What technology/apps do I need in Neurology?

[807crash]

I finished my Residency in Neurology a few years back, and after taking time off for family reasons, will be re-entering Neuro as a Fellow in the coming year.

What are the essential electronic devices that folks are using now, and your favorite Neurology/Medicine apps?

To put this in perspective, when I was in Residency I used a Palm Pilot and epocrates and carried in my pockets a Pharmacopia, Harvard/MGH Handbook of Neurology, my residency's pocket handbook, and probably my own little notebook to take notes and have my own protocols at hand.

What do you carry? What is essential these days?

I did just buy a iPad mini, but do not have an iPhone.

Thanks a lot for your input.

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[807crash]

anyone..? anyone...?

Anything would be helpful, especially if current residents could pipe in...

 

[typhoonegator]

7 hours is not much time to percolate.

You don't need any "apps". We don't even know what sort of fellowship you are entering.

 

[807crash]

Sorry, you're right.

General Neurology recs are fine. Just knowing what residents are carrying now in the hospital is a good start, as I feel really out of touch. I'll be doing Neuro-onc with both outpatient and inpatient care (including ICU) with quite a bit of medicine/radiology thrown. I'll be reading a lot of MRI's daily.

So there are no pharmacy/med calculator/medical reference/ICU/radiology etc.. apps that people are using now? You're not writing notes or pulling up labs on your iPads during rounds? I don't need to get an iPhone? That would be great...

That would surprise me... but what do I know.

 

[807crash]

So how about any medical students?

Do I only need the same epocrates on a Palm Pilot and the same pocket books I was using 5 years ago? No iPhone, no iPad, no apps are useful today on the wards?

Sorry if I sound clueless, but I am MD PhD and completely out of touch with what is going on now, worse due to my recent long absence.

 

[Thama]

So how about any medical students?

Do I only need the same epocrates on a Palm Pilot and the same pocket books I was using 5 years ago? No iPhone, no iPad, no apps are useful today on the wards?

Sorry if I sound clueless, but I am MD PhD and completely out of touch with what is going on now, worse due to my recent long absence.

MS4 here: what I've seen recently that is probably the cheapest option is getting an iPod Touch and setting it up for network access at your hospital. You can even use Skype or Google Voice with it as a pseudo cell-phone when in wi-fi range. That gets you access to the Apple medical app environment. EDIT: Just saw you have an iPad mini, that should be fine for all this though it might make for a large phone- you could get a small headset though if that's important to you.

I'm a droid person myself so I don't know all the apps available in the Apple ecosystem, but in my experience these days Medscape>Epocrates as a drug and basic reference app, and if your institution has access to UptoDate they have an app as well. Our hospital has apps to allow access to paging and medical records systems but that's dependent on your institution. The few neuro-specific apps I've downloaded have either been unimpressive or neat to play with but not very essential for a clinician.

 

[RenegadeSynapse]

Need is somewhat relative. I certainly know folks who prefer to have a pocket drug reference and really use their phone / tablet minimally or not at all.

That said, if you are looking for some general recommendations because you are interested in using them, here are a few (caveat, I'm an MS4 starting internship next month, so little real world experience thus far):

Drug reference: Epocrates (what I typically use), micromedex, medscape...most will typically do the job. Pick one or two and have it available.

General reference/resources:UpToDate if you have access through your institution, medscape. I would also add a plug for Read by QxMD here. It's a great app that lets you follow most major journals. If you have a login access through your institution, you can set it up to go through that proxy and download the PDF.

Medical calculator:I may be able to remember how to correct calcium, but I don't commit most formulas to memory. QxCalculate, MedCalc, both are good. I have both because sometimes one will not have a formula I'm looking for.

Neuro specific things: As Thama said above, I haven't used many on a frequent basis. I like having a decent brain atlas that I can use to explain to more visually inclined patients precisely where and what things are going on with their or their loved ones brain. 3D Brain, FINR Brain are both good.

For peripheral neuro stuff, there is an app called Nerve Whiz done by the folks at Michigan. It's a very well done app, I have not really done any significant amount of NM as a medical student, so I don't know how useful it would be.

Note: this is all for the Apple environment. By now, most things are available on both android and iOS, but your mileage may vary.

RS

 

[Hank Rearden]

The Neuro Toolkit app is good for calculating TPA dosage and has lots of other useful things as well. I have it on the iPhone. Not sure if it's available on Droid.

 

[807crash]

Thank you guys so much for this info. It is really helpful. Some of the names are familiar from the web, but several are new so thanks. I need to look into Google Voice as well.

Did many of you access hospital medical records systems/radiology viewing from your home? As I recall, the last time I did it 5 years ago it was very slow and it didn't work well with my internet access/OS. What speed internet do you guys have at home that seems to work for this?

 

[typhoonegator]

I do teleneurology from home with nothing more than a 5 year old computer and standard cable internet. That includes streaming video and audio from multiple sources, with radiology and lab review from a hospital EMR. Never had a problem.

We do have to VPN, but I can do that from a Mac or a PC these days without much trouble.

 

[807crash]

Thank you! This is so helpful.

Do you know what speed internet you are using? My local provider (AT&T) offers higher speed UVerse 3 --> up to 24 Mbps, and regular DSL 768kbps -> up to 6 Mbps. I'm moving closer to my job, so I have the chance to get a cheaper deal and realized a higher speed might help.

 

[typhoonegator]

Thank you! This is so helpful.

Do you know what speed internet you are using? My local provider (AT&T) offers higher speed UVerse 3 --> up to 24 Mbps, and regular DSL 768kbps -> up to 6 Mbps. I'm moving closer to my job, so I have the chance to get a cheaper deal and realized a higher speed might help.

I have the base plan from RCN in Boston.

 

[807crash]

I have the base plan from RCN in Boston.

wow... I looked it up. Yours is totally fast. RCN goes from 25 Mbps to 75. No wonder it works so well for you. Actually the fastest I can get even get in my area is 12 Mbps, and I only have 3 Mbps right now. So I suspect I do need faster service.

 

[typhoonegator]

Huh. Guess I didn't know how lucky I was!

 

[0nsp]

Need is somewhat relative. I certainly know folks who prefer to have a pocket drug reference and really use their phone / tablet minimally or not at all.

That said, if you are looking for some general recommendations because you are interested in using them, here are a few (caveat, I'm an MS4 starting internship next month, so little real world experience thus far):

Drug reference: Epocrates (what I typically use), micromedex, medscape...most will typically do the job. Pick one or two and have it available.

General reference/resources:UpToDate if you have access through your institution, medscape. I would also add a plug for Read by QxMD here. It's a great app that lets you follow most major journals. If you have a login access through your institution, you can set it up to go through that proxy and download the PDF.

Medical calculator:I may be able to remember how to correct calcium, but I don't commit most formulas to memory. QxCalculate, MedCalc, both are good. I have both because sometimes one will not have a formula I'm looking for.

Neuro specific things: As Thama said above, I haven't used many on a frequent basis. I like having a decent brain atlas that I can use to explain to more visually inclined patients precisely where and what things are going on with their or their loved ones brain. 3D Brain, FINR Brain are both good.

For peripheral neuro stuff, there is an app called Nerve Whiz done by the folks at Michigan. It's a very well done app, I have not really done any significant amount of NM as a medical student, so I don't know how useful it would be.

Note: this is all for the Apple environment. By now, most things are available on both android and iOS, but your mileage may vary.

RS

This is a really good list. Looking at my phone, my most used app is Lexicomp. Fantastic drug app that can do drug interactions or ID pills based on pt description. It is expensive unless you have an institutional subscription. My general reference is UpToDate, as mentioned above. The free Nerve Whiz app from U Michigan is fantastic for localization of neuromuscular cases. The last 2 apps I have are an NIHSS calculator (used frequently) and an EDSS calculator (never used).

 

[807crash]

This is a really good list. Looking at my phone, my most used app is Lexicomp. Fantastic drug app that can do drug interactions or ID pills based on pt description. It is expensive unless you have an institutional subscription. My general reference is UpToDate, as mentioned above. The free Nerve Whiz app from U Michigan is fantastic for localization of neuromuscular cases. The last 2 apps I have are an NIHSS calculator (used frequently) and an EDSS calculator (never used).

Thanks so much for your input. NIHSS calculator is a great one. I really appreciate your suggestions guys!

 

[Ginkoba4]

OKN strips for ipad or iphone, that's how you catch all the hysterical blindness and abnormal OKN responses!

 

[neglect]

Use this app for memory loss in adults, can bill 96120, which reimburses 50 dollars.

 

[dodobirddh]

I would recommend the following apps on iOS platform... they have been a great addition to me!

1.Neurology Advisor (for literature and news)
2.Read by QXMD (journal search)
3.NIH stroke scale from statcoder (NIHSS scoring app)
4.Neurology Dx (a differential diagnosis app)