissions of unstructured data—such as messaging content, still images, videos, PDFs and synchronous video chat—in a HIPAA-compliant manner.

“The app enables practitioners and health care providers to build their professional networks to manage care transitions, referrals and consults efficiently,” says pingmd CEO and cofounder Gopal Chopra, M.D. “It enables patient engagement to manage patient queries, surveys and care management for primary, specialty and chronic care.”

Grant uses the app every day in support of consults and reports enhanced productivity when working on complex decisions that require group interactions in real time.

“Now I benefit from efficient referrals from my external primary care network and the availability of better and more secure communications with my colleagues and care teams,” he says.

His favorite features of the app include the video chats, VoIP, networking, referrals and its ease-of-use when compared with other solutions.



Mobile medical apps ease communication among physicians, nurses and patients

It all adds up to better patient care experiences.

By David Geer | Fall 2015 | Tech Notes


As we approach year 2020, 5G wireless communications will come into use, according to the Next Generation Mobile Networks Alliance. That’s when multimedia and communication applications in medicine will grow to include ubiquitous 3-D medical imaging and high-quality video calls and conferences anytime, anywhere.

While we wait for 5G, mobile apps available today include drawMD for sketching out the body with drawings and overlays of medical conditions for patient education. This app should see broad exposure thanks to its recent retooling that enables physicians to use its templates and resources across many specialties.

The eAttending app enables the physician to be in many places at once virtually—at least where verbal orders are concerned. Errant transposition of prescription spellings due to unclear voice communication should be a thing of the past.

The Medicode app pushes medical algorithms further from printed paper resources, helping to save more patients (and trees). If you never forget your phone, you’ll never be without a backup in the form of Medicode’s algorithmic life support data.

drawMD illustrates what the doctor needs to say

DrawMD urology

The drawMD app helps physicians illustrate conditions to patients.

DrawMD from Visible Health is an iPad app that enables physicians to illustrate health information by drawing when consulting with patients. “There are more versions of drawMD in the works and plans for up to an infinite number of additional apps down the road,” says John K. Cox, President of Visible Health, Inc., in Austin.

The app helps a physician educate patients about their conditions and the procedures they are about to undergo. “The drawMD app makes medical concepts understandable as the physician selects a template with a background image, such as a prostate,” says Cox.

Physicians use their fingers to draw on the template and map out conditions such as a prostate tumor, its orientation, and how to treat it.

The physician can also add the drawing and any subsequent drawings to the patient’s medical record or email it to other physicians.

Eli Sprecher, M.D., is a general pediatric fellow at Harvard’s Boston Children’s Hospital, where he serves a 15,000-patient hospital-affiliated pediatric practice that is largely comprised of complex pediatric cases. Sprecher was looking for a way to better explain his patients’ conditions and needs to both them and to their parents. “While I was still a resident, asthma was a big issue as a chronic disease in children,” says Sprecher. A visual aid would help to illustrate the difference between kids who have their asthma under control and kids who don’t have asthma.

Using the pediatric version of drawMD, Sprecher educates patients, explaining their conditions so they can understand their health. “I also use it to explain pathophysiology from lab findings, to explain the medical history, and to guide parents in what to look out for,” he says.

Sprecher’s favorite features in the app include the quality of the ability to annotate and draw on the templates. “Kids love to draw on it. It also helps me to customize and emphasize medical information,” Sprecher says. A physician can draw attention to a certain area of concern in a template, call out certain aspects through illustration, and generally make the discussion more effective through imagery.

Sprecher says that Visible Health has been very open to suggestions. He is looking forward to the additional medical conditions that drawMD will eventually include. “I would like to see the ability to pull background images from one app to the next,” he says. “It would be nice to add animation and video with more dynamics, to illustrate joints in motion, for example.”

If all goes as planned, Visible Health will have provided a major release overhauling the drawMD app as of early September 2015. “We are releasing a unified drawMD application (today there are many of them, each specialty-specific) in which users are able to configure content from across our library to meet their needs. The initial launch will be available for both iOS and Android in both phone and tablet form factors,” says Cox. This release should address much of Sprecher’s wish list.

Medicode keeps algorithms handy


Medicode is available free in the Apple App Store.

This app for the iPhone and iPad is a life support reference tool that presents information as an overview of an entire algorithm or as a step-by-step walk through in using the algorithm in an emergency, says Karl Disque, D.O., cofounder of National Health Care Provider Solutions (NHCPS) in Henderson, Nevada. “Physicians use it to eliminate carrying books and cards in pockets so they can instead keep the latest algorithms for BLS, ACLS and PALS on their smartphones or tablets,” says Disque.

Anesthesiologist Baroukh Levi, M.D., works at the West Suburban Medical Center in Oak Park, Illinois. “Though I use algorithms for life support protocols frequently, it is good to have a reference to refer to,” says Levi.

Levi has memorized the necessary algorithm information he needs in his work. “There are also pocket references and cards available with this information—they are just never handy when you need them as they are easy to lose or damage,” says Levi. “But I always have my phone with me, and it keeps a wealth of information available at the tap of my finger.”

Levi likes the ease of use of the Medicode app as well as its simplicity. “It presents the most important information quickly,” he says.

eAttending rescues verbal orders from the clutches of communication errors

EAttending iPhone

The eAttending mobile app is available for $24.99 at the Apple App Store. The first 10 faxes are free.

This app for the iPhone, iPad and iPod Touch replaces verbal orders, enabling a physician to send signed written orders via fax to any nurse’s station equipped with a fax machine, says Larry A. Wolk, M.D., the app’s creator. “There has been a need for this app since the inception of phone orders to take the burden off the nurse to get the verbal order that they take down as a written order correct,” says Wolk.

“An eAttending fax-based written order has the same accuracy and authority as a signed, written order given by the doctor in person,” says Wolk. The app enables the physician to record and send prescription names accurately so there’s no miscommunication. The app is also useful when faxing pharmacies directly.

A physician can add medications and dosages to communicate via the app using its internal drop down menu, by copying and pasting the data in, or by typing the information into the app. The physician then selects the nurse’s station and fax number from among those previously recorded in the app for repeated use.

Miles C. Ladenheim, M.D., is a psychiatrist based in Wynnewood, Pennsylvania, who practices in the Philadelphia area. Ladenheim found verbal orders to be challenging. “Medicine is rapid. You can’t ask a nurse to wait until the doctor gets back to the floor to prescribe medication. If the patient’s condition changes, a medication change is needed as soon as possible,” Ladenheim says.

At this point, traditionally the nurse would call the physician and discuss the patient’s condition, and the physician would give a verbal order for a different medication, Ladenheim says. “The doctor must sign such an order in person in 24 hours. This is OK if the doctor will be in the hospital the next day,” he says.

eAttending enables the physician to give a signed remote order that produces a written document at the nurse’s station via fax, meeting regulations without further signing and without miscommunication.

Ladenheim’s favorite features include the ability to record frequently used medication and fax information in the app so he can select it rather than type it out again and again. “It saves me a few seconds each time, avoids errors, and I also don’t particularly like the iPhone keyboard especially well,” Ladenheim says.



Data on the go

Medical apps that support remote electronic consultations and provide multimedia anatomical navigation give physicians more options then ever.

Summer 2015 | Tech Notes


Medical technology includes tools that extend a physician’s access to information and help them magnify and clarify the precise physical need of patients. These medical apps enable remote consultations and map the human body.

CodeHeart: Cardiac consultations at the click of an app

The free CodeHeart app from Vidyo for mobile Apple and Android devices is available via an encrypted link. For more information, visit or contact Eileen.M.Searson@MedStar.Net.

4 Satler w technology 2010 467

Lowell Satler, M.D., is developer of the CodeHeart app, which compresses the time for cardiac consultations.

Using any device with wireless access and a camera, a referring physician can contact an interventional cardiologist at MedStar Heart & Vascular Institute—the busiest and largest private, not-for-profit hospital in the nation’s capital—for a consultation complete with ECG images, says Lowell Satler, M.D., medical director of the Cardiac Cath Lab with MedStar Heart & Vascular Institute.

When an ER physician orders an ECG for a presenting patient, they must evaluate it and follow with a treatment plan. For a second opinion, they would previously have had to fax the ECG to a tertiary care facility, such as the MedStar Washington Hospital Center, and place a voice call for the consultation.

“This process takes time—about 10 minutes or more. Even a one-minute delay can be critical for a patient having a heart attack,” Satler says. CodeHeart compresses that time through real time consultations via secure, HIPAA-compliant, two-way video calls with digitally transmitted ECGs.

To use the app, physicians click on the CodeHeart desktop icon to open the app, automatically connect, and join a split-screen video call with a cardiac specialist. “Physicians conduct concurrent, face-to-face conversations in real time. The referring physician holds the ECG up to the computer camera or uses their smart phone to capture the image, which the system then transmits to our consulting cardiologist,” says Satler. The system saves all video call data so either physician can call it up again at any time.

John Schnabel, M.D., is medical director of Emergency Medical Services at Calvert Memorial Hospital in Prince Frederick, Maryland, which sees 42,000 patients annually and also runs three urgent care centers locally that see 20,000 more in acute care patients.

Before using CodeHeart, Schnabel’s team had to share an ECG on a physical print out via fax.

As in any hospital, the ED at Calvert Memorial must care for patients with acute myocardial infarction and heart attack symptoms. “This easy-to-use application allows us to communicate seamlessly with internationally renowned interventional cardiologists at the MedStar Heart & Vascular Institute,” Schnabel says. “We use an HD camera to read the EKG while we communicate with the interventional cardiologist, who is able to ask us to zoom in on the EKG or otherwise share information.”

Schnabel’s favorite CodeHeart features include the simplicity of launching the app, the high image quality, and the fact that he has not seen any real glitches with the app. “That’s amazing these days,” he says.

The BioDigital Human: Viewing the body in 3-D

The BioDigital Human app from BioDigital, Inc. works on Apple and Android devices. A basic version is free; a premium version is available for $48 per year. Customization is available and priced on a case-by-case basis.

BioDigital image Eye Cross section

Visualizing complex anatomy and system relationships becomes easier with the 3-D BioDigital Human app.

“Built as an entirely cloud-based simulation platform, the BioDigital Human presents thousands of medically accurate anatomical subjects and health conditions within an immersive, interactive, 3-D environment,” says BioDigital CEO and cofounder Frank Sculli. Once a physician chooses a visual from the content hierarchy, they can add detail, then print a snapshot to instruct the patient. Each visual comes with links and descriptive data.

The value in the tool lies in its efficacy in clarifying the human body and informing patients about their health and conditions so they can make medical choices with confidence.

The tool offers a layering capability for adding multimedia content over the 6,000 pieces of human anatomy. “Similar to the way geo-browsers such as Google Earth have revolutionized the way we navigate our planet, the BioDigital Human provides a powerful body visualization platform. Once integrated with patient health records, the platform has the potential to deliver increasingly personalized views of the body,” says Sculli.

Roberto L. Flores, M.D., is a reconstructive plastic surgeon at NYU Langone Medical Center and an NYU Associate Professor of Surgery. Flores was looking for an easier way to explain procedures to patients and to his residents and fellows when he found the BioDigital Human app.

Before adopting the app, he used anatomy textbooks to explain procedures. “The textbooks were limited in that they could only express 2-D information, and only from one perspective at a time. I found myself jumping around to 20 or more pages to explain a procedure,” Flores says.

Textbooks were equally perplexing in preparation for actual operations. “If I was going to prepare for a complex surgery, I found myself referencing several anatomic textbooks in order to obtain all the vantage points of the anatomy that I needed in order to process the surgery to my satisfaction.”

With the BioDigital Human, Flores can explore and manipulate all aspects of the human body in virtual 3-D. “There is no limit to the type of anatomy you can study or the vantage point from which you can view it,” Flores says. The app enables a highly sophisticated study of the relationships between bodily structures that is impossible with textbooks. “I can convey complex anatomic and surgical information to my patients and trainees using the app as my visual guide,” says Flores.

BioDigital is adding disease-specific tutorials to the app; Flores would like to see that work continue. “I think there is also a great opportunity to make versions of the BioDigital Human that are suitable for children at different ages, so they can learn about the human body,” he says.

RubiconMD: Remote specialist consultationsfor PCPs

The RubiconMD platform is available to primary care providers through a smartphone’s web browser and to specialists online and through an app for any Apple device via a monthly subscription or a pay-per-case basis. For more information, visit

RubiconMD Platform

RubiconMD maintains a panel of specialists who provide remote consultations to primary care physicians.

Primary care physicians use the RubiconMD app to contact specialists online for remote consultations. On receiving the patient’s case, the specialist returns a clinical opinion.

“The PCP selects from 32 specialists and sends any labs or photos with the patient case and question,” says Gil Addo, RubiconMD’s CEO.

RubiconMD maintains a panel of specialists from elite U.S. academic medical institutions who are available to field consult requests. “We have designed the platform to fit seamlessly into a PCP’s clinical workflow so providers can efficiently send questions to specialists and receive timely answers,” Addo says.

Tom Brown, M.D., is an internist and medical director at four AFC-Doctors Express Urgent Care center franchises: one in West Hartford and three in Danbury, Connecticut. Brown develops best practices for streamlining patient flow and improving the efficiency of care while also caring for his patients. He was looking for a more expedient way to access and leverage the expertise of subspecialists when he found RubiconMD.

“I use the platform with patient diagnoses where I do not have a great amount of experience or a high confidence level. For example, I use RubiconMD with orthopedic fractures to determine in a timely manner whether or not patients require orthopedic evaluation,” Brown says. “I like that I can upload images and X-Rays, and also ECGs to RubiconMD for cardiologists. I get a response in a few hours and receive an email alert notifying me.”

David Geer is a regular contributor to PracticeLink Magazine’s Tech Notes department.



On the go? Keep on going with these apps

By David Geer | Tech Notes | Winter 2015


Any of these scenarios sound familiar?

To watch and learn from a surgeon’s techniques, you have to stop serving patients and go to a specific location at a set date and time.

To read quality medical research, you have to take time away from your work to search and find resources.

Your licenses and certifications risk lapsing unless you manually reapply and renew them.

Waste time no more.

Instead, explore these three free apps you can use to meet your research, practical education and certification needs while you’re on the go.

Aggregate your content with Docphin

Docphin is available free on iTunes, the App Store and Google Play.

Docphin Logo

Docphin Logo

This free app for iPhone, iPad and Android devices streamlines access to medical research from more than 5,000 journals and recommends content that is relevant to your interests and the topics that are trending among your peers.

“Physicians save their subscription credentials to their mobile device and quickly access PDF versions they can save for later or share with colleagues,” says Sachin Nanavati, cofounder of Docphin.

Docphin accepts content from hospitals for physicians’ research needs. Docphin’s hospital platform enables medical departments and residency programs to add clinical guidelines, hospital protocols and decision-making references for mobile access and provides detailed engagement metrics to help accelerate the implementation process within the health care system. “Residency programs can leverage Docphin’s unique platform to track and measure objective metrics that can be used to help meet new accreditation milestones set by the ACGME (Accreditation Council for Graduate Medical Education),” says Nanavati.


Docphin aggregates medical research from any of more than 5,000 journals. The hospital platform also provides mobile access to specific clinical guidelines, protocols and decision-making references for on-the-go access.

The makers of Docphin strive to make evidence-based medical research more accessible through mobile technology and keep the content meaningful for providers who have limited time and resources.

Rishi Sharma, M.D., is chief gastroenterology fellow at the Henry Ford Hospital in Detroit. “As a training physician, my goal is to be current with the latest research articles that are relevant to my interests and that journals I trust and respect publish,” says Sharma.

But since most of the content is fragmented, it can be hard to keep up with research.

“I often don’t have time to read articles when I discover them,” he says. Sharma tried manually flagging articles in emails and lists to read later. However, this proved time-consuming. “I marked articles in various places and then—when I couldn’t relocate them consistently—I had to find the articles via my hospital’s library website, which could take several minutes.”

While looking for other ways to stay current, he came across Docphin.

With Docphin on his iPhone, Sharma can locate saved articles while moving through the hospital. “I can bring up the app any time to browse trending articles and to search for and access landmark papers. Since I have affiliated my account with my institution, I can get to a full-text article very easily, which saves me a lot of time,” he says.

Sharma has found Docphin especially useful in staying abreast of specific diseases and treatments. “I am able to stay up to date with Hepatitis C treatments, which have been changing rapidly over the past few years,” he says. “Being able to read the articles easily on my phone during brief periods of downtime has helped me treat patients because I am able to offer them a greater understanding of future options regarding their treatment.”

Learn from a curated library of videos on MEDtube


MEDtube is available free on iTunes, the App Store and Google Play.

MEDtube is available free on iTunes, the App Store and Google Play.

“The MEDtube app brings a library of 11,000-plus medical videos to physicians’ phones and devices globally,” says Wojtek Dolkowski, MEDtube’s CEO. Practicing physicians, universities and trusted medical institutions contribute the video and multimedia medical resources including surgical videos, animations, visualizations, presentations, interviews, academic lectures, reports and podcasts.

MEDtube follows stringent quality guidelines to produce video materials that stand up to high scrutiny. “MEDtube’s editorial team, which consists of physicians with expertise across specialties, reviews all submitted materials before accepting them into the library,” says Dolkowski.

Jeffrey Eakin, M.D., a board-certified general surgeon specializing in minimally invasive gastrointestinal, bariatric and robotic surgery and practices at Specialty Surgery of Utah in West Valley City, was searching for a solution to a challenge when he found MEDtube.

“I was trying to find high-quality video content that is curated and allows me to see world-class surgeons performing cutting-edge operations with a laparoscopic or robotic approach,” he says.

Eakin had been viewing YouTube videos in an attempt to meet this need. “But now [the YouTube] ecosystem is over populated with irrelevant and low-quality material that often doesn’t even pertain to what is advertised,” Eakin says.

“The ecosystem MEDtube has created provides me with relevant. high-quality videos that help me to branch out my techniques and stay current on changes in my field. It is a great resource to cruise on my iPad when I have downtime at lunch or in between operations,” he says.

The only improvement Eakin recommends would be for MEDtube to enable some kind of social networking with the app. “I would like to see more ability to create a social network consisting of the app’s users so that we can connect with each other and share ideas in a more fluid, facile fashion,” he says.

CertAlert+ helps you manage your certifications



CertAlert+ is available free from iTunes and the App Store. Android version coming soon.

CertAlert+ for iPhone and iPad enables physicians to track, share and manage their medical certifications and licenses. Rather than carrying certification cards in their pockets as proof, they can store images of certification cards on their devices.

“Physicians can export and share their certification card images with the parties that require them via email. They can set reminders to renew certifications to avoid untimely expirations. CertAlert+ really simplifies managing your certifications, licenses and in-service credits,” says Karl “Fritz” Disque, D.O., a board-certified, practicing anesthesiologist and cofounder of National Health Care Provider Solutions (NHCPS) in Henderson, Nev., which produces the app.


CertAlert+ is available free from iTunes and the App Store. Android version coming soon.

Richard Andersen, D.O., a family medicine physician at Captain James A. Lovell Federal Health Care Center in North Chicago, was looking for an easier way to manage his required licenses and certifications. “I was using traditional paper records with some assistance from my administrative staff,” he says. But this approach was fraught with inconveniences such as slow and tedious license renewal and sharing.

Andersen uses CertAlert+ on his iPhone, which he always carries with him. “CertAlert+ stores my license, certification, and in-service information and gives me reminders to renew them,” he says. Now, he can quickly, easily and personally maintain these records for real-time viewing and sharing.

Andersen is happy with the intuitive way that CertAlert+ captures license and certification records. “Rather than typing in large amounts of data by hand, I can take photos of the front and back of cards and certifications. It makes it easy to track the information I need,” he says.

CertAlert+ replaces all the busy work of tracking paper cards and manually reapplying for certifications once they have expired, all while keeping the certifications at hand and current.

Says Andersen: “Before I have to renew my licenses or certifications, I enter the information into the app and set reminders to notify me when I need to renew each of them.”

David Geer is a frequent contributor to PracticeLink Magazine’s Tech Notes department.




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