The mystique surrounding Apple’s unveiling of the iPad in January speaks to our lasting cultural fascination with handheld mobile computing. While the iPad represents a new development in this market, smartphones and their predecessors have been a topic of discussion among pharmacists, nurses, and physicians for years, since the introduction of the first generation of personal digital assistants (PDAs) in the late 1990s. At the time, these devices seemed to hold limitless potential for health care professionals. The concept of storing and accessing clinical and drug-related information from a device small enough to fit in your back pocket had a certain futuristic luster, and many thought of the “Pocket PC” as the next technological frontier.
To some extent, they were right. Smartphone technology has advanced at lightning speed in the past 3 years, and the products it has spawned have been almost universally embraced. Despite a host of flashy features and slick interfaces, smartphones like the iPhone, BlackBerry, and Motorola DROID are remarkably basic in their appeal. Like the ancestral telephone, they tap into fundamental human desires for communication and social interaction. In this sense, smartphones are intuitive, and individuals in the health care industry are quickly finding new ways to incorporate them into their personal and, increasingly, their professional lives.
An Essential Tool
For pharmacists, that transition from personal to professional has been slightly less accelerated, but not insignificant. Since the fall of 2009, the University of Florida’s College of Pharmacy has required its students to carry an iPhone or an iPod touch, but that mandate is currently under review. Although many pharmacists have smartphones, whether they will become an essential everyday tool in retail, hospital, and clinical pharmacies is still unclear. Some consider the phones unnecessary distractions, while others consider them a vital professional lifeline.
Concerns about limited screen size, battery life, and spotty wireless coverage are also barriers to use among pharmacists, whose busy schedules and specialized focus demand reliability and refined functionality.
With its crystal-clear, 9.7-inch screen and speedy A4 processor, Apple’s iPad is a step in the right direction, but its drawbacks are significant. The current version, for example, cannout run more than one non-Apple application at a time. This limits the iPad’s potential for the kind of simultaneous multitasking many pharmacists require. The pharmacy community’s adoption of smartphones is also heavily dependent on the success of electronic health record (EHR) implementation. A synchronized network of communication and data storage devices, both mobile and stationary, will likely be necessary to support the robust electronic prescription system that is outlined in the Obama administration’s newest strategy for bringing medical records into the digital age. If the government’s recently announced federal subsidies prompt truly meaningful use of EHR systems, smartphones could become a key line of communication between pharmacists, physicians, patients, and insurance providers. Several smartphone applications, such as Epic’s Haiku and Airstrip Technologies’ Airstrip OBSERVER Suite, have already been developed in anticipation of the new EHR standards, and more applications are likely to appear on the market as this technology matures.
Medical Apps for the Pharmacist
Among the wide selection of medical applications currently available for smartphones, a handful are designed with pharmacists in mind, and still others have crossover potential. Because the market is unregulated, and new apps are being introduced on a daily basis, it can be a challenge to uncover relevant, practical applications from trustworthy sources. Lexi-Comp and Epocrates have long traditions of providing medical information to health care professionals, and both have developed smartphone applications that are widely used and highly recommended by pharmacists.
Lexi-Comp has provided independently collected and validated medical content to clinicians for more than 30 years. Its comprehensive suite of PDA applications ranks consistently high in online reviews. Several of Lexi-Comp’s databases are uniquely suited to pharmacists’ interests, covering specialized drug topics such as allergies, interactions, toxicology, pharmacogenomics, natural products, household products, and pediatric and dental medications. Lexi-Drug ID is a unique text-based program that helps identify drugs based on characteristics like shape, color, and dosage form. Ideal for patient counseling, the Patient Education database contains question-and-answer pamphlets on medications. Overall, Lexi- Comp’s main drawback is its pricing, which varies based on the product, but may be cost-prohibitive for some. To help manage costs, pharmacists can elect to create customized subscription bundles based on their needs.
For individual pharmacists, Epocrates is also an option. EpocratesRx offers coverage similar in scope to Lexi-Comp, but at no cost. It includes detailed information on 3500 brand and generic drugs and can check interactions among as many as 30 drugs at a time. Using the app’s “Pill ID” feature, pharmacists can enter a drug’s key characteristics and quickly see a list of matching drugs, complete with photographs. The app also includes formulary information for major national and regional health insurance providers. A paid version of EpocratesRx features a longer list of drugs, including OTC and alternative medicines. Epocrates content is subjected to a rigorous review by a highly credentialed board of physicians and pharmacists.
For now, smartphones’ primary function in the pharmacy seems to be that of a mobile, interactive drug encyclopedia that is both constantly updated and easily searchable. Applications like EpocratesRx and Lexi-Comp, while useful, are unlikely to give smartphones the push they need—away from the “novel and useful” category and into the pharmacist’s toolbox. It is clear that those already using smartphones in their personal lives have significant motivation to incorporate them into their pharmacy practice, but whether or not the rest will come to consider smartphones smart enough for pharmacies remains to be seen. â–