Drug and Disease Updates
Large or Small: Thoughts on Choosing Your EHR Vendor
DocAlert Messages: Editor's Pick
FDA MedWatch Updates & Labeling Changes
Epocrates EHR Has Launched!
It's Here: Epocrates Essentials Deluxe for Android
Free Access to Epocrates CME Online
Where We Stand Today: An Update on Meaningful Use
Visit Us at AAFP
What's This Disease?

At Epocrates, we pride ourselves on providing you with the most useful and innovative digital solutions and tools to improve your efficiency, productivity, and above all patient care. This month brings two of our most exciting new releases—Epocrates EHR, and Epocrates Essentials Deluxe for Android. Epocrates EHR boasts a highly intuitive interface, enhanced task management for handling interruptions, and customization features that maintain the highest standards of patient care and productivity. Android users can now appreciate ICD-9 and CPT® billing codes and dictionary access, in addition to thousands of integrated drug & disease monographs and diagnostic tools.

But it's not just tools. Read on to glean from the expertise of Dr. Tom Giannulli and Dr. Anne Meneghetti as they respectively help us contextualize medical tools in the narratives that keep us curious.

Share: Twitter mail

Clinical Editorial

Large or Small: Thoughts on Choosing Your EHR Vendor
Tom Giannulli, MD
Chief Medical Information Officer, Epocrates

Recent news about extending the Stage 2 reporting deadline for demonstrating Meaningful Use (MU) 1 has underscored a prevailing concern among physicians: When choosing an EHR partner, who is best suited to help me achieve MU and other EHR goals? Is it better to choose a big provider or a small provider of EHR solutions?

My small practice physician colleagues especially feel the onus of having to deicide between big and small—recognizing advantages and potential problems in both. Big providers can offer powerful solutions, but can prove unwieldy and restrictive, promoting a one-size-fits-all, cookie-cutter approach. Small providers can be nimble and sensitive, perhaps more responsive to their customers, but may not have the resources to quickly address challenges in technology, delivery models, and evolving MU rules.

When I developed iChart, the first electronic medical record for the iPhone and iPod touch, I was leading a small healthcare technology company called Caretools. Our single focus was information management at the point of care.

Already a leading developer of mobile point-of-care reference tools that enhance the practice of medicine, Epocrates recognized the potential for a symbiotic, beneficial relationship, and acquired Caretools. That partnership provided the backing, experience, and support needed to build Epocrates EHR into the powerful tool it is today.

By leveraging my vision with Epocrates' vast resources and experience, we've developed a best-in-class EHR built for the small practice but powerful enough for larger institutions. Our commitment to providing accurate and trusted medical tools in a digital age is important to keep in mind when considering an EHR vendor that can help you work through the challenges of MU reporting. This commitment gives us unique insights about the needs of the practicing physician.

We'd like to think of ourselves as an EHR provider that is combining the best elements of large and small vendors—the best of both worlds—to help you achieve MU.

What are your thoughts on the vendor landscape in the EHR marketplace? I invite you to write to: ehrsupport@epocrates.com.

Share: Twitter mail

DocAlert Messages: Editor's Pick
Anne Meneghetti, MD
Director, Clinical Communications

Emerg Med J doi:10.1136/emermed-2011-200078
Images in emergency medicine

ECG interference from the iPhone
A S Lota
[Excerpts] [Free full-text PDF]


Drug and Disease
Otitis externa
Iliotibial band syndrome
Evaluation of food allergies and sensitivities
Constipation in children
Evaluation of tremor
Chronic atrial fibrillation
Evaluation of neutrophilia
drug updates
(brentuximab vedotin)
Afeditab CR
(first-time generic for Uroxatral)
Amethia (levonorgestrel/ethinyl estradiol)
(Centruroides immune Fab)
(levonorgestrel/ethinyl estradiol)
Diabetic Tussin Nighttime Cold & Flu
(first-time generic for Ancobon)
(first-time generic for Arixtra)
(carbamide peroxide oropharyngeal)
Lupron Depot-6 Month
(spinosad topical)
polymyxin B ophthalmic)
Neo-Polycin HC
polymyxin B/hydrocortisone ophthalmic) )
Nifediac CC
Nifedical XL
Nulojix (belatacept)
PCE (erythromycin base)
Phoslyra (calcium acetate)
Polycin (bacitracin/polymyxin B ophthalmic)
Selsun Blue Itchy Dry Scalp (pyrithione zinc topical)
T/Gel Daily Control (pyrithione zinc topical)
Xolox (oxycodone/acetaminophen)
Zelboraf (vemurafenib)
Share: Twitter mail

A 44-year-old man presented to the emergency department with cocaine-induced chest pain. There was no previous cardiac history. His initial ECG was abnormal. On examination, he appeared well and a charging iPhone 4 was found beneath his forearm. The device was removed and another ECG was recorded.

ECG interference can arise from numerous potential sources. AC interference is minimized using physical shielding and electrical filters, essential given that ECG voltages are in the order of millivolts compared with the mains supply [USA 120 V]. Direct contact with the device may have bypassed these measures, and figure 1A shows AC interference as the characteristic ‘thickened baseline’ with 2 sinusoidal waves every 1 small square (50 Hz). Electromagnetic interference from mobile communication devices is common, hence restrictions on use in certain settings. The GSM receiver has been shown to cause high-voltage spike at regular intervals.1

1. Baranchuk A, Kang J, Shaw C, et al. Electromagnetic interference of communication devices on ECG machines. Clin Cardiol 2009;32:588–92. [PubMed® abstract] [Free full-text Clin Cardiol article PDF]*
Copyright © 2011 BMJ Publishing Group Ltd and the College of Emergency Medicine. All rights reserved.

*Please note that external links are not Epocrates information. The views expressed on these websites are solely those of the authors' and do not necessarily reflect the opinions or endorsement of Epocrates.


Share: Twitter mail

FDA Medwatch Safety Alerts

Prescription drugs: Celexa (citalopram): abnormal heart rhythms associated w/ high doses; Epogen/Procrit (epoetin alfa), Aranesp (darbepoetin alfa): boxed warning; Actos (pioglitazone): potential increased risk of bladder cancer; Ortho Evra (norelgestromin/ ethinyl estradiol) transdermal: adverse rxns; Coreg (carvedilol),Coreg CR: adverse rxns; Nitrostat (nitroglycerin) Sublingual: contraindications, cautions; Micardis (telmisartan): cautions; Ranexa (ranolazine) extended-release: contraindications, warnings, cautions; Chantix (varenicline): warnings, cautions, adverse rxns; Spiriva HandiHaler (tiotropium): cautions; Flovent HFA (fluticasone propionate:adverse rxns; Paxil (paroxetine), Paxil CR: contraindications, cautions; Wellbutrin (bupropion HCl), Wellbutrin SR, Wellbutrin XL: cautions; Aplenzin (bupropion HBr) extended-release: cautions; Seroquel (quetiapine), Seroquel XR: warnings, cautions, adverse rxns; Flomax (tamsulosin): warnings, cautions; Kenalog-10 (triamcinolone acetonide), Kenalog-40: warnings, adverse rxns; Mobic (meloxicam): cautions; Dostinex (cabergoline):contraindications, warnings; RotaTeq (rotavirus vaccine, live): contraindications; Arava (leflunomide): warnings, cautions; Bentyl (dicyclomine): warnings, cautions; Gilenya (fingolimod): warnings, cautions; Truvada (emtricitabine/tenofovir): warnings, cautions; Cordran (flurandrenolide) Lotion: cautions, adverse rxns; Kemadrin (procyclidine): cautions; Creon (pancrelipase): cautions, adverse rxns; Prograf (tacrolimus): warnings, cautions, adverse rxns; Tev-Tropin (somatropin): warnings, cautions, adverse rxns; Human Growth Hormone (somatropin): possible increased risk of death

OTC products: Zegerid OTC capsules: warnings

Share: Twitter mail

Epocrates EHR Has Launched!

And as a special incentive to our valued Epocrates members, we're offering you our Early Adopter Special. For a limited time, Epocrates EHR is available for a monthly subscription cost of $179/month/paid seat—a 55% savings compared to our regular subscription rate. This offer is valid through March 31, 2012, at which point the monthly cost will go back to the regular price of $359/month/paid seat.

Designed with input from physicians like you, Epocrates EHR features an intuitive interface, Surescripts-certified ePrescribing, lab integration, problem-specific note templates, and more.

With Epocrates, you've come to expect all-inclusive, transparent pricing and simple purchasing. And now, it's even simpler to purchase, with considerable savings on our intuitive new EHR system.

Take advantage of our exciting Early Adopter Special.


It's Here: Epocrates Essentials Deluxe for Android

Epocrates Essentials Deluxe, our top-tier clinical reference suite, is now available for Android devices and packed with useful point-of-care resources. Includes thousands of integrated drug & disease monographs and diagnostic tools, plus ICD-9 and CPT billing codes and an extensive medical dictionary. Learn more


Free Access to Epocrates CME Online

Choose from more than 100 accredited activities covering a wide variety of specialties.

This month's featured activity:

Identifying Rheumatic Conditions in the Primary Care Setting


Where We Stand Today: An Update on Meaningful Use

The recent shift in Meaningful Use (MU) timelines will positively impact practices that adopt an EHR and report in 2011, while leaving all other timelines in place. Two federal advisory committees have recommended a one-year delay in the deadline for meeting Stage 2 requirements, and it is expected that the Centers for Medicare and Medicaid Services will now set 2014 as the new cutoff date. Eligible professionals (EPs) who attest to meeting 90 days of Stage 1 requirements in 2011 would now have three years before needing to demonstrate that they have met requirements for Stage 2.

For EPs who haven't yet transitioned to an EHR, 2012 is a great year to start—and the last year to begin reporting in order to receive the full program incentives. Those who start in 2013 or later will receive a smaller program payout. Medicare providers who wish to take advantage of the full payout benefits have until October 1, 2012 to start reporting and earn the maximum Medicare incentives. Medicaid providers have until 2016 to implement and receive full payout benefits. Under the HITECH Act, individual healthcare providers demonstrating Meaningful Use are eligible for up to $44,000 or $63,750 under Medicare and Medicaid rules, respectively.

To date, 2383 practices have already demonstrated Stage 1 requirements for Meaningful Use, and have received payouts as part of the $400 million in Medicare and Medicaid incentive payments granted this year through the HITECH Act.

Interested in learning more about how Epocrates® EHR can help guide you from planning through optimization and help you achieve MU? Download our white paper on frequently asked questions about MU, or visit our site for more information.


Visit Us at AAFP

Despite all possible social media options, there's nothing quite like face-to-face. Come visit Epocrates at booth 1121 at AAFP: American Academy of Family Physicians 2011 Scientific Assembly, at the Orange County Convention Center in Orlando, Florida from September 14-17, 2011.

We will be exhibiting live product demos of our EHR system, led by Dr. Tom Giannulli, Chief Medical Information Officer and the visionary behind the solution's design. We'll also ensure your Epocrates software is running smoothly, and answer any questions you may have.



Test your knowledge!
Can you identify the disease in this image?


Find this image and many others in Epocrates Essentials for BlackBerry, iPhone, Android, and Epocrates Essentials Deluxe for iPhone, BlackBerry, and Android.

Log in to Epocrates Online for continually updated drug information and disease content and images.

Mobile Updates

Update (sync) your device regularly to download free clinical content and news, including new drugs and DocAlert messages.

We always love to hear from our members about Epocrates products or any other topic at youropinion@epocrates.com. We occasionally select reader comments to feature in future newsletters. All readers featured in the newsletter will receive a free one-year subscription to the premium product of their choice.

Email Us

Inquiries: Newsletter | Clinical | Suggestion | Sign up

Technical: Email | Website

Copyright © 2011 Epocrates, Inc. All Rights Reserved. Epocrates, iChart and DocAlert are trademarks of Epocrates, Inc. in the United States and other countries. All other trademarks referenced are the property of their respective owners.

Epocrates, Inc., 1100 Park Place, Suite 300, San Mateo, CA 94403 www.epocrates.com