Two years ago, after devoting several years to administrative medicine and business, I decided to return to full time clinical pediatric practice. Although relieved that my clinical judgment remained intact, I found that much had changed in clinical pediatrics, especially with the array of new drugs and dosages to treat pediatric problems. My re-entry into clinical medicine motivated me to explore my options for handheld prescribing technology, and I became an early Epocrates subscriber.
The Epocrates suite of products has expanded dramatically over the last two years in response to the needs of practicing physicians. I now routinely use the Epocrates Rx Pro premium drug reference and Epocrates Dx disease reference in the course of my daily patient encounters. I've also had the opportunity to sample Epocrates' newest application, Epocrates Lab, which completes (at least for now) the application suite, called Epocrates Essentials.
Essentials is aptly named in that this suite of applications has become, in my view, the gold standard for mobile medical resources in the marketplace. Although there are a number of alternative products available, none has the accuracy, ease of use or integrated features of Essentials. In the past, I relied on textbooks and frequent trips to the office or home computer to obtain clinical and diagnostic materials. With Epocrates, I now have essential diagnostic and prescribing reference information immediately available to me at the point of care.
All references and tools within Essentials are now tabbed, allowing easier access to needed information. Under the Rx tab, I can look up information on over 3,000 brand and generic drugs, including dosing, contraindications, and cost information. In my practice, consistently accurate drug dosing is essential to eliminate or reduce medical errors. Epocrates provides pediatric dosing for most medications I prescribe to my patients; tapping on any underlined, highlighted medication launches a weight-based dosing calculator, which is medication specific. All the physician needs to do is input the medication strength or liquid formulation, the child's weight, and the dosing interval - the dose is accurately calculated and instantly displayed. Medication safety precautions for pregnant or breast-feeding mothers, invaluable for the pediatrician, are also available.
Within Rx, there is a tool called MultiCheck, which enables me to check for adverse drug-drug and drug-herbal interactions among up to 30 medicines at a time. Running a Multi-check is an instantaneous, one-step operation that provides indispensable information for my patients who take multiple medications.
Under the Dx tab, I have the ability to access scientifically valid, bullet-point monographs for more than 1,200 diseases and conditions, many of which apply to my pediatric patients. Epocrates Dx is based on Griffith's 5-Minute Clinical Consult, but unlike other versions of the 5-MCC, Epocrates Dx is frequently updated and expanded.
Using Dx, basic clinical and diagnostic information, surgical and medical treatment options, patient education and monitoring tips, and key preventive care information are all instantly available. Unlike stand-alone programs, Dx provides direct links to other references within Essentials, so that tapping on a 'drug of choice' instantly launches Rx, which provides up-to-date information on the corresponding drug. From there, it's a snap to cross-reference other medications for the clinical condition.
Lab is the newest addition to the Epocrates suite. Selecting the "Lab" tab launches this application, which provides the user with references to hundreds of diagnostic laboratory tests, either individually or by panel. The program offers interpretation of abnormal values, and cross-links to both Epocrates Rx and Dx applications. In addition, useful pricing and Medicare reimbursement information is available, as are tips for collection and preparation. As with other Epocrates apps, Lab is updated frequently with a touch of your HotSync button.
Other tools within Essentials that I have found indispensable are Epocrates ID infectious disease guide, Tables and guidelines, and MedMath medical calculator. The application has been updated to make the use of Epocrates ID seamless. Clicking on the "ID" tab launches the integrated infectious disease application. This tool is invaluable in that the clinician can cross reference antimicrobials by system, specific organism, or by the drug itself. Integrating ID with Rx enables me to make consistent, rational medication choices, and ensures appropriate dosing for my pediatric patients. I also use the Tables tab frequently. As with all Epocrates information, this section is updated frequently, so I can be assured of the most current, scientifically-valid data on a variety of topics, such as immunization schedules (including catch-up schedules), travel immunizations, normal pediatric vital signs, steroid comparisons, and comprehensive PALS algorithms. Finally, by clicking on the 'black bag' tab, the application calls up a menu of tools, notably MedMath, which includes over 30 medical calculators, e.g. body mass index calculator.
Although I was initially concerned about patients' and families' reactions to my using a handheld device at point of care, I quickly discovered their reactions to be unequivocally positive - from the perspectives of being reassured of proper drug selection and dose, and the general high-tech feel of their office visit.
Epocrates Essentials is the quintessential, all-in-one clinical reference application suite for the practicing physician. It's been redesigned to take up less space on your handheld device, syncs seamlessly and rapidly to allow for weekly updates, and provides accurate, integrated information in the palm of my hand. I have fully integrated Essentials into my daily office routine, and use it any number of times in a typical practice day. I recommend the Epocrates product suite to my colleagues without reservation.
For more information on Epocrates Essentials