The Digital Doctor

Hi everybody, my name is Dr. Abison Logeswaran and I’m currently working as a specialty registrar in Ophthalmology at the Royal Free London. Upon completion of my medical degree, I went on to complete my MSc in Health Informatics at City University London. Completing my MSc part-time while undertaking my foundation training (first two years of working life after completing my medical degree) was no easy feat, but they complemented one another perfectly. I was able to appreciate the ever increasing role that data analysis, technology and statistics will play in the future of medical practice. Antiquated thinking and sunken-cost fallacies have held back innovation for too long, and now is the time that healthcare professionals with a passion for informatics can make a difference. We need to adopt and integrate technology into our working lives to increase efficiency, improve patient safety, and make the healthcare experience better for all.

A simple way to get started is to utilise mobile applications. Being able to carry a personal computer in the palm of your hand, is a luxury that physicians of the past never had. I would like to thank Max for providing me with the opportunity to share some of my favourite applications that I hope enhance your medical practice (disclaimer: these apps are useful adjuncts but do not replace clinical decision making, guidelines or protocols).

MedCalX

If there is any one single application that I would recommend, this would be it. It really is the all in one app. Evaluating the risk of a patient developing a stroke or deep vein thrombmedcalx.pngosis, usually, involves the need to calculate cumbersome scores that determine further investigation and management. Thanks to MedCalx, these are all available at a click of button. Within seconds you’ll know your patient’s level of risk and whether your next port of call is a CT or x-ray. In addition, advanced functionality will actually support your clinical decision making. The ABG interpretation tool is a quick way of determining your patients’ physiological status and you can even calculate the anion gap.

Medscape

This app is popular with both healthcare professionals and patients alike. It has some cross-over functionality with MedCalX, such as a range of a diagnostic/prognostic criteria calcScreen Shot 2016-08-07 at 01.00.33.pngulators. Its real strength lies in its drug interaction calculator. Prescribing medication often becomes second nature to doctors and runs the risk of complacency. This is particularly important in the prescription of anticoagulants; whose concentrations can be sensitive to the effects of concomitant medication. Within seconds you’ll know whether medications interact with one another, enabling physicians to adjust doses appropriately.

Microguide

This is another important time saver. In medical school, we are all taught about antibiotics, their mechanisms of action and the types of infections they treat. However, the working reaScreen Shot 2016-08-07 at 01.04.25.pnglity is that due to population variations, and differing geographical resistance patterns, each trust will have different antibiotic policies. Thankfully a lot of trusts have signed up to Microguide. Using this app, you’ll be able to simply look up your trusts antibiotic policy stratified by the site of the infection.

British National Formulary 

This is the gold standard for looking up drug doses, indications, interactions and side effects. However, from personal experience I found it to be cumbrous when looking for bnftreatments on a given condition. This app shines when you want to find out information about a particular drug. If wanted to prescribe co-amoxiclav for an pneumonia, you could look up the drug, dose, duration and contraindications in seconds.

FastECG

ECG interpretation is a skill acquired through years of experience and a sharp eye. Junior doctors on the shop floor often need a second opinion to confirm the diagnosis. However, help may not be at hand and the ECG may need to be faxed over to a senior. Yes, you did readecg that right, hospitals still use fax machines !! This is slow, inefficient and in most cases of poor quality. Thanks to the great minds at MobileMed and Sichtwerk that will hopefully be a thing of the past. Simply take a photo with your smartphone, and an anonymous ECG will be uploaded to the fastECG website. A code will be generated that can be given to the reviewing clinician. Using the code, they can access the fastECG site and interpret a high quality image of the ECG.

Induction

Phoning people with referrals, chasing bloods and harassing radiologists is pretty much the inductionbane of a foundation doctors’ life. If you’re running from location to location, you probably won’t get you very far. Using the in house directory is painfully tedious and often out of date. Thanks to the induction app, you will have all the updated bleeps and extensions at the palm of your hand.

 

These are just some of the few apps that got me through my foundation training. Hopefully, these apps will inspire you to collaborate with people like Max, who not only possess great technical skills but have an understanding of the practicalities and nuisances of the healthcare industry.

 

speaking
Dr. Abison Logeswaran talking at the Royal Society of Medicine

 

 

 

 

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