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March 2005 - Issue No. 45
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Advocate of the Month Alain Fedida, MD
I am a full time cardiologist in a faculty practice in New York City, where I function as Co-Director of Nuclear Cardiology and Director of the Cardiac Special Care Unit.
My involvement with Epocrates began at the ACC Annual Scientific Session in 1999. I met the Epocrates team at an exhibit there and we had a conversation about enabling physicians with this developing technology. My adoption of their Epocrates Rx drug database sparked my interest in mobile technology.
The Epocrates Rx reference has since served me admirably in patient care, teaching and discussions with colleagues, in the Emergency Department, Office and Hospital settings. I always have this information available at the bedside and in the office in order to verify dosages, check for drug interactions (with the MultiCheck feature), look up cost and formulary information, and help pregnant patients make informed decisions regarding the safety of medications they need to take. The Docalert messages help me keep up with developments in and outside of my specialty when I'm on the go. I also use the free drip rate calculator Epocrates MedTools application to calculate infusion rates.
In 2001, I volunteered to attend to rescue workers at "Ground Zero" in New York in the wake of that tragedy from Sept. 11-14. My Epocrates drug reference was invaluable as a mobile resource. I anticipate that Epocrates' references will also help me in my volunteer work as a medical reservist ...
Epocrates plays an important role as part of a mobile technology solution for practicing evidence based medicine. It's also a valuable teaching tool for house staff. In the future, I hope to see Epocrates' drug and clinical information evolve as a tool in part of a mobile technology solution for electronic medical records.
Advocate Program
We created the Advocate Program for anyone who is interested in sharing information about Epocrates software with peers.
If you would like to become an Epocrates Advocate, please write to advocates@epocrates.com. Include your name, credentials or titles, city and state, and your sub-specialty (if applicable).
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National Patient Safety Awareness Week 2005
The National Patient Safety Foundation (NPSF) has designated March 6-12 as National Patient Safety Awareness Week. The theme of the week this year is Effective Communication: The Patient Safety Tool of Choice. NPSF, an independent, nonprofit research and education organization, recommends that providers listen to their patients, speak in simple terms and encourage them to be a partner.
Hundreds of thousands of healthcare professionals are already showing their commitment to patient safety by using Epocrates' mobile and online references. In a recent survey of over 1,300 physicians in our network, 97% said they believe that clinicians using clinical PDA software provide better quality of care and improved patient safety. 91% believe that using Epocrates references has helped them to avoid Adverse Drug Events (ADEs) or medical errors - 60% of them estimate that they avoid more than 1 ADE per week.
Epocrates references can also be great patient teaching resources. Why not access the Epocrates application while you are with your patients? Many clinicians tell us how impressed their patients are that they have the latest clinical information at their fingertips. Epocrates Rx Online web-based reference, with its large-screen format and patient education handouts, makes it even easier to share Epocrates information with patients.
The Epocrates team thanks you for your continued support of technology solutions that improve patient safety.
Clinical Updates
Expanded Metabolism & Excretion information
| In response to customer requests, our Medical Information Editors are in the process of expanding the Metabolism and Excretion sections in Epocrates Rx drug monographs. The updated metabolism information (still located within the "Other Info" section) provides a more comprehensive statement that includes the site(s) of metabolism (if known) and specific information on the influence of the agent on important human cytochrome P450 isozymes. |
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The revised excretion information includes: sites of excretion, percentage elimination by each site and elimination half-lives. With over 3,300 drug monographs in our database, this update involves a lot of new data and will therefore be added in several steps, so please AutoUpdate regularly to get all of the content as soon as it is available.
New renal & hepatic dosing information
Our editors have also started to add more detailed information on dosing of drugs in adult and pediatric patients with renal or hepatic impairment. Renal and hepatic dosing recommendations for systemically available drugs appear in the "Adult Dosing" and "Peds Dosing" sections, following all FDA-approved indications and off-label uses.
When available, information to guide dosing by renal or hepatic function criteria is presented. The recommended action (e.g. "adjust dose frequency") as well as specific dosing recommendations are included. Where dosing in renal or hepatic impairment has not been studied and recommendations do not exist, that information is also noted.
Over the next few months, renal and hepatic dosing recommendations will be incorporated into all systemically available drugs in the Epocrates Rx database (starting at A and going through to Z). Please AutoUpdate regularly to ensure that this revised content and all the new medications and indications are available at your fingertips.
The Epocrates medical editors added 3 new drugs and made 260 revisions to the Epocrates databases in February.
View update details
Please note that the Epocrates Dx disease reference is regularly updated and that if you subscribe to Epocrates Dx and have AutoUpdated this year you already have the 2005 updates from Griffith's 5-Minute Clinical Consult.
Volunteer Nurse Reports Back From Banda Aceh
Jeanie Schmidt, a California RN who has used Epocrates references for several years, recently volunteered with the International Medical Corps (IMC) in Banda Aceh, Indonesia, for 3 weeks. Banda Aceh was the region worst hit by the earthquake and tsunami disaster of December 27th, 2004. On the day of Jeanie's return to the U.S., she sent us a first-hand account of her experiences.
Excerpt: The environment was harsh and filthy with no water or toilets available. There were no bedpans and we made urinals out of water bottles. We had no way to clean up the patients. The mosquitoes and the flies were rampant. Cats were everywhere including eating mice in the ER & chaos was constant.
Read Jeanie's full report
Tsunami Aid
Epocrates Essentials for Macintosh
At the end of 2004, Epocrates launched a version of the Epocrates Essentials all-in-one guide to drugs, diseases and diagnostics for customers who synchronize their mobile device with a Macintosh computer. A Mac-compatible version of Epocrates Essentials for Nurses is also available. Please let your colleagues who use a Mac know that these products are available for them.
Thank you to everyone who donated an old PDA to Satellife. To date, more than 350 PDAs have been donated by people in the Epocrates network.
Satellife's Executive Director, Holly Ladd, says "Thanks to all of the generous Epocrates customers who responded to this call for help, SATELLIFE has already begun to distribute the mobiles to healthcare partners in Africa. One of the first programs to receive the units is a family practice training program in Kenya where they will be used with reference books and patient tracking programs. Shipments will soon be out the door to the medical school at Makerere University in Uganda, a community health program in Kenya, the Aga Khan hospital in Kenya and to a health data collection program in Ghana. Our partners in Africa will be using these devices for patient tracking, accessing current health information and collecting community health data.
We have seen firsthand how modest investments in technology can transform health care in the world's poorest countries. A mobile computer, which we here in the U.S. consider an everyday tool, can carry a virtual library of critical knowledge to the most remote African village plagued by malaria and AIDS thus dramatically improving the quality of care provided to the community, alleviating much suffering and ultimately, saving lives. We are so grateful for the support of the Epocrates customers in helping us continue this important work."
Learn how to donate your old PDA or monetary donation to Satellife
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Q. Can I sort the calculators in MedMath?
A. Yes. You can view calculators by type and create a list of your favorite calculators.
Palm Users: Tap on the MedMath icon under the black bag tab to open MedMath.
To view calculators by type, tap on "All" on the top right to display the drop-down menu. Choose a class of formula (e.g. "Cardiology", "Lab", "Renal") by tapping on it. Select "Last Used" to view your most recently used calculators (to clear your last used list, tap on the "MedMath" tab on the top left, tap on "Options" and "Clear Used List").
To create a list of your favorite formulae, display the drop-down menu or navigate to "Options" as above, and select "Edit Favorites". Tap on a formula to add it to your Favorites list. Tap on it again to remove it from the list. Once you have edited your favorites, select "Favorites" from the drop-down menu to view the list.
Pocket PC Users: MedMath is now available to anyone using Epocrates mobile references for Pocket PC. If you have version 7.0 or higher of our software, simply AutoUpdate to install MedMath to check what version you have, tap on the Rx tab, tap on "Tools" and "About Epocrates"). If you have an older version, you need to re-download the application. Learn how.
Tap on the MedMath icon under the black bag tab to open MedMath.
To view calculators by type, tap on the 'down arrow' on the top right to display the drop-down box. You can view the formulae "By Name", "By Class" (e.g. "Cardiology", "Lab", "Renal"), or "By Favorites".
To create a list of your favorite formulae, open a favorite formula and then tap on "+Favorite" beneath the number pad. To view your favorites, select "By Favorites" from the drop down box in the upper right corner. If you always want to see your favorites first when you launch MedMath, tap on "Tools" and then on "Preferences" and select "Default to: By Favorites". You can edit your favorites at any time by tapping on "Tools" and then on "Edit Favorites".
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Epocrates Inc., 1100 Park Place Suite 300, San Mateo, CA. 94403 | www.epocrates.com
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