How medical reference apps are enabling shared decision-making

By Bill Siwicki
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Dr. Manish Naik recently examined a patient in his office who was reluctant to get a flu vaccine because of a history of egg allergy. Naik conducted a quick search through his medical reference app and reviewed study data with the patient on the safety of flu vaccination in patients with egg allergy.
 
After seeing the latest study data and guidelines, the patient agreed to get both the flu and pneumonia vaccines. Because the patient’s underlying medical conditions placed him at higher risk for complications from flu or pneumonia, he received an important treatment directly because of quick and easy access to good data, said Naik, chief medical information officer and a practicing internist at Austin Regional Clinic.

Various app players

A variety of tech vendors offer medical reference apps on the market. These include Doximity, DynaMed Mobile, athenahealth’s Epocrates, Figure 1, Isabel, Medscape, Pepid and Read by QxMD.

Just this past September, Epic System’s Haiku app for iPhones started providing Doximity members one-touch dialing of patients through Epic’s mobile EHR. The integration between Doximity Dialer and Haiku also makes it possible for doctors to access patient records and communicate with patients from their mobile phones without exposing their personal phone number.

Medical reference apps promote the practice of evidence-based medicine and give both patients and providers confidence in the diagnosis and treatment plans being chosen, Naik said. 

The software helps him function in ways that are both more cost-effective and lead to less overall utilization of medical resources by avoidance of unnecessary diagnostic testing and consultation with specialists for knowledge gaps.

Austin Regional Clinic uses the UpToDate medical reference app from Wolters Kluwer. The material, for primary care and 25 specialties, is written by 6,000 physician authors around the world. Individual subscriptions start at $499. 

Wolters Kluwer said UpToDate is visited more than 1 million times per day and in those visits, 30 percent of the time a clinician changes their diagnosis, making a more accurate, evidence-based decision.

Integrated with EHR workflow

Naik can access his medical reference app via his smartphone, laptop or desktop. And the egg-allergic patient is just one of the many people he has engaged in shared decision-making. 

“The flexibility of using it on multiple devices allows me to access information on the go,” he said. “It is integrated into our EHR workflow. Healthcare providers can access it directly from the electronic health record.”

In scenarios where Naik has had to tell a patient he would take time to research the problem and follow up with them later, he now has been able to do a quick contemporaneous search for information during a visit. 

As a result, the patient is saved from having to make another visit or phone call -- and Naik doesn’t have homework to do after a visit.

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