Healthcare professionals often need to look up guidelines when treating patients. Newly qualified (junior) doctors may not be as familiar with these guidelines, so they often have to refer back to books and manuals. Carrying a pile of books around, however, isn't very convenient option for new doctors.
Growing mobile technologies offer better health solutions on-the-go for both students and physicians, who are always in quest for the best medical reference app.
But, with the multitude of medical apps available on the market today, the real question is which one is actually the best solution. Answering this question for medical reference apps is tricky. They all have to be fully accomplished, providing a well-referenced evidence-based content, having a modern design and easy-to-use interface, to help make sure that medical professionals, especially junior doctors don't forget any key information important for their patients' treatments.
One of the earliest entries aimed toward new interns and junior doctors was Patient Safety Manual app, created by Cranworth Medical and Guy's and St Thomas' NHS Foundation Trust. The Patient Safety Manual app allows junior doctors to quickly access the plethora of information required for the safe treatment of their patients. Its creators describe this patient safety manual as an invaluable guide to common clinical situations and commonly needed reference material, including optimum fluid management, common drug doses and clinical scoring systems.
It sounds what junior doctors may need, but does this app really offers enough to be the best, or at least great? It's the purpose of this review to find out.
The Patient Safety Manual app opens to the home screen, which is basically an alphabetical index of the all content and references available within the app. At a quick glance, you can see what the content is about. There is information about how to manage certain conditions, or fluids and drug dosage, how to perform certain procedures, or to interpret ECGs and clinical scores such as the AUDIT, CHADS2-VASc or TIMI.
Each of the references listed on a home screen, has an icon beside its name telling which category it belongs to. 3/10 icon is designated for Clinical scores category that can also be accessed by taping on the same icon in the footer. Clinical scores are also listed alphabetically, ranging from Abbreviated Mental Test and ABSD2 scores to Wells Score and WHO Performance Categories.
Tapping on each score opens a new screen with questionnaires and/or guidelines on how to perform certain screenings and assessments. These guidelines are mostly textual based with some of them presenting information using simple charts and tables. They are not calculators, which is what we expected to see.
Besides Clinical scores, you can access other reference materials by tapping on More tab in the footer. You'll see them listed in similar fashion with associated icons beside each.
Fluids category provides guidelines and information regarding fluid management, with general considerations, as well as assessment recommendations for certain conditions, such as hypercalcaemia, hyperkalaemia and hypoglycaemia.
Drugs category provides guidance on common drug doses, which are basically just analgesics, anti-emetics and laxatives. This category also guides medical providers through general precaution steps regarding certain drugs, such as antibiotics, blood thinners, NSAID, opiate analgesics, insulin, etc.
Next category is Presenting (complaints), which provides a reference material on how to manage most common clinical situations, from acute kidney injury, chest pain, hypertension to stroke and TIA. This category is too important to be 'hidden' like this within the app. We're not sure why the app developers didn't place it in the footer for easier access, for example, instead About section (which could be moved to More section). Also, I think they should have come up with a better name.
Anyway, reference materials provided within this category offer basic guidelines for common health conditions. Each guideline provides different steps, depending on the condition, ranging from assessment, risk factors, symptoms, diagnose, to fluid and drug therapy (if applicable) and other treatment suggestions.
Information in some of these guidelines is quite scarce, such as in part about allergies, while some information is available in separate app, such as deep venous thrombosis. Parts about chest pain and stroke contain useful graphs explaining the protocol from the patient's admittance to the risk evaluation and recommended further actions.
Graphs are also available in Investigations section, which explains how to interpret blood gas and ECG results. These graphs show how normal ECG looks like, as well as rhythms and waves common for certain heart conditions, such as atrial fibrillation, myocardial infarction, ventricular tachycardia, etc.
Common procedures, such as NG tube management, insertion of catheters and venous devices, are also provided here, as well as referrals and other guidelines, including advanced life support, AMBER care, surgical safety checklist, etc.
Each of these guidelines can be bookmarked and accessed later via Bookmark icon on the home screen. You can also use search option available on the Index page, but it's not advanced at all. It basically just returns results listed there.
While the design and interface are pretty simple and straightforward, some things could be fixed for better user experience. For example, Index tab is useless, because all sections are listed and accessible elsewhere. It would be better if some more useful sections, for example Presenting, which lists guidance for common clinical situations, is shown on home page. Same applies to Fluids, Drugs, Investigations and Procedures sections, which shouldn't be hidden within More tab (About tab is more suitable for that).
Search is also redundant, because users can find what they need simply swiping through the index list. It should provide more complex search algorithm for better results.
The app also includes very little backup information about certain medications, and only includes limited number of medication types. The app also didn't include particular health conditions which are very common in clinical practice (such as pneumonia), as well as information about some clinical scenarios and procedures.
Overall, this isn't the best medical reference app available. It isn't great either. So far it's just a mediocre guidance tool for new doctors, with a lot room for improvement.
Benefit: Medical residents, students and junior doctors may find it useful for basic information, but not for impressive content.