by Jay Luxenberg, MD, CMD

As I watched group of attending physicians at work while they were admitting patients to our nursing home, I was struck by how often they were consulting their smart phones, iPads or laptops. In particular, smart phones seem to be the most commonly used resource. This year, CALTCM intends to highlight some of the technological tools, particularly “apps”, which facilitate better care for long-term care residents. As an Apple addict, I have to admit that my own familiarity is with Mac applications, iPhone and iPad apps. I’d love to hear of your own experience with other platforms.

Perhaps the best place to start when considering medical apps is a web site devoted to reviewing them. iMedicalApps.comgathers reviews from medical professionals, including medical students, and I have found it a useful tool in identifying those apps that are truly useful while eliminating lots of the junk that is out there. They are platform agnostic, so there are plenty of Android and Windows Phone app reviews as well as iOS (Apple’s operating system for phones). They periodically issue useful lists such as the top 10 free iPhone medical apps.

I also think it is very important to think about apps that are not specifically medical, but make life in long term care medicine much easier. I am a big fan of Evernote. Evernote is a program which runs on Macs, Windows, and Linux. There are versions that run on the iPhone, iPad, Blackberry, Android, and others. In fact, they tout that they are available for “nearly every computer, phone and mobile device.” What it is is a way to sync notes, pictures and sound files between your computer and your mobile device, while keeping copies “in the cloud” where you can access them from any computer you happen to be at. What good is this from a medical standpoint? Simply, I keep copies of all the state and federal regulations that we live and die by, I keep all the little tables and algorithms and lists that I find useful for differential diagnosis, etc. I keep information I need about the CCRCs and RCFEs and hospitals that I need to have handy. I keep copies of forms like the POLST, and scales like the GDS, and key papers, all as pdfs. I can then e-mail them to students or colleagues when they come up in conversation. I keep scans of my Passport and itinerary when I travel for meetings. I put in handouts, such as the pdf AMDA now uses instead of paper handouts at the national meeting. I put in the manual for the phone system at work, and “how to” instructions for tasks for our electronic health record system. I put in the manuals for my camera and all the other gadgets I use. I put in the budget categories I need in my role as an administrator. I put in ICD9 codes and E&M codes. I put in driving and bus directions to our facility from the university, so I can save time instructing students how to get there. I know of others that even record Grand Rounds on their cell phone, to play it back at their convenience. It also handles pictures, so I can snap a picture using my phone of a poster at a meeting and have it available when I get back to work.

Did I mention Shared Notebooks? Even with a free Evernote account, you can set up a notebook to share. There is a core group at our nursing home that is working on end-of-life care issues. We set up a shared notebook with shared resources like Joanne Lynn’s Sourcebook, the Handbook for Mortals, the Stanford End-of-Life Care Curriculum, a RAND Heath White Paper, POLST forms in every language available, and lots more. I share it with a limited number of coworkers, but one could also share with the whole world. Paying customers can also allow their shared notebooks to be modified by any of the people sharing it. Think how useful it would be to have policies and procedures available, or protocols for informing the physician about changes of condition, similar to the AMDA “know-it-all”™ cards, but customized per each physicians preference. How cool.

You probably get it now – I use Evernote as a portable brain. I can clip a web page or put a note into my cell phone, and using the magic of “The cloud” it will be available wherever I am. I can organize these files, and share subsets with different teams at work, or different groups of friends and family. Best of all, unless you are a particularly heavy user, it is free! Of course, I am a heavy user, but the annual price for storing huge quantities of data is very modest.

In upcoming editions of the Wave, we plan to highlight many useful apps, and I would love to hear from you if you have a particular favorite. E-mail me at: [email protected]