At his hospital, “we peer review every 7-day readmit, not to look at the individual but to look at whether we can learn from it and ask, can we prevent it.”
The index “documents the score and the reasons,” suggesting “if anybody ever needed medical home postdischarge intervention, it’s this guy.” The index also may help providers decide timing for palliative care discussions, he said.
6. Sanford Guide to Antimicrobial Therapy – $29.99/year and GoodRx – Free
“We occasionally get a page: Please discharge your patients. Stop holding them in the hospital,” Dr. Pittman said. That sometimes happens because a patient about to be discharged has a lab come back showing an infection in their urine, and it’s tough to figure out which antibiotic to prescribe.
“If ever a book were meant to be digitized, it’s this Sanford Guide,” he said. It provides the best regimens for which drugs to use, but not their costs.
But what about cost? An app called GoodRx gives prices for drugs at pharmacies within a certain distance. “It levels the playing field for the seeming racket that is drug pricing,” Dr. Pittman said. “You type in the medication, and it overlays a map with pharmacies nearby, and links those prices.”
For example, one drug option, fosfomycin, will cost $70-$80, which may be too high for a patient, while another, nitrofurantoin, costs $23-$28. “That looks a lot better, and you just saved your patient $50.”
7. CORE – $39.99
A 22-year-old chemical dependency unit inpatient complains of knee pain after sitting in long group sessions and wants dilaudid. “How can the hospitalist test for patellofemoral syndrome?” Dr. Benson asks.
The physician turns to CORE, or the Clinical Orthopedic Exam, which can show a nonspecialist how to recognize a true orthopedic problem for multiple body sites, he said. The app shows how to perform 67 tests on the knee, in this case, with 94% diagnostic accuracy, and links to YouTube videos demonstrating the proper way to administer the “moving patellar apprehension” test.
8. VisualDx – $99 a year
A young male patient is admitted with visual changes and a palmar rash, and the hospitalist doesn’t know what to do, Dr. Pittman says. This app provides a homunculus and ways to describe the rash, including pictures one can use to match the patient’s symptoms.
“Instead of the one thing on your list, which was syphilis, the patient and his wife will be so relieved that the rash is actually just dyshidrotic dermatitis.”
9. ARUP Consult – Free online
An admission from the ED brings a 58-year-old woman with acute kidney injury suspected of having vasculitis. What’s the work-up?
Dr. Benson turns to this diagnostic lab reference guide produced by a nonprofit affiliate of the University of Utah, Salt Lake City, to select and interpret tests. “I type vasculitis,” and it shows some options and algorithms, with links to pertinent guidelines, and identifies the medical reviewer during the last update.
“This is critical when there’s a shelf life on knowledge. And the price is right,” he said.
10. Evernote – Free
“This is my favorite app,” Dr. Pittman said. “Not only for personal use, but for making professional notes as well.” A team folder, shared with his colleagues, “becomes a record of what we’ve learned during the month.”
It holds journal articles, recordings, notes, attachments, and photographs of things to remember, he said.
Dr. Benson and Dr. Pittman had no financial conflicts of interest to disclose.