Mobile Technology for the Physician Assistant

1. Mobile Technology for the Physician Assistant Karen Humphries, BHSc (PA), CCPA karen.humphries@medportal.ca

2. Disclosure • I am a member of the Board of Directors, Canadian Physician Assistant Education Association • I am employed by The Ottawa Hospital • I am not acting or speaking in any way on behalf of or representing any organization • I am receiving no financial compensation from any company mentioned in this presentation • Brand names of products mentioned in this presentation are the trademarks of their respective companies • No other disclosures

4. Technology has come a long way….

5. 1895:the first x-ray is (accidentally) performed

6. 1901 – first transAtlantic wireless transmission, received at Signal Hill NL

7. 1903 – first successful powered, piloted flight

8. 1908 – the first production Model T is assembled

9. 1908 – Bakelite is invented • Belgian inventor Leo Baekeland created Bakelite, the first plastic • Light, durable and colorful, plastic today feeds a $260 billion industry, used in a seemingly endless array of products from phones to keyboards, credit cards to medical devices • Plastic spin-offs include neoprene, Plexiglas, nylon, Teflon and Kevlar – where would we be without plastic???

10. 1922 – Insulin is discovered

11. 1928 - Penicillin is (accidentally) discovered

12. 1931 – first electron microscope is invented

13. But wait, there’s more… • 1945 – atom bombing of Nagasaki and Hiroshima • 1946 – the ENIAC is introduced to the public • 1958 – the microchip is invented • 1969 – first ATM is invented • 1969 – and the internet is created…

14. And then… Mobile technology was born…

15. Mobile technology has changed the way we do a lot of things… • Over 80% of physicians use a smartphone, and 60% own a tablet • Over half a million apps for everything and everything available through the App Store (Apple exclusive) • Currently over 5600 apps are available through the App Store related to medicine, health, and fitness for both clinicians and the public alike

16. Where does one start? • Mobile technology is currently one of the most dynamic fields in medicine with the greatest potential to change clinical practice. • As the app market increases exponentially, one must be cautious regarding the quality and utility of these applications.

17. What about the evidence? • It is imperative that while we transition to the use of mobile technology, we do not compromise on the principles of evidence-based medicine when caring for our patients. • When evaluating any app or program, keep in mind the principles of EBM – make sure you are using the best available evidence to make clinical decisions • That’s easier said than done, isn’t it?

18. What about security? • Use a passcode! • Alphanumeric codes are much more difficult to guess than 4-digit PINs • To change on iPhone/iPad: • Settings Passcode Lock • Change “Simple Passcode” to Off • Enter new alphanumeric passcode

19. Security cont’d. • Data encryption – generally enabled on most devices with passcode • Remote wiping – removes all data from device remotely • Cloud technology – the device only acts as a portal of interaction with a central server that houses the application

20. So what does this mean for the practicing PA? • Four main categories of mobile apps: • Clinical reference • Medical calculators • EMR access • Patient education • Depending on your practice setting, all or only some will be relevant • The majority of apps reviewed today will generally fall into at least two or more of these categories

21. Clinical References • Medscape, from WebMD http://www.medscape.com/

22. Clinical References • Epocrates http://www.epocrates.com/

23. Clinical References • LexiComp http://www.lexi.com/

24. Clinical References • PEPID www.pepid.com

25. Clinical References • UpToDate http://www.uptodate.com

26. Paeds • Pedi QuikCalc 2.1 www.pediquikcalc.com

27. Other handy resources • Micromedex – drug info is free, other info is $9.99-$29.99, no BlackBerry app available • PubMed mobile – quickly search all sorts of EBM publications for free • AHRQ ePSS – USPSTF recommendations • iMedicalapps – actual user reviews of all the latest mobile apps across all specialties

28. More handy resources • Diagnosaurus – differential dx for multitude of conditions, symptoms, systems. Free online access, free app for BlackBerry, Palm, Android, $1.99 for the app for Android/iPhone/Windows phone • MDCalc – no app available, but great web resource for everything from Ottawa ankle rules to eGFR calculation. Just make sure you select SI units, as it defaults to Imperial

29. MDCalc

30. More resources • DrawMD – using iPad, offers interactive visual guides to explain conditions and procedures. User can draw or write on an existing image, or upload one of his/her own. Images can be e-mailed to patients so they have a reference.

31. drawMD

32. I’m sorry, I didn’t quite catch that… • MediBabble – it’s free, and once downloaded you don’t need an internet connection. • Only a few available languages and French is not one of them (coming soon though) • For patients with hearing difficulties or in noisy environments, turning your iOS device to landscape mode will enable a full-screen display of your selected phrase in large text. http://www.medibabble.com/

33. MediBabble

34. Your what hurts? • Google Translate – not as precise as MediBabble but offers many more languages. • Internet connection is required. • Most basic app features are compatible with all mobile devices, but enhanced features such as text-to-speech are not available for BlackBerry http://www.google.com/mobile/translate/

35. Google Translate

36. Notes on the go • Evernote, Dropbox – free apps to access your documents, photos, videos, etc. online • Can be used to save web pages in their entirety, organize business cards, and store and organize notes into “notebooks” – handy for reference materials you want to be able to access quickly • Accessible from any device with an internet connection; Premium services allow full downloads onto your devices • Data is encrypted, but may be vulnerable

37. Pitfalls • Telephone versus text orders? • Blurring of the line between home and work • Over-reliance on technology rather than clinical acumen

38. Thank you

39. References • http://www.nobelprize.org/nobel_prizes/medicine/laureates/1945/fleming-bio.html • http://oinks.squeetus.com/2011/05/how-im-a-lot-like-alexander-fleming-only-noble-prize-less.html • http://www.nobelprize.org/nobel_prizes/physics/laureates/1986/ruska.html • http://labrat.fieldofscience.com/2010/08/nanofibre-paint-that-kills-mrsa.html • http://www.thehenryford.com/exhibits/showroom/1908/model.t.html • http://www.time.com/time/photogallery/0,29307,2026224,00.html#ixzz27zSdEAzW

40. References cont’d. • "Guglielmo Marconi - Biography". Nobelprize.org. 7 Oct 2012 http://www.nobelprize.org/nobel_prizes/physics/laureates/1909/marconi-bio.html • http://www.library.upenn.edu/exhibits/rbm/mauchly/jwm8.html • http://www.krysstal.com/display_inventions.php?years=After+1950 • http://gizmodo.com/5944013/14-people-using-hilariously-giant-old-cell-phones • http://www.imedicalapps.com/2012/09/mobile-health-devices-clinical-setting/#more-38949 • https://www.dropbox.com/help/27/en • www.evernote.com