Sites Providing PDA Pulmonary Applications

Introduction

Over the past 8 years, physician adoption of personal digital assistants (PDAs) has increased (1). Despite this, most physician use their devices for personal rather than professional purposes (2). Part of the reason is lack of specific applications for professional use as well as the lack of interoperability with other systems physicians use. The design limitations of current mobile devices were also sited as a factor.  Over the past two years several new devices with far greater capability, including integration with cell technology, have been introduced including high-end BlackBerry®s, the Apple iPhone™ and the Google™ Android™. These devices allow connection to the World Wide Web allowing for some interesting capabilities. This review is a general look at what applications are currently available that are of potential interest to pulmonologists.

One additional note is that Google is becoming a great way to research medical questions. An interesting description is in a recent British Medical Journal editorial (3). It is not, however, entirely clear that this is a good trend when used by patients (4).

Last Update: February 2010

Search

The search for websites addressing the topic of mobile device applications used the Google search engine with a search string of  [application pulmonology OR pulmonary palm OR pda OR “pocket pc” OR blackberry OR iphone OR android OR "palm pre" -ductus]. This yielded 10,800,000 sites. This particular search string results in a list of sites all of which include somewhere within them the words “application”, either “pulmonary” or “pulmonology”, and at least one of the terms “palm”, “pda”, "pocket pc", blackberry, iphone, android or “palm pre”. The term “–ductus” is added in order not to include sites having to do with Patent Ductus Arteriosus (PDA). Google has a proprietary algorithm for determining relevance of the results and the order it returns them in is usually incredibly appropriate. This means that as you work down the list, the sites are generally less and less related to the specific search terms even though they indeed contain all of them.

A potential problem with using Google and the web to search for applications for the Apple iPhone and iPod Touch or the Palm® Prē™ is that both vendors have sites accessible only by their specific devices listing all of the applications. At present, there is no way to find out what is available for these devices except by happening upon a site run by someone who has designed applications for the device. Since serious medical applications are generally created by larger organizations, they often are listed on major software distribution organizations which seem to remain the best sources of medical software. There is a site listing most, if not all, applications for Google Android phones. It appears to be an independent site rather than one created and supported by Google.

This year, the sixth hit was the same reference to a Palm Tips article in 2003 that was the number four hit last year. No previous versions of this Best of the Web article shows up at all which is interesting and requires some investigation.

The review specifically included those sites that are primary sources for applications skipping sites with articles about PDAs (including Mobile Musings [formally Palm Tips]) and references to individual journal articles. I also skipped sites that did not include anything specifically intended for a pulmonary, critical care or sleep audience. The first 150 sites were reviewed and it was indeed found that sites farther down the list were less pertinent. These sites tended to be website reviews or referrals to sites that were listed earlier.

The first application site listed (ranked 9) was for MedRules, which has not been updated in over 5 years and is only available because there is, presumably, some demand for it. Google does check sites that are frequently updated on a more regular basis but older, stagnant sites can still be ranked fairly high.

For this review, sites returned after the first 50 listings, tended to be more general and less likely to be of immediate use to the pulmonary/critical care practitioner. It should be stressed that if you are looking for more specific applications, run the search with more specific terms, e.g., leaving out "pocket pc," if you only want Palm and including the terms “drug and interaction” if you are interested in possible interaction checkers. The reason that Google includes the time the search takes (almost always less than a second), is to encourage users to iteratively search, adding and removing terms based on the previous search results until you find exactly what you are looking for.

Best Websites

Skyscape

The search, not surprisingly, included several vendors of PDA software of which this was the first. This is a site offering an extensive collection of medical software for handheld devices, which is their main business. The site has links to find applications based on your training level or specific needs such as education, clinical or drug reference. The physician section is divided by medical specialty and includes a heading for pulmonary and critical care which, at the time of my review, had 67 titles although several were general medical references. Each application has a tab listing which platforms it supports, with most applications supporting all devices including Symbian OS cell phones.

1. Authority: This site is a source of mostly commercial software for all types of PDAs. A small number of free applications are listed. Medical software including Veterinary is the only product they carry. They are involved in the creation of some but not all of their titles. In general, the software they provide is high quality. Rating: 4

2. Currency: Titles vary in quality and currency. The date of last update of a title is not typically displayed although it is occasionally suggested (at least the year) by the title. Rating: 3

3. Accuracy: Accuracy depends on the original source but is mostly good. Rating: 4

4. Navigation & Readability: Finding titles is quite easy. Browsing by discipline, medical specialty and category as well as search features are all supported. Rating: 5

5. Utility: The material varies from free to expensive. No membership is required. There are a number of excellent applications available. Rating: 4

Summary: A useful site for finding medical software.

CollectiveMed

This is another site offering a variety of software. This particular site also specializes in medical offerings. A number of their offerings are actually provided through Skyscape®. They currently mostly support Palm OS, Windows® Mobile, Blackberry and Symbian OS devices although the offerings through Skyscape cover a wider range of devices.

1. Authority: This is also a source of both commercial and some free software for PDAs of all types. Medical software is the only offering. They are not involved in the creation of their titles. In general, the software they provide is high quality. Rating: 4

2. Currency: Titles vary in quality and currency. The date of last update of a title is often not displayed although it is occasionally listed for reference works. Rating: 3

3. Accuracy: Accuracy depends on the original source but is mostly good. Rating: 4

4. Navigation & Readability: Finding titles is quite easy. Browsing by discipline, medical specialty and category as well as search features are all supported. Rating: 5

5. Utility: The material varies from free to expensive. No membership is required. There are a number of excellent applications available. Rating: 4

Summary: A useful site for finding medical software.

National Guidelines Clearinghouse from the Agency for Healthcare Research and Quality (AHRQ)

This is the PDA site offered by the National Guidelines Clearinghouse, which is funded by the US Agency for Healthcare Research and Quality. All National Guideline Clearinghouse™ (NGC) Guideline Summaries are available in a text format, downloadable for use on Palm-based PDAs. Many of the sources use the proprietary Apprisor™ reader, which is available at no charge for iPhone/iPod Touch, Windows Mobile, Palm OS Classic and BlackBerry devices. As noted in the ratings, there is both new and old material. Some summaries are designed for use with any PalmOS reader such as iSilo™, TealDoc™ or Palm Reader®, which are available separately.

1. Authority: This PDA site is operated by the National Guidelines Clearinghouse. It is an index to guidelines from many sources. The sources are provided with no ranking but seem to be carefully chosen. Rating: 4

2. Currency: The currency depends on the specific guideline. It is not clear whether there is any ongoing review, although the page was updated within the same week of examination. Rating: 3

3. Accuracy: Again, accuracy depends on the link followed. As noted above, the sites seem to be carefully chosen, but the National Guidelines Clearinghouse takes no responsibility for content. Rating: 3

4. Navigation & Readability: The links are listed alphabetically by specialty. There is a listing of what will be found if the link is followed, which is of some use. Rating: 3

5. Utility: The sites are well chosen and represent potentially useful guideline information. Rating: 4

Summary: A good source of links to other sources of information. It is specifically aimed at guideline-type content.

Unbound Medicine

This is another site offering multiple medical applications.

1. Authority: This site provides commercial software for PDAs of all types. Medical software is their only offering. They do not create their titles but offer applications from several well known medical publishers. In general, they provide high-quality software. Rating: 4

2. Currency: Titles are generally high quality and appear to be current. The date of last update of a title is often not displayed. Rating: 4

3. Accuracy: All titles are from well-known and reliable sources. Rating: 4

4. Navigation & Readability: Finding titles is quite easy. Browsing by discipline, medical specialty and category are all supported. There is no search capability. Rating: 4

5. Utility: The material is fairly expensive. No membership is required. There are a number of excellent applications available. Rating: 4

Summary: A useful site for finding medical software.

PalmGear Software

Palmgear is now one of four specific device websites offered by PocketGear in Germany. The sites have specific listings of applications for PalmOS, Windows Mobile, BlackBerry and Google Android devices. There are currently no offerings for the Apple iPhone/iPod Touch. The sites offer an extensive collection of software for these handheld devices, with a large number of nonmedical applications in addition to some medical applications. Specific pulmonary offerings are available.

1. Authority: This site is a source of both commercial and free software for the PDAs mentioned above. They do not create any of their titles and are a source for obtaining the software. The user needs to be judicious in choosing which titles to buy. Rating: 4

2. Currency: Titles vary in quality and currency. The Palm OS titles, like the device, are no longer current. The date of last update of the title is always shown. Rating: 4

3. Accuracy: This depends on the original author and is highly variable. Rating: 3

4. Navigation & Readability: Finding titles is quite easy. Browsing by category, device type and search features are all supported. Rating: 5

5. Utility: The material varies from free to expensive. No membership is required. There are a number of excellent applications available. Rating: 4

Summary: A useful site for finding medical and nonmedical software.

Other Important Sites

• Mobile Medica Apprisor Guideline Viewer
  http://www.apprisor.com

  This site was reviewed in Palm Tips, April 2004. The site provides a free reader which only works with guidelines that have been created by Mobile Medica. Apprisor packages guidelines for the American Heart Association, the American College of Chest Physicians and the American College of Physicians. A number of these organizations have no recent updates.

Disclaimer

The author has no personal or financial interest in any of the websites discussed above. The author has no personal or financial interest in any of the websites discussed above. The reviewer has no personal or financial interests in any of the websites described.

References

1. Baumgart, DC. Personal digital assistants in health care: Experienced clinicians in the palm of your hand? Lancet 2005;366:1210-22.
2. Chin, T. Untapped power: A physician’s handheld. American Medical News 2005;48(2): 17.
3. Giustini D. How Google is changing medicine. BMJ 2005; 331(7531):1487-8.
4. Ahmad F, Hudak PL, Bercovitz K, Hollenberg E, Levinson W. Are physicians ready for patients with Internet-based health information? J Med Internet Res 2006; 8(3):e22.