Software Links for iPhone of interest to Nurse Educators

One of the frustrations of the iTunes Store is the number of supposed "Medical" apps that are not designed for healthcare providers or students. The folks at SoftwareAdvice.com, a commercial site that is paid for through vendor links, offers a great page highlighting some of the best medical software out there for iPhone and iPod Touch. Out of the over 1500 medical apps they determined only about half were actually of use to professionals. I mostly agree with their list. Also be sure to check out the spreadsheet of the over 700 medical apps. It's a great tool for finding apps you never knew about.

NANDA: Suicide by Greed?

I was sent a document by NANDA-I outlining their fees for use their diagnostic labels in publications. I was stunned by the fees. For example, just to create a list of terms is $250. But wait, there's more. If you want to create a textbook using the diagnoses be prepared to fork over anywhere from $3500 to $65,000! These numbers do not even include their use in software. I asked last summer for the cost and was quoted $3000 plus $2.50 for every copy of the program sold.

Nursing is in great danger of being left behind as electronic health records go online. We need a way to communicate what we do. While many have complained about the circuitous language and downright silly labels of some NANDA nursing diagnoses, they at least provide a common language for documentation until something better is developed.

If NANDA-I and Wiley-Blackwell Publishing insist on taking this usurious tack then we should let NANDA-I diagnoses die a quick death. Many of the terms they use could be challenged as in the public domain. Only a list of diagnoses and definitions that are in the public domain will provide us with the common language that can be used freely for practice, documentation, research, and billing.

NLN Nursing Education Summit 2009

Be sure to save the dates of September 23 to 26 for a trip to Philadelphia and the NLN Education Summit. I have attended nearly every one for the past few years and find them very valuable. It is a great opportunity to hear about advancements and issues in nursing education from across the USA. It is always good to meet fellow nurse educators facing the same issues you do. I often find new ways of thinking about a problem that helps me in my teaching. Issues of admission, classroom instruction, clinical instruction, special students, and community involvement are just some of the topics you are bound to hear about. Hope to see you in Philly!

Palm OS: RIP

Palm has announced the end of development of its PalmOS, or operating system. They are opting for a web-based system and hoping to survive in the shadow of the Apple iPhone and RIM Blackberry. The are moving to their Palm "Pre" smartphone that requires network access to operate.

It has been frustrating for nurse educators that the current PalmOS has been unchanged since 2004. That is an eternity in personal computing. The future of small PalmOS devices that have been popular with nurses such as the E2 and Tx is more uncertain than ever. Considering the huge processing, graphics, and memory advantages of the Apple iPod Touch, let alone the easy installation of applications through iTunes, it was clear the end of Palm as a clinical choice was near. Nurse educators considering adopting the Palm should do a careful consideration of price, value, and support ease before making a decision.

Nursing Central from Unbound Medicine

Unbound Medicine has released Nursing Central for the iPhone and iPod Touch. It offers the Davis Drug Guide, Lab and Diagnostic Tests, Diseases and Disorders reference, and Taber's Medical Dictionary. There is also a Medline Journal citation and abstract explorer. The Nursing Central app is offered free on iTunes but unlike Skyscape it has no free references for download. However, unlike Skyscape the references will reside on the iPhone or iPod Touch and continue to work after the subscription period of one year. During that year you have unlimited free updates.

The Nursing Central titles stick much closer to Apple Guidelines for the user interface. The Skyscape titles look more like Palm apps. Performance is good and I had no crashes. The user interface is pretty intuitive as the icons are clear about their purpose. Even the front page icons for each title are beautifully rendered. One shortcoming is that some titles in appendices get truncated due the use of large font sizes. I hope that is corrected in an update.

One issue for faculty is the cost. The only package offered is a $159 subscription. I look at this as $40 for each of the reference titles plus the Medline search tool for free. That is a reasonable price per title when compared to the print editions. The biggest benefit is that the reference titles continue work after the subscription. As of today Unbound Medicine is the only company offering this. Skyscape, Epocrates, Lexi-Comp and Pepid all shut down at the end.

Installation is easy but requires installing the app on the Apple device and then paying for the subscription online. Once the username and password are entered the titles begin to download. Be sure you are in a WiFi area when loading.

Overall, Nursing Central brings nursing educators to a point where we no longer need to recommend the use of a Palm or Windows Mobile device for clinical references. With the addition of some of the free and inexpensive medical formula tools, assessment guides, and learning aids available in the Apple App Store we now have a powerful handheld computer for clinical use.

My Skyscape: First iPod Touch Medical Reference App

The iPhone could never become truly a handheld computer for the healthcare community until the reference applications could reside on the device. Web-based versions that accessed the database wirelessly have been available but are slow and awkward to use. Now Skyscape has brought their vast selection of titles to the iPhone.

They have done it by making a free portal application My Skyscape available on iTunes. Enter your Skyscape account info and you can then download purchased titles to your iPhone or iPod Touch. They are also giving away some basic titles including their Archimedes medical formula and reference guide.

The current titles appear to follow the basic layout of the Palm OS titles but with some size changes to take advantage of the iPhone's larger screen. Control is easy with a finger and it is a pleasure not to use a stylus.

I tried to buy a title but the app would not let me register. A Skyscape support person tells me it will be one to two weeks before titles will be able to be downloaded. In the meantime you can access the web-based version of purchased titles.

Skyscape has drawn first blood in the medical reference wars. The creation of a portal removes the hassle for Skyscape of putting each title on iTunes. It also lets them keep their subscription model. The portal also lets you keep all your titles under one home page icon. So go ahead and try it, just remember you'll need to wait a bit until you can buy new titles.

For nurse educators the availability of the Skyscape library really makes the iPod Touch the handheld computer to consider first. The ease of installation, use of iTunes for synchronization, and the ability to wirelessly install applications opens a new day in the use of handheld computers in clinical nursing education.

The Handheld Computer to Beat for Nurses: Apple iPod Touch

Apple has updated the iPod Touch , adding a speaker, improving battery life, and allowing the addition of third party applications. All at a lower price. An 8 GB Touch is now $229 making it a better bargain than any Palm OS or Windows Mobile device. The ability to show video, browse the Internet with a full-fledged browser, and use healthcare-related applications make it more versatile than any previous handheld.

The iTunes App Store has thousands of applications. The number of useful healthcare apps is still small but growing quickly. Expect to see the classic reference titles for sale soon.

For nurse educators considering which handheld to recommend to students, the iPod Touch must be seriously considered. It provides a powerful computer that will serve students well past graduation. The fact that it is also an iPod only helps make it an easier sale to students.