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Put powerful tools in your palm without spending a dime.
After
shelling out hundreds of dollars for a personal digital assistant
(PDA), most physicians hope to use it for more than a high-tech address
book. Much of the medical software that can help you accomplish that,
however, can cost more than $100 - or about half the price of good
low-end PDAs.
Fortunately for those who don't want to pay for new
software, many of the best medical applications for the Palm OS are
available free on the Internet.
Free to a Good PDA
Here are 10 free applications, listed in
no particular order, that I have found useful, plus one that comes
standard on the Palm OS of which you might not be taking full advantage.
- Epocrates Rx ( http://www2.epocrates.com/products/rx
) - This regularly updated medication database's free basic functions
include adult and pediatric dosing, contraindications, adverse effects,
pricing, formularies and more. Its multicheck function, allowing
cross-checking of interactions among up to 30 medications, is
especially useful. For a yearly fee, the software can be upgraded with
additional options.
- MedRules ( http://pbrain.hypermart.net/medrules.html
) - This collection of evidence-based clinical prediction rules
includes Bishop Score, Ranson's Criteria and a tool that identifies the
risk of mortality in community-acquired pneumonia. This program has not
been updated in years, but it is still available because of popular
demand.
- MedMath ( http://smi-web.stanford.edu/people/pcheng/medmath
) - This collection of useful formulas is offered in an easy-to-use
interface. Another program that does nearly the same thing is MedCalc (
http://medcalc.med-ia.net
). Try both of them, and decide which one works better for you. Also,
MedMath is bundled with an Epocrates Rx upgrade.
- ATP III Guideline Calculator ( http://hin.nhlbi.nih.gov/atpiii/atp3palm.htm
) - This program calculates individualized LDL treatment goals using
the Adult Treatment Panel III cholesterol guidelines. In the past, the
ATP III calculator did not work on Palm OS 5, but the program has been
upgraded and should work now (it does on mine, anyway). Just be sure to
download it from the Web site listed here. Other sites might be linking
to older versions of the program. Alternately, you could try Stat
Cholesterol ( http://www.statcoder.com/cholesterol.htm ), which offers much of the same functionality.
- Stat Cardiac Clearance ( http://www.statcoder.com/cardiac1.htm
) - This software features easy-to-navigate algorithms for determining
presurgical cardiac clearance. It is based on algorithms from the
American College of Cardiology/American Heart Association 2002
guidelines and the American College of Physicians 1997 guidelines.
- Johns Hopkins University Antibiotic Guide ( http://www.hopkins-abxguide.org
) - This is a regularly updated infectious disease guide. It features
treatment guidelines, diagnostic criteria and comprehensive information
about medications and organisms. It took me some effort learning how to
best navigate this product, but ultimately it proved useful and
informative.
- Stat Growth-BP ( http://www.statcoder.com/growthcharts.htm
) - This tool calculates age-adjusted percentiles for height, weight
and body mass index. It also provides age-adjusted norms for blood
pressure.
- MentStat ( http://www.tonywitte.com
) - This is an easy-to-use electronic crib sheet for a Mini Mental
Status Exam that automatically tabulates the score as you check off the
patient's correct answers. MentStat includes instructions and tips for
administering the exam. It's nice not to scramble around your filing
cabinet looking for a written copy of the test (it will be available on
your handheld), but you will still need a pen and paper for a few of
the items. Another nice thing about MentStat is its small size; it uses
only 8 KB of memory.
- Diagnosaurus ( http://books.mcgraw-hill.com/medical/diagnosaurus/
) - This application provides lists of differential diagnoses for
various signs, symptoms or diseases. It's useful not only for
generating ideas about what could be causing a patient's symptom (such
as right upper quadrant pain), but also for reminding you of possible
alternate diagnoses for a current diagnosis, (e.g. cholecystitis). In
some cases, it provides etiologies or causes of certain entries, such
as lactic acidosis.
- Shots 2005 ( http://www.immunizationed.org
) - This software graphically represents the standard immunization
schedule, with information on indications and contraindications,
adverse reactions, administration and catch-up dosing. It is provided
by the Group on Immunization Education of the Society of Teachers of
Family Medicine.
Bonus: Memo Pad
(standard on most Palm OS PDAs) - This application is perfect for
organizing your personal "index cards” of information gleaned
from lectures, rounds and journal articles. It's a great place to stash
just about any bit of information that you want handy. For example,
some of the things I have found useful to store in my Memo Pad include:
- Commonly used CPT and ICD-9 codes;
- A list of pregnant patients whose newborns I need to see in the hospital;
- Hard-to-remember
mnemonic devices, such as SIGECAPS for the criteria for depression or
MUDPILES for the causes of metabolic acidosis.
Your imagination is the only limit to Memo Pad's usefulness.
Powerful Information
Most
of these applications display the standard legal disclaimer that they
are for informational or educational purposes only and should not be
used for clinical decision-making. However, having these powerful yet
free tools literally at your fingertips could make your life easier and
improve your patient care.
Written by Timothy A. Ferenchick, MD, Dr. Ferenchick
is in private practice in West Reading, Pa., and is an adjunct
professor at the Family Medicine Residency Program at the Reading
Hospital and Medical Center. ©2005 American Academy of Family Physicians
Editor's note: For more information about using your PDA in your practice and for more applications, visit http://pbrain.hypermart.net , run by Kent E. Willyard, MD.
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