MedTools

A unified repository of surgical implants, technique guides, comparisons, and unpackaging videos.

With so many orthopedic implant companies and device options, I am amazed it has taken so long for someone to create a central educational repository.  MedTools is attempting to do just that in the form of both a website and app.  The app itself is well organized with a side-bar menu organized by body part, and sub-menus organized by implant type.  For a generic implant type (ex: Volar Distal Radius Plates, or Total Knee Arthroplasty), the user can quickly see a collection of all available companies and device offerings.  In some cases (total joint arthroplasty) this can include well over 20 different implants from more than 10 companies.  Users can then select a specific implant to obtain product information such as technique guides, reference charts, and photographs of the surgical tray to help familiarize one’s self with the instrumentation.  The app and website have also started video taping “unboxing” of specific devices to ensure that surgeons and their operative staff are prepared and familiar with devices they plan to use.

Overall, this app seems to have been a long-time coming and reflects a significant investment in work and time.  I anticipate the breadth of implants will grow significantly in the near future, which should greatly increase its value and overall utility to surgeons.

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DASH Outcome Measure

Utility for administering and scoring the DASH Outcome Measure

This app is very simple and does exactly what it is supposed to do: it helps providers (surgeons, therapists, researchers) administer the DASH Outcome Measure (Disabilities of the Arm, Shoulder and Hand).  Objectively, the app has very few flaws or limitations.  The user is provided with various setting options, resources from the website, and the option of either the complete DASH or the QuickDASH. The questionnaire is then provided in its standard form, and appears very similar to the PDF version that is available online.  A patient number can be assigned, and a copy can be emailed to the patient as well as the administrator.

From a clinical perspective, the app does not maintain a database of patient scores and does not provide an easy way to integrate scores into the medical record.  That would take an additional manual step on the part of the medical practice or research group.  However, overall, this is a very useful and easy app for scoring the DASH.

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OrthoGuidelines

App for reviewing the AAOS Guidelines and Appropriate Use Criteria for specific diagnoses.

I applaud the AAOS for creating a very useful and intuitive app for reviewing and consulting the AAOS Guidelines and Appropriate Use Criteria for specific diagnoses.  As most orthopaedic surgeons and trainees are aware, the AAOS has committed a significant effort to developing useful guidelines and tools to help surgeons make the appropriate surgical decisions when treating a number of common conditions.  Until now, the guidelines could only be accessed in their PDF form.  This app allows anyone to review the published guidelines in a very useful format.  The app currently includes 17 guidelines (CPG) and 4 appropriate use criteria (AUC) modules.  The guidelines can be sorted by strength and stage of care.

Overall, the app is well made and a great step forward in improving access to these important tools.  I recommend the app to both trainees (for both education and testing purposes) as well as surgeons (for treatment purposes).

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OrthoBullets: Bullets*

OrthoBullets’ stand-alone and companion app with study material, images, questions, and quizzes

OrthoBullets has scored a home run with their new Bullets* app available from the iTunes store.  This app is can be used as a companion app to the existing OrthoBullets website, but also functions extraordinarily well as a stand-alone resource.  The app consists of 5 sections: Topics, QBank, Cases, Evidence and PASS.  The topics section includes all information on the OrthoBullets site, separated in the same familiar lists and easily searched by keyword.  I found the search and browsing to be very fast and intuitive.  Importantly, each topic includes the same figures, diagrams, and questions associated with the web version to help learn concepts through the VEPTR technique.

The QBank also integrates with your existing online login and automatically transfers over your existing TestMaster scores and personal tests.  It also allows you to create new tests which can be defined by test style, topics, number of questions, etc.  The format will be very familiar to existing OrthoBullets users.

The cases will be familiar to any OrthoBullets user, and includes a presentation, images, and the valuable comments and discussion that ensures.  One of the newest features includes the ability to select “Evidence” to support an answer to a question, greatly enhancing the validity and value of this service.  The evidence can also be searched independently, and by specialty.  All of this is seamlessly integrated into the mobile format.

Lastly, the PASS section is available to residents who already use the PASS system in their residency program.  While I could not test this section entirely, it appears to function similar to the website equivalent.

Overall, the Bullets* app is a full-featured educational tool for any orthopaedic student, resident, fellow, or attending.  With quick and easy access to the entire OrthoBullets database combined with cases, quiz access and a versatile interface – I highly recommend this free app to everyone.

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RealWorld Procedures

Video and text tutorials for common procedures

RealWorld has created another app (in addition to RealWorld Orthopaedics) with tutorials for common procedures.  Those relevant to orthopaedic surgeons include digital blocks, local anesthesia, shoulder reduction, suturing, and upper limb slings. Each tutorial has a short video (1-3 min) with a text description of the background, precautions, equipment, positioning, procedure, and complications.  Overall, the limited orthopaedic procedures are relatively well represented and can assist a junior resident or medical student prepare for a first-time procedure.

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My Academy

AAOS Academy Meeting 2015 

My Academy is the AAOS 2015 official academy meeting app. My Academy is meant to help academy members and vendors navigate the Academy meeting. This app is a dramatic upgrade from prior academy meeting apps. I can honestly say the AAOS did it right this time. The app has features that allow you to easily search lectures and vendors, find out when and where they are and point you in the right direction with a map. The interface is friendly and easy to use. The messaging features and auto-reminders help you manage your time. The app is free with registration and will be a must have at the next Academy meeting.

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Orthopedics Patient Education by CoherentRX

Orthopedics Patient Education by CoherentRX   

Anatomy and Educational tool 

CoherentRX  has created an app to help orthopaedic surgeons and their workforce improve patient education and comprehension. CoherentRX Orthopedics has multiple features: 3-D anatomy visuals, drawing tools to mark visuals, photo and screenshot uploads as well as text and email info that is HIPAA compliant. While all of these features are powerful tools the app lacks ease to use. CoherentRX Orthopedics is very well priced $2.99/year (one of the cheaper patient educational options) however it is not the best patient educational tool on the market. While it has multiple features that are useful, the lack of disease specifics educational modules makes it difficult to actually use in practice. I applaud CoherentRX on making an Orthopedic app that has the potential to improve patient comprehension and education, however the app is still behind other players in the market.

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https://itunes.apple.com/us/app/medibabble/id355398880?mt=8

Ortho10 Pro

Simple ICD-10 look-up for orthopaedic surgeons

Ortho10 is the first and only ICD-10 code look-up app specifically for orthopaedic surgeons.  The app has a very simple and intuitive interface which makes finding the proper code, and saving common codes, very easy to do.  Any user can easily find the proper code within less than 6 taps, regardless of any pre-existing knowledge of ICD-10. The app first opens to a list of body parts each on separate tiles.  Once a body part is selected, you have specific options relevant to that region, such as osteoarthritis, fracture, joint pain, sprain, etc.  As the user continues to drill down in choices they are prompted to select a more specific diagnosis, laterality of the injury or pathology, and the type of encounter (initial or subsequent, as required by ICD-10).  The user is then clearly presented with the diagnostic code and a description of the code.  At every level, there is the opportunity to move back up the selection tree and change a response.  And, once a code is selected, it can be saved in favorites for quick reference at a later time.  Overall, the app is easy to use and will be very important and useful as the mandatory transition to ICD-10 takes effect.  The app has already undergone revisions and improvements since its initial release, and we anticipate additional improvements and expansions.  There is currently a free version with all codes but limited additional features, as well as a paid version with enhancements such as “favorites” and “recently used” codes.

Free version:

Pro Version:

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MedTunnel

HIPAA-Compliant secure healthcare communication

This app is meant to remove fax and paper from cluttering your life. MedTunnel is trying to revolutionize the way the healthcare providers share and send information. This company has provided a service that protects patient privacy, but improves communication and makes your phone easy to use. Many apps already offer HIPAA compliant text or email tools via your phone. However, MedTunnel has given users the tools to make sharing information between physicians and patients more robust by giving users the ability to email or send documents. MedTunnel is one of the only HIPAA compliant messaging services that allow a user to take a photo with their phone and turn it into a pdf file and allow pdfs to be viewed and annotated, all on a phone. These two features make the app one of the best HIPAA compliant communication tools on the market. In addition the app is only a small portion of the larger desktop platform that has been created by MedTunnel. The desktop version allows users to have more control of their content and allow all files on any desktop running MedTunnel to securely be saved to the cloud. One concern about the app is you need the desktop version to set up some of the features and without setting these features the app is not the easiest to use.  For the app to be useful to you and your practice you would need the staff and other providers in your practice to adopt the app for the best use of these features. Overall an excellent HIPAA compliant communication app for healthcare professionals.

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Measure Whiz

App to assist in measuring Upper Extremity range of motion from The Hand Center at the Orthopedic & Sports Physical Therapy Associates

Measure Whiz was created for use by Occupational Therapists to assist in measuring and recording upper extremity range of motion (ROM) using a mobile device. This app is intriguing as it leverages the phone’s gyroscope to measure angular differences in all three planes, but its usefulness is limited as it has minimal features, a large range of error, and is difficult to use for certain measurements. The app interface is very basic. From the home screen you can select ‘History’, ‘Range of Motion’, and ‘Assessment’. The ‘History’ and ‘Assessment’ options are just voice memos which can easily be record over accidentally.  The ROM options include Wrist, Forearm, Elbow, Shoulder, Digits with specific motion sub-options per joint. There is no option for lower extremity ROM measurements.

By selecting a specific joint and motion you can then measure the ROM live. Position the handset distal to the joint in a neutral position and press ‘Start’. Then allow the patient to move the body part being measured and then tap the ‘Finish’ Button. The ROM is displayed and updated live. The app does not lock the plane of measurement and allows ROM measurements in the X & Y plane simultaneously. This allows for different acceptable phone positions, but leads to errors in measurement with any movement out of plane. It is very sensitive & dependent on initial position when zeroed. Using the app can be difficult as you must stabilize the device against the body part being measured which can be difficult for wrist ROM and near impossible for digit ROM. It worked adequately for forearm, elbow and shoulder ROM.

A ‘New Patient’ button at the bottom of the homepage clears the app information. Multiple patient data is not supported and data is not saved for later. Data is lost when app is closed and there is no prompt when the ‘New Patient’ button is pressed, making it easy to accidentally clear the data. Overall the app is quite finicky. There are better goniometer apps out there and a real goniometer is probably better and more accurate.

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PreOpEval

Preop assessment tool 

PreOpEval is a preop app to help guide how to evaluate patients for non-cardiac surgery. The guidelines are from the American College of Cardiology and American Heart Association and the American College of Chest Physicians most recent recommendations. The app has a cardiac evaluation algorithm to help users decide what a patient’s pre op risk is prior to surgery as well as give guidance regarding key medications, test to order and timing of surgery after cardiac events. While these guidelines are accepted by the ACC/AHA/ACCP it does not mean that is what your local anesthesiologist will follow. Overall a useful tool for residents/students/ancillary staff to help think about what labs need to be ordered, which patients need further workup and how to handle patients on particular medicines.

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Touch Surgery

3-D Surgical Simulation App        

Touch Surgery is a 3-D surgical simulation app to help surgeons/assistants/students become more familiar with particular surgical procedures in their respective field. The app has recently been updated and now offers an even larger library of fundamental orthopaedic procedures that you can download onto your device. The visual clarity and upgrades have drastically improved over the last year. Once you have downloaded the procedure there is a simulation demo that takes you through a step by step demo. The simulation reviews patient set-up, incisions and which neurovascular structures to avoid as well as retractor placement using gestures you make on your device. Once you have completed the demo you can then test yourself through the procedure and see if you are improving your scores. Overall, the best surgical simulation app still out there. It has a clean interface and practical demos for learning orthopaedic residents and students. Some of the apps are 3-D modules which are better made for an iPAD. Hopefully more of the orthopaedics demo’s will be converted to a 3-D format.

In the news

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Throw Like a Pro

Baseball throwing injury prevention app released by Dr. James Andrews and Dr. Kevin Wilk

In response to the increasing rates of “Tommy John” surgery as a result of throwing injuries, this app has been released to help young baseball players prevent injuries and safely participate in sports.  The purpose of this app is to provide information about safe participation that keeps players out of the operating room.

The app includes an overview of baseball throwing injuries, statistics, and general guidelines for prevention.  The app then divides recommendations into Pre-Season and In-Season sections.  In Pre-Season, videos are included that demonstrate how to perform 5 different stretching exercises, with instructions to complete them daily.  Next, the player performs the “Throwers Ten” which includes videos of 20 more exercises that should be performed with 10 repetitions, 3-4 times/week.  Lastly, there is advice for a throwing progression with a module that talks the player through the distance and number of throws to build up.

The In-Season module includes a warm up with stretching (same videos), a thrower’s ten band workout (more videos), a throwing warm up and a pitching warm up.  The app includes a pitch-count tool which can be modified for the patient’s age, rest days, and maximum pitches desired (and advised).

Overall, the app has a very high production quality and includes important information from leading surgeons in the field of throwing injuries. They estimate a 60% reduction in throwing injuries if used properly.

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FracturED

App for learning skills needed to treat fractures in the emergency department.

Created by an emergency medicine resident, this app is organized into modules for educating residents about how to care for fractures in the emergency department. The app begins with basic information, including annotated images for demonstrating surface anatomy, bones, and nerve distributions.  The app is then organized into cases which include a brief story of the patient, appropriate xray imaging with various views, and a discussion of the pathology and treatment options.  The discussion also has an extensive list of references for additional reading.

As of this review, the app includes 20 cases for the “Hand and Wrist” including a demonstration of how to apply various splints.  However, the general “upper extremity,” “lower extremity” and “foot” sections are all marked as “coming soon.”

This app is a useful learning tool for ED residents, but is currently only limited to the upper extremity.

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DocSpera

HIPAA compliant secure collaboration platform for surgeons

DocSpera is a company and app developed specifically for collaboration and case sharing among medical professionals.  With an orthopaedic surgeon co-founder, it has been tailored for the proceduralist, and functions well as a networking and case-sharing tool for surgeons.

The app requires registration as a verified physician. Once complete, all functionality is available for free, including access to the contact list, invitations to join specific networks, the ability to upload documents and images to a personal filing cabinet, and messaging features.  Some of the most useful features include the ability to create a personal network for a practice, society, or specialty interest group.  Discussion threads can be initiated by any group member and are visible only to those within the group.  In addition, because of its HIPAA compliant standards, specific patient information is secure through the platform and protected for public view.

Overall, DocSpera is a great solution for practices or providers looking to collaborate and share information about patients and cases.

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California Orthopaedic Association

Conference app for the 2014 California Orthopaedic Association and QME Course

This app is created for attending the COA 2014 Annual Meeting in Monterey, CA.  Presumably, future meetings will have similar apps that will support equivalent functionality, including an agenda, speakers/evaluations, list of attendees, social events, QR reader, map, photo feed, etc

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Bone Ninja

Sophisticated app for pre-operative planning of osteotomies and limb correction.

Although it has a catchy name and cute icon, Bone Ninja is neither a toy nor a game. This is a sophisticated and serious app created by the International Center for Limb Lengthening to teach planning for limb lengthening and alignment surgery. The app was primarily used as a tool for the deformity course that they host, and I advise that anyone interested in the app either take the course or watch one of the introductory lectures.

The app itself includes a library of images for practicing and learning. This includes both frontal and saggital plane views of limbs with various angular deformities. The user can also upload their own image. Once an image is selected, you enter the editing mode. The features are impressive, and include calibration and enhanced editing tools such as various select functions, linking options, the ability to free-cut the image, angular and length measurement tools and rulers, and more. It even has “hardware” icons that can be added to the images.

As stated above, this app is not for amateurs and includes lessons and resources for learning, including links to YouTube videos (Part 1, Part 2, Demo).

App website: http://www.lifebridgehealth.org/RIAO/BoneNinjaAppforiPad.aspx

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MediBabble

Medical Translator App

MediBabble is a powerful translation tool to help providers communicate with non-English speaking patients. There are many apps that provide translation tools to providers, but I have to say MediBabble is the best one on the market (and its free!). MediBabble differentiates itself with a robust database of pertinent medical phrases (including orthopaedic ones) organized in a standardized history-taking format. It does not require the user to be connected to the internet and it actually has medical phrases that are spoken to the patient from your phone. This app is probably best for intermediate language speakers who do not have the medical vocabulary to perform a complete history. Having tried the app myself I found it extremely useful as many of the phrases allow me to ask the patient close ended questions that I didn’t know ask with my mediocre spanish. Currently the app is available in Chinese, French, German Haitian Creole and Russian. Overall, a fantastic app that will help mediocre language speakers with history taking. I just wish the app would translate all that the patient was saying for me……..  but I guess that is called using translator services.

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FRAX

A digital and mobile tool for calculating the FRAX score.

This app is a very useful and free tool for calculating the WHO Fracture Risk Assessment Tool (FRAX).   Created by the International Osteoporosis Foundation and Doctot, the app is intuitive and simple to use.   The app includes a detailed section about FRAX and its purpose: to calculate a patient’s 10-year probably of fracture based on BMD – and references have been provided.  To use the actual assessment tool, select “start the test.”  The app then walks you through a series of 14 questions on the FRAX, such as age, gender, ethnicity, weight, height, history of fractures, co-morbidities (smoking, steroids, RA, osteoporosis, alcohol), type of fracture, and T-score.  The final result is a FRAX score that estimates the risk of fracture based on the validated tool.  Users can then save the score with a patient’s name. Overall, this very simple app is both validated and effective and should be highly considered for anyone who already uses FRAX in their office.

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PingMD (updated)

HIPAA compliant messaging

PingMD is a creative app to help providers securely and efficiently communicate with patients and other providers. This app creates HIPAA compliant text-messaging. If you did not know, text messaging through your phone provider does not meet HIPAA compliance guidelines. As a result, PingMD was created to fill this void. Overall the app is very user friendly and has a clean interface. Patients and other coworkers can send messages, photos and videos to help communicate with one another. The main criticism with PingMD in my prior review was that it was cumbersome to find other coworkers and patients. *PingMD has just released an update that allows users to easily find coworkers through their current phone contact list.* This update is a powerful move by PingMD. This network based app depends on other providers and patients using the app for it to be successful. Over time as more hospital systems adapt and integrate mobile health solutions this app will likely becoming an everyday part of patient and physician interactions. 

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My Knee Guide

Patient resource for those considering knee replacement

My Knee Guide is a complete resource for patients considering knee replacement surgery. I am extremely impressed with how this app personalizes the experience of knee replacement surgery to the patient. The app has creative stories of real-world patients and their experiences of undergoing total knee arthroplasty. The in-app features include: calendar with reminders of surgery specific details and checklists, email alerts to remind patients what to do and when, location based resources of local hospitals and surgeons with SCIP protocol compliance rates and many more resources. Personally my favorite part of the app is “my surgery guide” which informs patients day by day exactly what to expect before and after their surgery. This app will assist the orthopaedic surgeon to set patient expectations and help patients stay informed throughout their treatment process. My only criticize with all the resources in the app is that patients may become overwhelmed. This is an app I plan to use with my patients to help them learn more about total knee replacement.

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PhotoGoniometer

Photo app for goniometer measurements

Photogoniometer is another goniometer app that uses photos to help practitioners measure limb angle. The app uses an innovative method of measuring angles where you first take a photo with the limb extended and then take a second photo with the limb flexed. The images are then superimposed and the limb angle is calculated. While this is a creative way to measure range of motion this app is much more difficult to use than having to actually take a goniometer out of your pocket to measure range of motion angles. Taking photos and then still having to measure the range of motion takes more steps than quickly measuring it in your office. I like how the app developers attempted to be creative with goniometer measurements, but it is not very easy to use. There is a light version that is free for users with advertising, but the paid version is only $0.99 and allows you to save photos. Maybe something researchers would use to save information? A creative goniometer app that is not very useful.

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Sookasa

Cloud based file storage that is secure and encrypted

Sookasa is a great HIPPA compliant solution to file sharing through the cloud. The seamless integration with Dropbox (the most popular free data cloud service) makes Sookasa very user-friendly and easy to use. Sookasa is valuable to medical professionals because it finally offers an easy to use cloud platform that is not exposed to security and compliance risks. You can encrypts files, create an audit trail, track files and allow administrators to easily delete and retrieve files.  The app allows users to securely view encrypted documents on your iPhone or iPad device. This service is a must have for all medical professionals who use dropbox/googledrive/box or any other cloud device where patient information is stored. If you are not using cloud based file storage in your practice due to concerns for security there is now finally a solution. Sookasa is a revolutionary new product that can change the way you manage your practice.

*The Fees are subscription based and can be pricey based on usage, but likely a worthwhile investment*

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OrtoEscores

Easy app to calculate outcomes scores for patients

This is a great app to help staff calculate relevant outcome scores for patients. The app includes 30 different outcome measures that surgeons can use to help establish measures for how patients are progressing through their care. The app has the functionality to email this information to the patient and to the surgeon. However, a significant portion of the app is in Portuguese as it was originally made for use in Brazil. Also, the formatting of some of the surveys on the iPhone are not the best Overall a great app to calculate outcomes scores that will be more useful once fully translated and more functional on the iPhone.

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Goniometer Pro (G-Pro)

Goniometer mobile application

This Goniometer app was developed by 5fuf5 and is one of many goniometer apps in the marketplace.  Goniometer PRO uses a simple visual tool to help providers mimic a standard clinical goniometer if one is not available.  While I initially struggled using the app, a very well done you-tube video clearly taught me how easiy it is to use. The app allows users to save angle measurements in a memory bank.   Users are able to use the app in the free preview mode, but after 12 uses you are forced to buy the unlimited version which is $14.99. While the app is an excellent tool and visually stimulating at this high of a sticker price there are other apps out there which work the same.

Overall a useful goniometer app with a high pricetag

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Canadian Orthopaedic Association

Mobile Access to the Canadian Orthopaedic Association

This is a weak mobile version of the Canadian Orthopaedic Association website. The app is meant to allow members to have easy access to up to date news and event information. However the lack seems to fall short of providing more than three articles in its news column and does not organize its events calendar well on the iphone. I acknowledge the innovation of using push notifications to remind members of upcoming events, but outside of this one good feature the app itself is lacking the information and thoroughness that the website clearly provides.

Overall a weak app for an important association.

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ACUMED Version 2.0

An app that provides information for Acumed’s different fixation systems

This app is a neat resource to learn about Acumed’s different fixation solution for different body parts. The app has a beautifully done feature that allows you to visualize devices in 3D space. While the app is probably more useful for the ACUMED reps than a typical orthopaedic surgeon it is still an interesting app with lots of device information. *WARNING* to download all the features on the app is approx. 400MB of memory. So while this awesome app has some really neat 3D tools to see devices for different types of fixation. Beware it can be memory drain.

Overall a visually impressive app not for everyday use

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Top Ortho “App”

Download the www.TopOrthoApps.com iPhone app!  You’re already on the website, why not have on-the-go access direct from your iPhone?  This app has all of the best Top Ortho App lists that you’re used to: Top Apps, Free Apps, iPad Apps, Journals, Sports Apps, and much more!  Full reviews and screenshots are all available for free.

This app has all of the best Top Ortho App lists that you’re used to: Top Apps, Free Apps, iPad Apps, Journals, Sports Apps, and much more!  Full reviews and screenshots are all available for free.

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Septic Hip

This quick-reference app is designed to use a popular clinical algorithm to assist with the diagnostic distinction between transient synovitis and septic arthritis of the hip.  The app is based on 5 clinical predictors: fever, weight-bearing, ESR, WBC (published by Kocher et al. in 1999) and CRP (added by Caird et al. in 2006).  The interface is simple and intuitive by allowing the user to select the predictors that apply to a particular patient.  By touching “next,” the user is then presented with the probability of septic arthritis as calculated by each study individually (validated), and the overall probability of septic arthritis (average of the two).  Overall, this is a simple app that offers a convenient way to utilize an existing and popular clinical diagnostic algorithm.

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iOrtho+

An-all inclusive physical exam and special test app including images, videos, and artwork to demonstrate the proper execution of each test.

This app is a comprehensive mobile orthopaedic guide that includes physical exam tests and mobilizations.  Although the app can be downloaded for free, only a limited number of exam tests and mobilizations are available until the $14.99 in-app purchase is made.  The app includes over 200 special physical exam tests, separated by body part.  For example, rotator cuff tests are divided by muscle, and subscapularis tests include lift-off (Gerber), internal rotation lag, belly press, belly-off, and bear-hug.  Each test includes a picture demonstrating the test, a brief description of the technique and interpretation, and Stat/Ref which summarizes the clinical evidence supporting the test’s sensitivity, specificity, and +/- liklihood ratios (with references provided).  A great feature is the addition of video for many of the tests.  The mobilizations section includes over 80 techniques images and descriptions.

The app underwent a recent update which now includes medical screening tests to rule out visceral pathology, impressive dermatome artwork, deep tendon reflex testing, C-spine screens such as NEXUS and Canadian spine rules, agility-functional testing for the lower extremity, and enhanced reference list to > 1100 sources, statistical data that includes clustering of ortho tests to enhance evidence-based clinical decision making.  And, if a desired test is not available, the app includes an “add your own test” section.

Overall, the app is best designed for medical students or junior residents who are learning the orthopaedic physical exam and special tests.  The app is very high quality for the extensive information and value it provides.

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Dragon Medical Search

Nuance has expanded their collection of voice dictation apps with a free app designed specifically for searching medical sites with speech.  The format is similar to the Dragon Search app, however after speaking a search phrase, the app simultaneously presents search results from Google, Medscape, Medline, drugs.mobi, and IMO.  Most providers are familiar with these sites, and when searching a phrase such as “femur fracture” the search engines returned relevant sites, articles, and information.  When searching a drug name, information from drugs.mobi was very useful with regards to dosing, side effects, and interactions.  The IMO search tab was incredibly useful for searching ICD9 codes and returned a complete list of relevant diagnostic codes for any pathology named.  Once again, Nuance has created a free app that can be of great value.  The app is limited by the fact that an internet is always required, however the utility of searching ICD9 codes from your phone is well worth the price (free).

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SugarSync

Overall: 4+
Functionality: 5
Coolness: 5

SugarSync is actually a cloud-based data back-up service that includes the use of their free apps.  But, because most surgeons are probably under-protected with regard to the security of their digital data, I strongly advocate the use of some type of auto-backup service, such as SugarSync or one of its competitors.  After paying for a subscription and installing the program onto as many computers as you would like, SugarSync will automatically back up your data in real-time both to the cloud, as well as between computers.  For example, in my home I sync my two laptops so that the data between my “home” computer and my “work” computer are always matched.  Then, I also sync specific folders (such as photos) between my computers and my wife’s computer.  Copying/transferring files with flash drives and emailing document versions have become obsolete.  Lastly, because I have the app installed on my phone and my iPad, I can access any file from anywhere, any time.  That includes photos, documents, or reading material and includes the ability to email the files directly to a colleague.  The price is competitive, and the functionality has redefined the way I manage my data.  For more information, see my FAQ section.

 Cost: Free app with subscription service.
Download Here

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Ortho Scores

Overall: 3-
Functionality: 2
Coolness: 3

This app is ideal for orthopaedic surgeons who routinely keep track of patient outcomes using assessment scores.  The app allows the user to organize a list of patients, contacts, and surgeons – but the “patients” function is clearly the emphasis.  Once entering a patient, the user can then walk through many of the most popular outcomes assessments for the hip, knee, shoulder, elbow, wrist, foot, ankle, and spine.  These include, but are not limited to, Harris Hip Score, Oxford Hip Score, WOMAC, SF-12, Knee Society Score, Constant Score, DASH, Quick-DASH, and the Oswestry Low Back Pain assessment.  The free version limits the number of patients that can be scored, and the full version allows for unlimited patients, unlimited contacts, and the ability to email the scores. Overall, this can be a very useful tool for both surgeons and patients to monitor outcomes.  Unfortunately, during testing the app was quite “buggy” and frequently crashed when running from my device.  Hopefully future updates will be more stable.

Cost: Free for Lite version, $99.99 for full version.  Spine Scores only for $19.99.
Download the Full Version Here
Download the Lite Version Here
Download Spine Scores Here

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Google Translate

Overall: 5
Functionality: 4
Coolness: 5+

Leave it to Google to creat one of the most creative, useful, and free apps available.  This app does everything you would expect from a translator: 1) It allows the user to speak into the phone and it performs voice-recognition and converts the speech to text, 2) It then translates the text into one of over 40 languages and displays the translation on the screen in the native alphabet, and 3) For many of the languages it can then speak the translated phrase back to the patient!  If this is not impressive technology, I don’t know what is.  In addition to the ingenious functionality, the app runs very fast, the dictation function is accurate, and I have yet to encounter a language that I need but do not have available.  For anyone who works in a hospital with an international patient population but where translators are not always readily available, this app is certainly one of the coolest and most useful I have ever encountered.

Cost: Free
Download Here

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MedCalc

Overall: 3
Functionality: 3
Coolness: 2

Everyone needs a good medical calculator on their smartphone, and MedCalc is my personal favorite based on the plethora of built-in equations.  The app has a very intuitive interface that can be easily navigated by users with any level of experience.  In addition, equations are organized by subject, alphabetically, and allows the user to easily mark his or her “favorites” for quick reference.  Some of the most useful tools that I have found include the opioid conversion tool, the dermatome distribution map, and the ISS calculation.  The app is also offered as MedCalc Pro for iPad and includes a full-size HD version with additional resources.  At $0.99 or $4.99, this app is a good option for someone that does not yet have their favorite medical calculator app.

Cost: $0.99 for MedCalc (iPhone); $4.99 for MedCalc Pro (iPad)
Download MedCalc (iPhone) Here
Download MedCalc Pro (iPad) Here

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Dragon Dictation

Overall: 4
Functionality: 3+
Coolness: 5

These days most surgeons are aware of commercially available voice dictation, such as Dragon and other brands, however few know that Dragon Dictation makes a free app for the iPhone.   That’s right: completely free.  Not only that, but even without voice training (as is required for the full computer-based version), this app has impressive recognition capability the first time you use it.  The app is limited by the fact that you can only dictate within the Dragon app, thus you cannot dictation directly into an email, text message, or note.  Of course, this is a limitation created by Apple which prevents one app from running “within” another app.  In addition, Dragon limits each dictation to 30 seconds.  However, because you can perform multiple dictations within a single document, and because the app allows you to easily copy, email, or text message your text – these limitations are easily overcome.   A great feature is that words that Dragon knows it may have mis-interpreted can be selected and the user is presented with similar alternatives.  From my experience, Dragon is accurate about 90% of the time, and if you include the alternative options, accuracy increases to >95%.  For someone who writes emails from their phone, this app has the potential to save you much time, frustration, and iPhone-related spelling errors.  I cannot think of a reason not to download the app.

Cost: Free
Download Here

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Epocrates

Overall: 4
Functionality: 4
Coolness: 2+

Epocrates continues to be the gold-standard for mobile drug-reference applications.  The app provides free medication information including dosing (both adults and pediatrics), interactions, contraindications, as well as a “pill identifier” to match a pill with its name according to shape, color, imprint, etc.  For anyone who cannot always remember the dosing and frequency of every medication, this app belongs in your pocket.  Unfortunately, Epocrates also insists on updating frequently and prompting users with “news” information that some may not find useful.  Thus, functionality is limited by the time it takes to occasionally update the app.  Otherwise, this app is a “must have” for any provider.

Cost: Free for drug reference, requires subscription for Essentials Plus with added features.
Download Here

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