Health App of the Month Will Be Back Next Month

“Time is what we want most, but what we use worst.”

–William Penn

April is almost over and I still have not completed my review of the latest health app I have been using.  The Health App of the Month will be back and better than ever in May. Hopefully, with time, I will have more posts this summer on many Digital Health topics.  As always, if you have any comments, suggestions or ideas for the site, please let me know.

Digital Health – views from around the world

It has been one year and one month since I started this website that focuses on real world applications of digital health.  I have had a lot of fun creating a this site and creating an online conversation about digital health.

The most exciting aspect of the website has been to see all the different areas of the world I have visitors to my website.  This March has been my 3rd best month in terms of total views.  While the majority of the views come from the USA, I have also had visitors this month from Brazil, Serbia, India, Venezuala, Belgium, Jordan and Spain.

I would love to hear from anyone outside the US about what digital and mobile health looks like in your country.  Add a comment to this article, or email me at dranderson@drmatthewanderson.com or reach out on twitter @DrAnderson19.

March 2017 Aspirin Guide App

Title: Aspirin Guide App
What it is: A mobile evidence based medical app for determining the need for aspirin therapy in heart diseaseHeart
What devices: Apple and Android devices
Cost: Free
Who should use it: mostly physicians but also patients interested in knowing more about preventing heart disease
Why use it:  The decision to use low-dose aspirin for the primary prevention of heart disease can sometimes be a difficult decision.  Physicians need to weight the benefit of aspirin against the risks of gastrointestinal problems.  However beneficial aspirin can be, daily intake of an aspirin can lead to abdominal pain, gastritis and gastrointestinal bleeding.
From a group of physicians at Harvard comes the Aspirin Guide app.  This app takes the most relevant evidence based guidelines to help in the decision making process.  Using ASCVD risk score and guidelines from the US Preventive Task Force, the app walks you through a series of questions about a patients medical history.  These include health factors such as smoking status, systolic blood pressure and cholesterol level.
The app then creates a recommendation based on those health factors.  What is really interesting about the apps recommendation it breaks down why it has that recommendation.  It provides the data on Number Needed to Treat (NNT) and Number Needed to Harm (NNH).   Physicians can really see where the risks are and how they compare to each other.  Its also a good way to discuss the risks and benefits with your patient.  There are also links to the medical journal articles for physicians to review as well.
I would caution any patient using this app, not to start or stop low dose aspirin therapy just using the app alone.  Use the information to start a discussion with your personal physician.  You can even email the results with NNT and NNH to your physician but do not adjust your own aspirin regimen without consulting a physician.

If you think fake news is bad for politics, you should try being a physician

This is an article that was originally published on KevinMD.  

       Much of the discussion surrounding the presidential election this year focused on “fake news.”  There were countless stories in newspapers and on television news shows about these obviously biased and fictitious posts that might have affected the outcome of the election. I could not help thinking during this campaign season that if you think fake news is bad for politics, you should try being a physician.

       As physicians, we are on the front line in the fight against fake news and deal with the fall out on a regular basis.  This is nothing new, especially for Primary doctors like Family Physicians, Internists and Pediatricians who have to deal with volumes of fake news within the limited amount of time they actually have with a patient. 

       Physicians are always trying disprove fake news with patients.  We talk about the limited benefits of numerous vitamin supplements in the face of countless publications and marketing efforts that do not have to be evaluated by the FDA.  Red yeast rice is not equivalent to statins for preventing heart disease.  Gingko biloba will not treat dementia, no matter how organic or pure it is, no matter how many people write about its effectiveness. 

       A website recently touted the 25 beneficial uses of Apple Cider Vinegar.  This list included treatments for acne, bad breath, under arm and foot odor, to kill bacteria causing a sore throat, prevent diabetes, lower cholesterol, improve digestion and remove warts.  But wait there’s more! Apple Cider Vinegar can give you healthier hair, whiter teeth and even better tasting barbecue sauce.  This is in addition to its ability to be a nontoxic cleaner for your kitchen and a weed killer for your garden.  This is a list of pure conjecture passed off as facts, and people believe it.  Even the comments section of the article has readers saying “good to know.”

       I have had several patients tell me about all the health benefits of vanadyl sulfate.  Specifically, they have stopped their medications for diabetes because of everything they have read about vanadyl.  Each patient’s course plays out the same way: these patients research for information, completely buy in to this natural supplement, stop their medications and then their A1c goes up dramatically.  But “Americas most trusted wellness doctor” says it works and is willing to sell the supplements to you as well.

       The most egregious and widespread item of fake medical news involves vaccines.  From causing autism to inciting sexual behavior, decades of fake medical news about vaccines exist.  Many times doctors are seen as complicit in pushing this harm on people.  A quick look at twitter for #vaccines, and the news of vaccination harms is overwhelming.  

       The whole fake news complex plays on the vulnerabilities of those searching for the information in the first place, looking for what mainstream media or money-loving, golf-playing doctors won’t really tell you.  You are being held down or missing out on critical information – information someone else doesn’t want you to know.  If you can get this information, everything will be better — your life, your health, your economy, your country.

       As a physician, I try to be a steward of medical information.  I want my patients to seek out good quality medical information on their own.  I steer them to websites such as Mayoclinic.org or Webmd.com and gently dismiss information from sources I do not trust.

       So fake news may have negatively affected the campaigns of Hillary Clinton and Donald Trump, but fake news affects every clinic and hospital in America every day.  This is not to say that political news is more or less important than medical information or that either is more susceptible to the “fake news” problem.  Inaccurate statements presented as facts should always be challenged, and the medical community has a unique and difficult responsibility to engage it.

February 2017 CDC Vaccine Schedules

cdc-opening-screenTitle: CDC Vaccine Schedules
What it is: A mobile app for all the CDC vaccine guidelines
What devices: Android and Apple devices
Cost: Free
Who should use it: Any healthcare provider or patient who wants to know more about CDC guidelines for vaccination
Why use it:  Vaccines are an effective and easy way to prevent disease and maintain healthy populations.  For many clinicians the source they use the most for vaccine schedules and information is the CDC website.  This CDC Vaccine Schedules app puts all the important information from the CDC website into a convenient mobile app.
    The information is broken down like most of the distributed vaccine information from the CDC.  The age categories include Birth to 5 years, Adolescents and Adults.  While looking at the graphics on a phone or tablet, turning your device horizontally allows for a broader appearance to the timetable.cdc-front-page
    There is also information on catch-up schedules for children, unique guidelines for pregnancy, immunocompromised patients and healthcare providers.  These are in separate listings on the front page of the app but there is also a lot of information available by tapping “note” from the vaccine schedule it self.
    Overall, this is a very easy to use reference from the CDC for all vaccination guidelines in the palm of your hand.

January 2017 LactMed app

Title: LactMed
What it is: A mobile database of information regarding the safety of medications and supplements during breast feeding
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What devices: Apple and Android Devices
Cost: Free
Who should use it: Physicians, nursing mothers
Why use it:  There are many things about bringing home a new baby that can cause a lot of anxiety.  There are new feeding and sleep schedules, baby proofing your house and maybe even other siblings who needs to get used to the new addition to your family.  Another source of anxiety can be trying to know whctzhat medications are safe for a nursing mother.  That is where the mobile app LactMed can come in handy.
       LactMed is a mobile searchable database that has thousands of medications created by National Library of Medicine, a part of the National Institutes of Health.  For each medicine, LactMed provides information on whether or not the medicine can be found in breast milk, whether it can have an effect on nursing babies and other options for that class of medication. It also provides information on whether or not the medication could effect lactation as well.
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       What’s is great about this app is that not only are there prescription medications but over-the-counter medications and supplements.  All this clinical information is updated monthly.
       This app is perfect for the primary care physician in clinic taking care of their patients who are nursing or for the doctor providing Urgent Care who has a nursing mother as a brand new and ill patient.  If you are not taking care of nursing mothers on a regular basis, it may be hard to stay familiar with medications that are safe for breastfeeding.  This mobile app will be a great, quick reference.
       For patients, specifically nursing mothers, this can be a great app to review the medications you are already taking or any new medications that are started while nursing.  It can be a good way to start a conversation with your physician about your medications.  Of course, always speak with your personal Obstetrician or Primary Doctor before making any changes to your medication regimen.

Review of 2016

good-year-1911507_1920     2016 was a very exciting year for me.  I completed my MBA, took on a new role at my institution as Associate Chief Medical Officer and in February I launched this website, Digital Health and You.  This website has been an important outlet for me and I hope  has helped improve the landscape of medicine and digital health.
     This year the website had 11 digital health app reviews published.  These included apps for understanding your lab results, cognitive behavioral therapy, concussion prevention, zika virus and even to help monitor your caffeine intake.
     I am really looking forward to 2017.  We will be discussing EMR’s, PHR’s, more Profiles in Digital Health and of course 12 new Health App of the Month posts.  My readership waxes and wanes, as does my ability to publish often but creating and maintaining this website has truly been a joy.