The healthcare field is inundated with new products and systems to help streamline patient care and make processing information more efficient. Some seem to cause more work, but occasionally, a product is introduced that completely changes the way the industry functions.

It is becoming more commonplace in the healthcare industry for physicians to carry around a personal data assistant (PDA). PDAs and the like have been available for a while as a tool to make important information easily accessible to physicians, but the systems that operate these PDAs can vary vastly in their effectiveness and offerings. In 1999, software company Epocrates Inc., San Mateo, Calif, released its first mobile clinical product, the free Rx drug reference.

Epocrates tools are continuously updated to help healthcare professionals stay current in the rapidly changing and developing field. The system was developed for physicians by practicing physicians, so the products and content are tailored specifically for the needs of clinicians.

Technology to the Rescue

Chicago-based Radiation Oncologist James Ruffer, MD, uses his PDA daily. "I kept track this morning, and, on a light patient day, it has been four times in only half a day." And he's clearly not alone. "In our group of 13 physicians, at least 11 have PDAs and have evolved over the last two years into becoming tech-savvy and allowed themselves to use technology to optimize patient care. Most of the physicians that I work with are using Epocrates or some other program," Ruffer reports.

In fact, more than 2,000 radiology professionals have subscribed to the program, and with the new products on the horizon it is sure to become more popular. The system is easily downloadable and offers a new user interface and a colorful new screen design.

This drug database helps healthcare professionals make determinations about possible drug interactions through the MultiCheck system, which checks for interactions for up to 30 drugs, proper dosages, formulary information based on patients' insurance coverage and offers an alternative medicine database.

"The newest drugs and their adverse interactions are more and more difficult to keep up on," says Ruffer. "I, therefore, find myself using Multicheck with almost every patient I see. I also give out patient education material provided by the online Epocrates tool for every prescription that I write – and then documenting the fact that I provided this information."

Problem Solved

The Rx database is electronically updated routinely by a team of physicians and pharmacists who continually research and review information from a variety of sources, therefore offering the most current drug information available. It can also inform healthcare professionals of the recommendations for specific treatment of different ailments.

As Julee Waldrop, MS, FNP, PNP, describes, "When the [U.S.] FDA approves a new drug or indication for an old drug you will have prescribing information at your fingertips months before it is published in another drug compendium."

Users can customize the default tabs and choosing certain tabs will bring up display headings and alerts. Users report that the alerts aren't overdone and actually help organize the information to aid navigation, which makes scanning text for information more efficient, and, in turn, improves more timely patient care. Clinical tables and guidelines include advanced cardiac life support guidelines, vaccination schedules and a medical calculator that includes more than 39 of the most commonly used medical applications.

The system will even update users with "DocAlerts" if important prescribing recommendations change or if adverse reactions have been discovered. It will also warn if a medication is suddenly taken off the market.

Covering All Bases

Though the company founded itself on the Rx program, it has also released other helpful databases. The Epocrates Lab offers a diagnostic and laboratory test reference with hundreds of tests and panels, preparation and collection information, and adult and pediatric reference ranges, among others.

The program will help interpret collected data by offering comprehensive differential diagnoses for abnormal values and will give follow-up information to help with diagnosis, thus making it especially helpful for radiology professionals.

Another database that completes the circle of healthcare information is Epocrates Dx, the disease diagnosis and treatment reference.

It includes more than 1,200 diseases and conditions with signs and symptoms, causes, diagnosis, treatment, medications and reimbursement codes. Like the Rx, it is frequently updated and expanded. Many PDA users are already familiar with Griffith's 5 Minute Clinical Consult (5MCC), and this is included in the new system.

"Epocrates Dx is comparatively streamlined with less on the screen and cleaner menus. Jump links are present within each topic, facilitating rapid selection of related topics," explains Rod Story, MD, in relation to other competitors' layout of 5MCC.

The format of Dx is similar to the other two databases, so it remains easy to navigate. And new disease monographs exclusive to Epocrates Dx are being developed and added regularly. Reports Edward Fang, MD, editor in chief of Epocrates Inc.'s medical information division, "Radiologists may benefit considerably from the broad scope of diseases and conditions that Epocrates Dx covers."

All three systems are connected, so navigation is easy. "The "Essentials' reference software is fully integrated, so if a physician is referencing a treatment for a disease, he can directly link to the drug monograph to identify dosing and potential adverse events or side effects," explains Fang.

Epocrates also offers continuing medical education (CME) courses via mobile devices that can be earned at a user's convenience. Physicians and clinicians read a short essay and simply complete a series of questions to earn CME credits at no cost.

Ruffer reports using this feature often. "I have been traveling quite a bit for business recently. Rather than reading a newspaper or novel, I have been racking up CME hours in a very easy, interesting fashion on my PDA using mobile CME."

And there's more on the horizon. "Epocrates is launching a new symptom assessment tool that will be available in the Epocrates Essentials premium drug, disease and diagnostics guide," says Fang. "In addition, we will be introducing a free version of our popular online drug and formulary reference."

"Physicians can download new information from the Epocrates network routinely by simply synching their mobile devices to a computer and connecting to the Internet," Fang continues.

But there is a downside. It's hard to find, but some of these databases do come at a cost. Though all are downloadable from the Internet, there is a yearly subscription charge for certain features and upgrades. However, the most commonly used function, the Epocrates Rx drug reference guide, is free to any healthcare professional with a handheld device.

"If it were not easily accessible and trustworthy, I would move to a different software program," says Ruffer. "I have used the software for a number of years, and it has consistently been right on the mark."

Overall, the product's value seems to outweigh the cost. Reliable data, instantaneous results and constant access are quickly making PDAs indispensable tools for practicing physicians. "I find it amusing, in a self deprecating sense, in regard to my dependence on [Epocrates] Rx," Rutter admits. "I remember as a med student being frustrated when attending doctors did not have complete control over the most recent drug releases and their interactions. As I have been out [of school] more years, I am now on the other side of the fence and realize that as I am away from the teaching environment, there are many other areas that I must maintain knowledge." With so many users, Epocrates has helped the healthcare field stay in tune with the latest research and information. To learn more, visit www.epocrates.com.

— Jennifer Pilling, MA, is a freelance writer based in Pennsylvania. Questions and comments can be directed to editorial@rt-image.com.