By John J. Fried
Almost as soon as the iPhone—and then its imitators—colonized belts, bags, and lab coat pockets, the effort to stay abreast of the latest developments in oncology took on a new dimension. Medical book publishers, medical organizations, and journals flooded iTunes, Android Market, and other Web sites with oncology-related apps for the devices.
Thus, in the smartphone era, while standing by a patient’s bedside, you could tap the eOpioid icon, stab at the screen a couple of times, and obtain the guidance you need to convert her to a different painkiller. In an examining room, you could turn to Blausen Cancer Atlas to help you explain the disease to a prostate cancer patient. Upon learning that a patient had started taking vitamins while receiving chemotherapy, you might consult Epocrates to help your patient avoid harmful interactions.
Somewhere along the line, however, it may have become apparent that there could be drawbacks to using those smartphone apps. The device’s small screen forces you to resort to a lot of finger flicking to move through articles and other printed materials, and it can be difficult to discern important details in graphics. Also, if you are, ahem, of a certain age, the small font size can prove a challenge.
When the iPad—and its imitators— came along, there was reason to hope that there would also be apps designed to take advantage of the larger screens. The endless scrolling and the squinting would be things of the past. Well, in many cases, it has not worked out that way.
Some publishers have gone the extra mile, adapting their medical apps to the much more generous screen size of tablets. Others, however, have taken the easy way out, doing no more than making their existing smartphone apps sort of compatible with tablets. Download many an app to your tablet and you’ll find that the app only fills in a 4-inch area within the tablet’s large screen.
Here, then, is a look at the way some important and popular apps are likely to function on your tablet. Note: All apps were reviewed on an iPad only. Some apps, as noted, are also available for some other devices.
NCCN Guidelines
www.nccn.org/mobile/default.asp
As of July 2011, the National Comprehensive Cancer Network (NCCN) was still trying to decide whether it should develop a full-sized tablet app, according to an e-mail I received from the network’s tech support. While it agonizes over that issue, you will only be able to use the smartphone version of the NCCN Guidelines app on your tablet.
Look on the bright side: If you are already familiar with the smartphone app, you are not likely to find many (if any) surprises when you load it onto your tablet. You will find any guideline of importance to you by selecting it from an alphabetical list or by entering appropriate key words in a search box. You can save the guidelines to your tablet, in case you have to consult them off line. Need help? Click the Settings icon, and then click on Help. You’ll find an e-mail link to use for obtaining support.
You can use the 2× magnifier icon in the lower right-hand corner of the tablet to fill the screen. However, you may find the resolution of the text a little fuzzy and probably not of much help. An app also is available for Android mobile devices.
Epocrates
www.epocrates.com/products
In case you have not run across Epocrates or have not paid attention to it in a while, its products include more than half a dozen digital references and medical tools. Some are free, including a guide to drugs (with a drug interaction checker) as well as an app with more than 100 CMErelated activities. Others carry subscription fees. For $99 a year, for example, you get access to Epocrates Rx Pro, which includes an infectious disease treatment guide and a guide to more than 600 herbal medicines. For $159 a year, you get what is included in Epocrates Rx Pro plus hundreds of disease monographs, high-resolution disease images, and lots of diagnostic and laboratory tests. If you have $199 a year to spare, you can buy Epocrates Essentials Deluxe, which also brings you ICD-9 and CPT codes in addition to the tools included in the other Epocrates works.
The bad news? The apps are smartphone size. As with the NCCN Guidelines app, you can use 2× resolution to fill the tablet screen. But look out for the fuzzy type.
The Epocrates Web site says that as of July 2011, Epocrates “supports Android tablets with OS version 2.2 only. Android tablets with OS 2.3 or higher are not yet officially supported....” That “officially” might be code for “download and see what happens.” Moreover, the website adds, “although it remains possible to install Epocrates to Android tablets with OS 2.3 or higher, the assistance that could be offered in the event of difficulties may be limited.” Support for BlackBerry, the publishers say, is still under consideration.
Medscape
www.medscape.com
Strictly speaking, Medscape is not an oncology reference work. However, with its tools for researching drugs and drug interactions; obtaining upto- date information on 4,000 diseases; reading medical news articles; enrolling in CME courses; and viewing images, videos, and tables, it can come in handy in almost any clinical setting.
To view its 2,500-plus images, watch its 150 videos, obtain the latest medical news, or take a CME course, you’ll need to keep your tablet connected to the Internet. To save battery life, however, you can download much of Medscape’s text-based information to the tablet and read it offline. And, yes, it takes full advantage of every millimeter of your tablet’s screen. There is a Medscape for Android devices running OS 2.1, according to a Medscape representative.
TNM 7.0
www.cancerstaging.org/staging
The TNM 7.0 app may be simplicity at its best. You need only tell it the size of your patient’s primary tumor, whether there are cells in nearby lymph nodes, and whether there are metastases elsewhere in the body. In a split second, you have your answer. TNM 7.0, which will cost you $14.99, is strictly small screen. How- Technology ever, given its uncomplicated interface, its inability to use a tablet’s full real estate is not a disadvantage.
Care360
www.questdiagnostics.com/hcp/connect/physician.html
If you want to see what a first rate tablet app should look like and you refer your patients to Quest Diagnostics for lab work, check out Quest’s Care360 app. It’s full sized, colorful, well organized, and easy to navigate. Care360’s main mission is to give you fast digital access to lab tests you ordered for your patients. You can use the app to order tests and then review the results. The basic Care360 is free. However, for $23 a month per prescribing physician, your practice can also use Care360 to manage prescriptions.