Imagine this scenario: You're a family physician who's admitted a man to the hospital with an acute myocardial infarction. You've run all the cardiac enzyme levels, done the initial ECG, and now he's stable--for the moment. So you head home for the night.

But in the back of your mind is that one troubling anomaly on his test strip. Ideally you'd like to remain at the bedside to see follow-up ECGs, but you can't be there 24/7. If you had AirStrip Cardiology, that wouldn't be an issue.

A mobile app produced by AirStrip Technologies, AirStrip Cardiology sends a patient's ECG tracing directly to an iPhone or iPad in near real time. A physician can see readings for each of the 12 or 15 leads, zoom in for a detailed view, move back and forth on the time line, and even do measurements in each waveform.

Of course, every silver lining has a cloud, and in this case, it's cost. This isn't a technology that simply requires the download of an inexpensive mobile app. As the vendor points out on its website: "The hospital must purchase the interface, server, and individual subscriptions from AirStrip for their physicians in order to operate the system using existing hospital IT infrastructure." Price will depend on the needs of the specific healthcare organization, AirStrip says.

But if this kind of service fits the needs of your hospital, price may be a secondary factor, especially if the application can reduce the risk of a negligence lawsuit.

12 Innovative Mobile Healthcare Apps

AirStrip Cardiology is only one of many practical--and very cool--mobile applications. As part of its first Mobile Application Smackdown competition, InformationWeek Healthcare would like to hear about other compelling and transformational mobile healthcare and telehealth apps that help practitioners communicate with patients or do their jobs better.

Finalists for the competition will provide live demos of their products at the first InformationWeek Healthcare IT Leadership Forum to be held at the Grand Hyatt Hotel in New York City on July 12, 2011.

Speaking of compelling mobile apps, take a look at DrChrono, an iPad-based EHR, that lets doctors input patient histories and physical exams, do e-prescribing and patient scheduling, and convert medical speech into text.

There's more: It tracks drug interactions, offers paperless medical billing, and has a template for SOAP notes--the traditional Subjective, Objective, Assessment, and Plan approach used to keep track of patients' course of treatment in many medical settings. All this is done without additional hardware, just an iPad and an Internet connection.

Also impressive is DrChrono's use of the iPad's camera and video capabilities to document symptoms. In my mind, that really takes the traditional patient chart into a whole new realm. Clinicians who still rely on paper charting have no way to document a skin rash in any kind of detail, for example, except to use lots of words to describe the color, size, and shape of the lesion.

With DrChrono on an iPad, all you have to do is snap a picture and save it to the system. And since the iPad also records video, a nurse or doctor can document an abnormal gait or a facial tic without typing in all those time-consuming words. Pricing for DrChrono varies from free to about $800 per month depending on the number of features you want.

UpToDate, another app to consider, is one of my all-time favorite programs for healthcare providers. UpToDate is a huge database of medical information, essentially an online library of textbooks in about 17 specialties, updated about every three months--which makes it stand apart from hardcopy textbooks, which are typically updated every three to five years.

I know several clinicians who use this tool regularly because it's so comprehensive and because its search engine lets them use it as a point-of-care resource. I've used it myself as a medical writer so I can speak from first-hand experience about its scope and depth.

Many medical resources are valuable as "browsing" libraries or to provide a general overview on a specific disorder. UpToDate goes beyond that because it enables the practitioner to answer specific questions he or she needs to answer while at the patient's bedside: What's a normal serum thyroxine level? What are the relative merits of ultrasound, mammography, and MRI for detecting breast cancer? Does this lesion look more like eczema or a fungal infection?

Granted the answers to these questions can be found elsewhere, but UpToDate provides them all in one place and from top-notch experts that physicians recognize and trust.

Should you subscribe to a service like this? Again it's a matter of getting the right fit. If your practice is composed mostly of nurse practitioners who are seeing routine conditions--runny noses, contact dermatitis, Lyme disease--then you may not be able to justify the expense. Individual subscriptions run from $195 to $495 per year with special pricing for group licenses.

On the other hand, a large group practice with several internists or subspecialists seeing complex cases that are difficult to manage may be able to fit it into the budget.

While UpToDate isn't yet available as a stand-alone mobile app, it can be accessed from a Web browser on a smartphone. You can also install the software directly onto a mobile device that doesn't have Internet access if it runs Windows Mobile 5 or Windows Mobile 6 and has a SD memory card slot.

So whether your clinicians need point-of-care research on the latest treatment protocols, or direct access to patient data, it's likely there's a mobile application or smartphone add-on that can fill the void. We look forward to seeing your favorites. Ours are located in the slideshow we just put together. I hope you'll take a closer look.

Nominate your favorite mobile health or telehealth application as part of our Mobile Application Smackdown competition.

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