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The development of smartphone with downloadable function and wireless network access is comparable to computers. Numerous medical applications (apps) are available for smartphones to download and assist health care professionals (HCPs) in many aspects of clinical practice, like Epocrates, PEPID, UpToDate, Medscape, Doximity, etc. Some apps are free download to use, some apps are required yearly payments for fully information access; some apps are designed for educational purpose, some are created as a communication tool. The purpose of this essay is to introduce free Medscape smartphone app and highlight the benefits in clinical practice. Medscape app for smartphone by WebMD is offered through Apple iOS and Google Android. Medscape has been recognized as a leading medical reference tool for all different levels HCPs, from specialists, primary care physicians, nurse practitioners (NP), medical students, nurses, etc. Medscape app has been benefitted on point of care use, medical education, and patient education for HCPs. HCPs can download free app on their phones and quickly look up drug information, locate the disease reference tool, stay with the latest medical news, access clinical practice guidelines on-the-go, and more. The important part of role of NP is teaching individuals and their families on health maintaining and disease prevention, beside diagnosing and treating patients. It is crucial for NP to understand apps correctly and effectively utilize in clinical practice.
Keywords: smartphones, medical apps, Medscape, clinical practice
Under the rapid ever-growing of technology and powerful technological transformation, informatics becomes a specialty which has been widely integrated into the healthcare system and environment. Many impressive technologies and practical tools have been invented to support health care and enhance patients’ safety for the best practice, such as CPOE, EMR, EHR, BCMA. Numerous medical apps are available for smartphone to download and assist health care professionals (HCPs) in many aspects of clinical practice, like Epocrates, PEPID, UpToDate, Medscape, Doximity, etc. Some apps are free download to use, some apps are required yearly payments for fully access. PR Newswire (May 28, 2015) described Medscape as “the leading source of clinical news, health information, and point-of-care tools and medical education” for HCPs on the commemoration of Medscape’s 20th anniversary. Medscape apps offers HCPs the most vigorous ad comprehensive medical and educational information at fingertips. How smartphone app benefits clinicians?
Smartphone Technology in Healthcare
Small smartphones are always on and can be carried every day, it becomes the most convenience and easiest source of accessing health information, which forms the essential communication tool for HCPs. Widespread using smartphone with advance technology by HCPs has transformed many aspects in healthcare practice. A smartphone is a mobile phone with more advanced features and greater computing capacity. Currently the majority smartphones’ operating systems, are Apple iOS or Google Android with wireless network access technology
and powerful processers, which can compare to computers. Ventola (2014) indicated the advance features of smartphone including web searching, global positioning systems (GPS), high quality video and audio recording with large memory capacity. Smartphone has combined communication tool and computer together into a handheld single device which can be placed in a pocket and easily access at the point of care by HCPs (p.356). Apps are applications can be simply downloaded onto a smartphone or other mobile device, Golden (2015) addressed apps are useful at the point of care in healthcare environment, including supporting patient on health and wellness management, obtaining handy helpful information at fingertips, and guiding patients to the most recent information at the point of care (p.1062). Fast development of medical apps and downloadable feature make smartphones as common tools for both professional and personal use in health care setting.
Medical apps have been assisted HCPs with different tasks, including at the point of care, treatment planning, documentation, interaction and cooperation of interprofessional heath care teams, as well as research and education (McGonigle & Mastrian, 2018, p.61). Among over 10,000 apps for HCPs, the most top apps chose by HCPs provide educational knowledge for point of care which includes integration of diseases and treatments, as well as drug tools; the second ranked apps used by HCPs support teaching patient on specific conditions (Golden, 2015, p.1063). Medscape app is a free medical app developed WebMD, which meets the criteria of top ranking apps and is available for Apple iOS and Google Android users. Medscape has been recognized as a leading medical reference tool for all different levels HCPs, from specialists, primary care physicians, nurse practitioners (NP), medical students, nurses, etc.
Medscape Smartphone App
Phillips & Thornbory (2014) reviewed Medscape as a free downloadable medical app through Apple Store or Google Play which provides the most up-to-date clinical information for health professionals. Medscape app has been utilized by more than half physicians and three out of four medical students in the United States (p.28). A simple registration is required to access enormous array of medical information in the app. On Medscape smartphone app home screen, Medscape Today provides the top news and perspectives from across medicine and earns CME all in one place; multiple tabs provide easy access valuable information of drugs & diseases, including drugs, conditions, procedures, drug interaction checker, latest clinical guidelines, pill identifier, calculators, etc.
Medscape can be a great drug reference for clinicians, which provides drug dosage and indications, interactions, adverse effects, warnings, pregnancy, pharmacology, administration, images, formulary, in addition with available pricing & savings. All drugs information are available at the point of care which can fast access and clear any question at the fingertips. Medscape serves as a mini textbook for diseases which offers quickly reference and refreshing medical knowledge for clinicians. Under Medscape home screen conditions tab, it provides detailed knowledge on each disease, from overview of disease and condition, clinical presentation, differential diagnoses (DDx), workup, treatment and management, to medication. Medscape also provides personalized professional development based on specialties and sorted by topics. It allows clinicians to follow the customized activity list, stay the latest in practice, and earn CME or CE credit on the go (“Medscape,” n.d.).
Mobile device with medical apps has changed clinical practice and assist HCPs on different tasks. Some benefits were reported by Ventola’s study (2014).
Clinical decision making at the point of care: Ventola (2014) reviewed studies and reported mobile device with medical apps were valuable tools supporting better clinical decision-making. Clinicians, medical and nursing students all indicated the most useful tools for supporting evidence-based medicine and clinical decision-making were drug reference, medical textbook, disease diagnosis, and medical calculator apps (p.362).
Drug Reference Tool: In the study, the prescribing accuracy was tested with using mobile device and medical apps, the result was found a statistically significant level on improving and understanding drug knowledge. Another study of risk assessment was conducted regarding the incident of gastrointestinal side effects with nonsteroidal anti-inflammatory drugs, the result was significantly reduced in HCPs group using mobile device app compared with a control group (Ventola, 2014, p.362).
Medical Education and Training: Ventola (2014) pointed out mobile devices with medical apps had increasing importance in medical education. Students can quickly and easily assess information regarding medical conditions and drug treatment, specially they can learn anywhere by accessing information or verify knowledge by utilizing mobile devices which consider as a “pocket brain” (p.361). As well as HCPs participate in CME activities through mobile device app, it keeps health professionals informed the most up-to-date evidence-based information and medical practice, furthermore it enhances evidence-based practice in health care (Ventola, 2014, p. 361).
Ventola (2014) summarized the benefits of HCPs using mobile devices with medical apps, including convenience, better clinical decision-making, improved accuracy, increased efficiency, enhanced productivity, etc (p. 362).
Using Medscape for Role of the NP
The important part of role of NP is teaching individuals and their families on health maintaining and disease prevention, in addition to diagnose and treat patients. Since medical apps for smartphones have been transformed into healthcare and clinical practice, it is crucial for NP to understand apps correctly and effectively utilize in clinical practice. NP as knowledge user and worker, need to know how to systematically evaluate an app for patient care. Mnemonic NPMEDAPP was created as the important characteristics of apps (Golden & Krauskopf, 2016, p. e27).
- Novel: As a clinician, we need to initially evaluate an app to confirm it is a good solution to we try to accomplish. The most valuable is a unique topic or delivery.
- Potential of benefit versus risk: Clinicians need to consider the app’s potential benefit and risk in our patient’s care. If the app has tendency of potential change the plan of care, FDA considers the app as high risk. Similar rule can be used to evaluate a medication on risk and benefit.
- Medially sound: The HCPs need to verify the information obtained from the app is reliable, accurate, and up-to date.
- Ease of use: User friendly can be determined by quickly learn to use and easily navigate through.
- Developer: As a knowledge user and health care provider, we need to identify the source and evaluate the potential bias, to ensure the reliability and authority of information.
- Audience: It is important to evaluate the app was created to assist which population, such as clinician-based, or information to clinician, or patient-based for better self-management.
- Price: Some apps are free to use, some may require payment to download for fully access, or payment is required for additional feature of the app.
- Platform: As a clinician, we need to know the app’s platform to determine the accessibility of the app. Is the app supported by Apple iOS or Google android, or support both systems?
As a future NP, I use NPMEDAPP to evaluate Medscape on accessing Type 2 Diabetes Mellitus (T2DM). Under smartphone app, I can easily and quickly locate T2DM under Disease & Conditions within Endocrinology category. The information of T2DM are very comprehensive. Each condition contains overview, clinical presentation, DDx, workup, treatment and management, guidelines and medication. Disease overview includes practice essentials with imagine, signs and symptoms, diagnosis, disease management, background, pathophysiology, etiology, epidemiology, prognosis, patient education. Clinical presentation involves history and physical examination. Under each condition, listing all references with direct link to access at fingertips. In addition, each disease has media gallery which includes important figures, boxes, tables, and other useful information for providers to utilize and access. These information included possible physical examination findings in patients with T2DM, diagnostic criteria table for T2DM, laboratory monitoring of patients with T2DM,
treatment guidelines of T2DM table, different types of insulin and individual usages, etc. Through review T2DM under Medscape app, the information obtained is like a complete text book with the most recent study and practice. The updated date was October 1, 2018 with detailed author, contributor information, and disclosures. Medscape from WebMD is developed by WebMD Health Professional Network, which honored many rewards to be a trust and reliable website for HCPs, such as Professional Website 2016, Best Professional Healthcare Media Brand 2015 and 2014, Trade-Health, Medical, Nursing 2015, etc. Medscape indicates the mission is to “improve patient care with comprehensive clinical information and resources essential to physicians and healthcare professionals” (“Medscape,” n.d.). NP needs to guide our patients to differentiate and utilize reliable information for their health care and wellness.
Conclusions & Recommendations
Health care providers expected to be more cooperated into every aspect of clinical as primary care providers. Medscape mobile appt can be an invaluable tool to expand clinical knowledge to support meaningful and best patient care. Systematically review of medical devices with apps are highly recommended to evaluate, validate, develop of EBP towards improving patient outcome as a meaningful purpose of medical apps application. (Ventola, 2014, p.363).
- 20 years of medscape — reflection, innovation and celebration. (2015, May 28). PR Newswire Retrieved from https://search-proquest-com.libproxy.adelphi.edu:2443/docview/1683513074?accountid=8204
- Golden, A. (2015). Federal policy and mobile apps. The Journal for Nurse Practitioners, 11(10), 1062-1063. https://dx.doi.org/10.1016/j.nurpra.2015.08.015
- Golden, A., & Krauskopf, P. (2016). Systematic evaluation of mobile apps. The Journal for Nurse Practitioners, 12(1), e27-e28. http://dx.doi.org/10.1016/j.nurpra.2015.10.005
- McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
- Medscape. (n.d.). Retrieved December 6, 2018 from Medscape: https://www.medscape.com/public/about
- Phillips, A., & Thornbory, G. (2014). Apps for health professionals. Occupational Health, 66(4), 27-29. Retrieved from https://search-proquestcom.libproxy.adelphi.edu:2443/docview/1520016317?accountid=8204
- Ventola, C. L. (2014). Mobile devices and apps for health care professionals: uses and benefits. P & T: a peer-reviewed journal for formulary management, 39(5), 356-364. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4029126/
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