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montageuserfeedback.pngWe love hearing from you about VisualDx and how you use our app/tool in your everyday practice. Our customers are the bread and butter of the company; your success is our success. We strive to make VisualDx the best it can be so that doctors, students and other healthcare professionals can diagnose patients quickly and accurately.

Hearing from our customers is one of the best ways to make that happen. Earlier this year, we asked for your thoughts on VisualDx. We’ve compiled that feedback into a short video.

Many thanks to those listed below for participating in this video!

Dennis Porto, M.D., a dermatology resident at Henry Ford Health System

Matt Innes, M.D., a transitional intern at Tucson Medical Center

Jane Clark, M.D., a dermatologist at the Hamilton Medical Center

Roman Bronfenbrener, M.D., a dermatologist at Stony Brook University Medical Center

Yosef Seewald, a dermatology PA-C MPAS at The Dermatology Group, PC

Ashley Dietrich, an M4 at the Medical College of Wisconsin

Travis Morrell, M.D., a dermatology resident at Loma Linda University Health

Tyler Shelton, a physician assistant at Florida Emergency Physicians

 

If you would like to submit video feedback, email our Community Engagement Coordinator Lauren MacDonough at lmacdonough@visualdx.com.

We strive to make VisualDx the best it can be so that doctors, residents, students and other healthcare professionals can diagnose patients quickly and accurately.

Filter Your Images

“Watch out!” I yell as a friend nearly walks out into traffic, eyes focused on his cell phone. You may have noticed more people walking around in this condition – passively enjoying summer and the outdoors and fully engrossed in their cell phones.

laureninpokemongofinal.pngAsk any of them what they’re doing. Their answer: “Catching ‘em all” by playing Pokémon Go. According to SurveyMonkey, Pokémon Go is the largest mobile game in US history with 21 million daily active users, beating Candy Crush Saga’s popularity (which peaked at 20 million). 

I grew up in the 90’s with a little brother. Pokemon, as a cartoon show and trading card game, was all the rage in my house. Now, that nostalgia has obviously returned with a vengeance for people my age and has captured the attention of the younger generation.

In Pokémon Go, you are a trainer tasked with catching cartoon monsters (Pokémon) with a flick of your finger, using them to fight battles at “gyms” and collecting special items as you walk around. Parks, landmarks and other public places serve as locations to find and battle Pokémon - think of it as Google Maps “gamified”.

So here’s the Poké-conundrum especially for parents. On the one hand, Pokémon Go is being touted as an “unintentional” health app. It gets people out of the house and exercising by walking certain distances to complete tasks like hatching eggs and finding new Pokémon. Plus, there’s the added bonus of exploration - players are trekking to new places in their neighborhood they might never see and are learning more about where they live.

On the other hand, the game poses some health risks. Players are distracted by the app, losing sight of what’s around them and tripping, walking into walls, traffic, even other people. Game developer Niantic smartly uses the app’s loading screen to warn players about distracted driving and walking. It reads: “Remember to be alert at all times. Stay aware of your surroundings.” But that warning isn’t being heeded by every player. The National Highway Traffic Safety Administration has warned drivers not to play the game while on the road. The National Safety Council is urging pedestrians to use caution.

flareonfinal.pngI talked with Dr. Eric Ingerowski, pediatrician and contributor to VisualDx, about what parents should know about Pokémon Go. He has seen first-hand both sides of the debate. “I have seen several patients that have walked more in the last week than they have all year but I have also seen numerous smashed phone screens because of players walking into trees or walls. I have seen numerous sunburns that patients have attributed to prolonged Pokémon expeditions without proper sun protection. I had one patient who had become temporarily lost because his phone battery died and he did not know exactly where he was.”

Ingerowski also warns about outside threats. “The exploratory nature of this game puts kids at risk by encouraging them to travel outside of their usual safe zone – often without parent’s permission or knowledge.  Because some Pokémon are located in woods or fields, exposure to ticks and other disease carrying insects may increase.  There are also concerns that the ‘gyms’ and other locations players travel to may be targeted by pedophiles, thieves, or by others with nefarious intent.“

His advice? Simple communication. Parents need to be informed about this game and actively discuss the risks and benefits with their children. Children should play in groups, always get parental permission when venturing out and let parents know where they’re heading.

Pokémon Go can be a fun, healthy way to get exercise and socialize as long as everyone plays safely.

About the Author

laurenheadshotsmall.pngLauren MacDonough is the Community Engagement Coordinator at VisualDx. Lauren holds a Bachelor of Science in Broadcast Journalism from Syracuse University and is completing her Master's degree in Integrated Marketing Communications at Nazareth College. She enjoys spending her free time as an actor/singer/dancer in Rochester, NY.

Between the increase in exercise and the risks of distracted walking, what should parents know about Pokémon Go to keep their children happy, healthy, and safe?

zikamosquitosmall.pngOn August 5th, an expected 10,500 athletes will march in the opening ceremonies in Rio de Janeiro, Brazil to officially commence the 2016 Summer Olympic Games.5 With an influx of thousands of athletes and spectators from around the globe, the potential exists to spread Zika virus, which is endemic in Brazil, worldwide. While many athletes are looking forward to their once-in-a-lifetime opportunity to attend the Olympics, others are hesitant of the potential risks incurred by competing in Brazil.

Zika virus is a mosquito-borne disease that can cause severe birth defects, including microcephaly (when a baby's head is smaller than expected for weight).2 Originally thought to be spread solely by mosquitoes, some researchers now believe sex with infected men may also be a transmission route.6 With so much uncertainty concerning the Zika virus, some physicians and professors have petitioned the World Health Organization (WHO) that the Olympics be postponed or even cancelled.9

Many top name athletes are pulling out of the games, citing Zika virus fears and other personal reasons. Steph Curry, runner-up in the NBA playoffs, withdrew from the roster because he wanted to heal his left knee, but stated he has other personal reasons for not making the trip. His teammate Andre Iguodola, a former gold medalist in 2012, is not competing due to fear of the Zika virus.1 Some athletes are taking other precautions. John Speraw, the US volleyball coach, said that he is going to preserve sperm prior to leaving for Rio in case he wants to have children in the future. Pau Gasol, basketball star for the Chicago Bulls, said he might do the same.

The golf world has taken the hardest hit. Just as golf returns to the Olympics for the first time in 112 years, some of the top golfers are avoiding a trip to Rio. The men's top four golfers, Jason Day, Dustin Johnson, Jordan Spieth, and Rory McIlroy all pulled out from the competition, citing Zika health concerns.  McIlroy, for instance, said the "risks outweigh the potential rewards."3 On the women's side, so far only Lee-Anne Pace, a South African golfer, has withdrawn from the games over concerns of the Zika virus.

Although the 2016 Olympics is a chance for golf to re-establish itself in the games, it comes at an extremely busy time for golfers, with the British Open and the PGA both scheduled in July. Add on to that 3 other majors, the Fedex Cup Playoff, the Ryder Cup, and the Presidents Cup, and pro golfers already have a lot on their plate. Serena Williams, who also struggles with balancing 4 majors, the Olympics, and various other tournaments, relates to these golfers, stating that most athletes in tennis and golf want to focus on the majors. Serena will attend the games; however, she says "[she will] definitely be going everywhere protected."7 But in sports such as track and field, archery, and gymnastics, the Olympics are the main focus of an athlete's entire career.

Many top female athletes have voiced their concerns about the emerging virus, including Hope Solo, the US soccer goalkeeper, and Simona Halep, a Romanian tennis star. No other top female athletes have yet to cancel their trip to Rio despite the risk. The reason many female athletes are opting to remain in the games is because of the wage disparity. Even though the Olympics don't directly provide money to the athletes, it is a critical time for women to get endorsements and exposure. Jessica Phillips, a cycling champion, says that women don't have the option of making significant amounts of money competing professionally, so skipping the Olympics doesn't have the same financial implications for men as it does for women.

Despite the threat of contracting the Zika virus, Olympic officials claim that there is a very low risk of contracting the disease. To lower the risk even more, the venues will be monitored constantly before and during the events. Stagnant water and sites where mosquitos breed will be removed daily. Fans will be happy that both the CDC and the WHO have announced that they are not in favor of moving the Olympics from Brazil.9

Even though athletes have been training their entire lives to compete at the highest level, the Olympics have become less of a priority to some due to the rigorous professional sports schedule and concerns of the Zika virus.

Photo provided by the Centers for Disease Control

1. Bonesteel, M. Stephen Curry won't play for Team USA at Rio Olympics. Washington Post. June 6, 2016. https://www.washingtonpost.com/news/early-lead/wp/2016/06/06/stephen-curry-wont-play-for-team-usa-at-rio-olympics/. Accessed July 7, 2016.

2. Mather, V. Jason Day, world's top golfer, pulls out of Olympics over Zika fears. New York Times. June 28, 2016. http://www.nytimes.com/2016/06/29/sports/golf/jason-day-zika-rio-olympics.html?_r=0. Accessed July 7, 2016.

3. Crouse, K. Rory McIlroy says he won't attend Olympics over Zika concerns. New York Times. June 22, 2016. http://www.nytimes.com/2016/06/23/sports/golf/rory-mcilroy-olympics-zika.html. Accessed July 7, 2016.

4. 2016 Summer Olympics. Wikipedia. https://en.wikipedia.org/wiki/2016_Summer_Olympics. Accessed July 7, 2016.

5. Zika virus: Olympic venues to be inspected daily before and during Games. January 29, 2016. http://www.bbc.com/sport/olympics/35444254. Accessed July 7, 2016.

6. McNeil, D. Sex may spread Zika virus more often than researchers suspected. New York Times. July 2, 2016. http://www.nytimes.com/2016/07/05/health/zika-virus-sex-spread.html. Accessed July 7, 2016.

7. Dunlap, T. Everything you need to know about athletes skipping the Rio Olympics - and how participants are addressing Zika fears. People Magazine. July 1, 2016. http://www.people.com/people/package/article/0,,20996464_21016159,00.html. Accessed July 7, 2016.

8. Zarya, V. Why female athletes can't afford to let Zika keep them from the Olympics. Fortune Magazine. June 8, 2016. http://fortune.com/2016/06/08/zika-women-rio-olympics/. Accessed July 7, 2016.

9. Kutner, M. 150 doctors, academics call for Olympics to move because of Zika. Newsweek. May 27, 2016. http://www.newsweek.com/rio-olympics-zika-open-letter-doctors-464381. Accessed July 7, 2016.

While many athletes are looking forward to their once-in-a-lifetime opportunity to attend the Olympics, others are hesitant of the potential risks incurred by competing in Brazil.

(July 6, 2016) - by Tracey Walker, Managed Healthcare Executive

CMS has updated rules that will allow qualified entities (QEs) to confidentially share or sell analyses of Medicare and private sector claims data to providers, employers, and other groups who can use the data to support improved care. In addition, QEs may provide or sell claims data to doctors, nurses, and skilled nursing facilities among others.

The release of finalized changes to what is called the Qualified Entity Program (QEP) may have a significant impact, according to experts.

"Allowing access to the CMS data vault could have an enormous impact on patients and consumers," according to Managed Healthcare Executive (MHE) Editorial Advisor Don Hall, a former health plan CEO, and current principal Delta Sigma LLC, in Littleton, Colo. "Quality information by provider, success of various treatments on patients by age and disease and pharmacological impacts are just a few of the benefits we could see."

Selling data through these new CMS rules will not improve clinical decision making, according to Art Papier, MD, CEO of VisualDx.

"The information that goes into the reports is as useful as the information that comes out," Papier says. "What will really generate better care and quality at hospitals is investments in health information technology to support better decisions by the clinician and patient. It's unlikely that selling claims data will have any impact on accuracy, quality and safety for people, but on the other hand it may possibly enrich an enterprising business person marketing the data as meaningful."

The QEP program was created under the Affordable Care Act. Currently, 15 organizations have applied and were approved by CMS as QEs to receive patient-identifiable claims records from Medicare, Medicaid and the Children's Health Insurance Program. To date, two have completed public reporting.

"Qualified entities must combine the Medicare data with other claims data [e.g., private payer data] to produce quality reports that are representative of how providers and suppliers are performing across multiple payers, for example Medicare, Medicaid, or various commercial payers," explains MHE Editorial Advisor Joel Brill, MD, FACP, chief medical officer, Predictive Health, LLC.

For example, qualified entities can conduct analyses on chronically ill or other resource-intensive populations to increase quality and drive down costs in the healthcare system," Brill says.

CMS also modified the definition of hospital association to include local-level organizations and is considering making Medicaid and Children's Health Insurance Program data available to qualified entities in future rulemaking, according to Brill.

"Managed care entities that are looking to identify value-based providers will likely be purchasers of QE data," he says.

Selling data through these new CMS rules will not improve clinical decision making, according to Art Papier, MD, CEO of VisualDx.

BUFFALO, NY (June 23, 2016) - The Greater Buffalo United Accountable Healthcare Network (GBUAHN) and the Greater Buffalo United Independent Physician Association (GBUIPA) are teaming up with Rochester-based company VisualDx for better accuracy in diagnosing patients. VisualDx is a web-based decision support system that provides 40,000 medical images and peer-reviewed expert information to improve and speed up diagnosing while the patient is still in the office.

"Putting VisualDx in the hands of our providers is in keeping with GBUAHN's and GBUIPA's commitment to utilizing the latest in medical technology," said Raul Vazquez, MD, chief executive officer of GBUAHN. "VisualDx offers the information needed to avoid misdiagnosis and avoid unnecessary tests and prescriptions. By simply entering the patients' findings, I can quickly see what other symptoms to look for and what questions to ask. Then the software guides me to a differential diagnosis while the patient is still in the exam room. VisualDx is integrated into out MEDENT Electronic Medical Record workflow. MEDENT's robust integration with VisualDx increases efficiency by taking advantage of patient specific criteria."

"Improving diagnostic accuracy is at the core of our mission. We are thrilled GBUAHN joins us in that mission. In light of the BMJ and IOM report on the pervasiveness of medical and diagnostic errors, we understand that doctors cannot memorize it all," said Art Papier, MD, chief executive officer of VisualDx. "With VisualDx, healthcare providers can receive diagnostic results in seconds, as if a teal of specialists were right in the room with them. Our support system allows healthcare professionals to actually see the images that support their conclusions and inspire confidence and increased patient satisfaction."

Physicians can begin building a differential diagnosis in seconds simply by entering a chief complaint, medication, or finding. Then through a guided workup, clinicians can add additional symptoms and findings. What sets VisualDx apart is the way it visualizes these diseases via the world's best image library and SympticonsTM, an exclusive symptom icon technology. Through the visualization, clinicians can easily and quickly see variations of disease to get to a fast, accurate diagnosis.

VisualDx is available both on desktop and mobile devices. The application contains more than 2,700 diagnoses, spanning across general medicine. VisualDx also allows sharing diagnoses with patients. They can actually see the images and verbiage that support their diagnoses.

Founded in 2012, the Greater Buffalo United Accountable Healthcare Network (GBUAHN) has over 6,000 members and is the seventh largest health home in New York. Established under the Affordable Care Act of 2010, health homes coordinate care for people with Medicaid who have chronic health conditions or who are at risk for developing chronic health conditions. This free service integrates all primary care, acute, behavioral health and long-term services and supports to treat the whole person. Care teams work closely with patients to get them all the services they need in the community. For more information on GBUAHN, visit www.gbuahn.org.

VisualDx is an award-winning diagnostic clinical decision support system that has become the standard electronic resource at more than half of U.S. medical schools and more than 1,500 hospitals and institutions nationwide. VisualDx combines clinical search with a database of 40,000 of the best medical images in the world, plus medical knowledge from experts to help with diagnosis, treatment, self-education, and patient communication. VisualDx expanded to provide diagnostic decision support across general medicine on March 1, 2016 and brings increased speed and accuracy to the art of diagnosis. Learn more at www.visualdx.com.

The Greater Buffalo United Accountable Healthcare Network (GBUAHN) and the Greater Buffalo United Independent Physician Association (GBUIPA) are teaming up with Rochester-based company VisualDx for better accuracy in diagnosing patients.

THIS WEEK, VisualDx released an update to the web application of VisualDx. We have been listening to your feedback and made feature additions and changes based on your comments.

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1. Updated look and feel for the web application homepage.

The homepage has a new look with a Quick Start Differential Builder button for users who want to quickly build a differential from common chief complaints. Clients with logos will notice a slight tweak in appearance. These changes will also be coming to mobile platforms over the next few weeks.

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2. More images!

We’ve added nearly 5,000 new images to VisualDx since March, bringing the image count to 40,000! Many of the new images are radiology and dermatology images. Pictured above are two such images. At left is a clinical image of aquagenic wrinkling of the palms - an example of a recently added rare condition. On the right you can see an x-ray image of the foot that has been added to the rheumatoid arthritis diagnosis. We previously covered rheumatoid arthritis, but only as related to the skin. We're pleased to add radiologic images as a more comprehensive illustration of this common disease. Additionally, users may notice that we now have a total of 3,200 SympticonsTM in VisualDx.

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3. Image filter within a diagnosis.

We’ve developed a helpful new feature for viewing images within a diagnosis - users can now apply filters. The main filters to quickly find an image include the ability to:

  • filter either by multiple or single lesions
  • filter by type of skin pigmentation from Type I - Type VI or a combination of those
  • filter by different image types such as clinical photos, radiology, histopath/lab, or Sympticon
  • filter by body location
  • OR combine any of the filters above to further refine your search

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4. Updated look and feel to the Diagnosis Details page.

We’ve responded to user feedback and improved the look and feel of the Diagnosis Details page. Each change is designed to make the page easier to navigate, read, and access important information.

  • We have made links and other content more user-friendly within the details and images sections. 

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5. Dynamic links within a diagnosis.

If your site uses dynamic links, they now appear in the left hand navigation of the diagnosis. In this example, a doctor may click on the dynamic link and be taken to the page to report the case of secondary syphilis as they are required to do.

These updated features are also available in our iOS and Android apps. As always, we want to hear from you on the product. Please contact us anytime.

This week, VisualDx released an update to the web application with iOS and Android apps updates coming soon. We have been listening to your feedback and made feature additions and changes based on your comments.

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A 40-year-old male with a history of alcoholism presents with abdominal distention and hematemesis. A 25-year-old African American female presents with a chronic cough with bilateral hilar lymphadenopathy seen on chest imaging. A 35-year-old intravenous drug user presents with fever, heart murmur, and splinter hemorrhages seen on extremity examination.

Those who have gone through medical training likely can quickly identify the above disease scripts as a bleeding esophageal varix, sarcoidosis, and endocarditis. This is the beauty of formal medical education; it ingrains in trainees a kneejerk ability to identify and diagnose textbook presentations of the diseases that present to clinics and hospitals everyday. However, while this system allows clinicians to readily identify common presentations of common problems, if one changes just a few clinical variables, this ability to quickly and decisively identify a root cause of the patient’s symptoms breaks down. For example, if we consider instead a 60-year-old female with no past alcohol abuse who presents with hematemesis, the diagnosis of bleeding varix may not come as quickly to mind. This is just one example of the issue clinicians face when encountering uncommon presentations of common problems.

While seasoned medical providers have the benefit of years of experience to help identify and diagnose these atypical presentations, for those of us just entering the field these cases pose increasing diagnostic challenges. With such an apparent and pervasive issue of medical and diagnostic errors1,2 at hand with the potential to negatively impact patients, what safeguards can physicians and trainees employ to reduce the prevalence of diagnostic and treatment error in their practices?

loganjonesquote.jpgBefore the advent of the internet and the rapid expansion and integration of technology in patient care, if a clinician had a clinical question they would have to hold onto the question until they had access to a library or other sources of text. Now in the 21st century, with the ongoing expansion of digital integration into our daily routines, the entire body of medical knowledge is just a click of a mouse or the tap of the screen away. Although this sounds good in principle, studies have shown that medical providers struggle to properly wield non-medically oriented resources like Google or even PubMed to answer patient care questions3-5. In response, numerous point-of-care medical decision support programs have emerged that can provide quick and concise answers that utilize peer-reviewed literature to help clinicians practice evidence-based medicine. These resources stand to help expedite the process of finding answers to questions that arise in patient care. Early evidence would even suggest that their broader implementation has observable improvements on patient outcomes6.

Despite slowly growing evidence that the utilization of electronic point-of-care decision support resources can help inform clinicians to improve their practices and in turn patient outcomes9-10, our institutions of medical education have been slow to formalize education surrounding the use of these tools. The physician of tomorrow will likely be expected to be masters of integrating the ever-expanding medical knowledge maintained by these resources with the clinical skills and professional abilities to care for our patient populations. So, until our institutions establish the expectation for education on these tools, it is up to each of us as professionals to inform and educate ourselves on how to use every tool available to care for patients - including point-of-care clinical decision support resources.

Throughout my own educational experiences, I have used many different programs and find that while none of them offers a “one size fits all” ability to help with all questions, several have made it to my top-pick category. Below are some of my top choices and how I find them useful. Ultimately, it is impossible, and frankly unsafe, to expect clinicians to learn and memorize the exponentially growing body of medical knowledge. Hence, as with basic procedural skills such as starting an IV and suturing a simple wound, all clinicians should be expected to be competent in the cognitive skill of augmenting their practices by accessing appropriate resources in a point-of-care fashion in the care of their patients.

 

  • VisualDx: "Differential expander" - Born with the intention of assisting in the diagnosis of dermatologic conditions and visible lesions. A must have for any clinician because weird rashes are always difficult to diagnose. Also, recently updated to include broader differentials for an even more robust, general medicine differential diagnostic engine. Great for visual learners – expanding to include pathology and microbiology images and radiography to support diagnostics and education.
  • Epocrates: "How do I treat this?" - The basic service offers drug interactions, pill identification, clinical practice guidelines, and other helpful resources. The full version offers user expanded access to disease monographs, lab interpretations, and evidence-supported treatment protocols.
  • UpToDate: "I have 10 minutes to learn about X before rounds" - An evidence-based clinical decision support system authored by physicians to help clinicians make the right decisions at the point of care. Provides a "medium" depth dive into pathophysiology, pharmacology, diagnostics, and treatment of thousands of diseases. Tables and charts are often concise and provide great direction on how to workup and manage medical/surgical problems.
  • Figure 1: "General knowledge expansion" - This community medical-image sharing application allows healthcare workers to share photos and discuss cases on a HIPAA compliant platform. You get to see a "once in a career" disease presentation every day.
  • Assorted Screening and Guideline Applications: "Healthcare maintenance / chronic disease management" - The screening and interventions found in these applications don't take up space in my brain, but they do on my iPhone. They have many detailed components and are easy to use at bedside – just don't forget to tell your patient you're looking up their CVD risk and not texting about dinner plans. My short list: AHRQ ePSS (USPSTF recommendations), CDC Vaccine Schedules, ADA SoC (Standards of Care), ASCVD Risk Estimator, and a link to the FRAX calculator. 


About the Author

loganjones320.jpgR. Logan Jones is a fourth year medical student at the University of Nebraska Medical Center (UNMC) and has a strong interest in medical education and healthcare policy. Logan has served in numerous leadership roles at UNMC, the Nebraska Medical Association, and The American Medical Association. His main areas of focus are Competency-Based Medical Education, Graduate Medical Education finance reform, and Healthcare Technology Innovation.  Logan also has a strong interest in Antimicrobial Stewardship and plans on pursuing a career in Infectious Diseases. He enjoys spending his free time cooking, maintaining his wellness through exercise and yoga, and listening to NPR and his favorite podcasts.


References

  1. Makary MDaniel M. Medical error—the third leading cause of death in the US. BMJ. 2016:i2139. doi:10.1136/bmj.i2139.
  2. Harvard School of Public Health. THE PUBLIC’S VIEWS ON MEDICAL ERROR IN MASSACHUSETTS.; 2014. Available at: https://cdn1.sph.harvard.edu/wp-content/uploads/sites/94/2014/12/MA-Patient-Safety-Report-HORP.pdf. Accessed June 21, 2016.
  3. Hoogendam A, Stalenhoef A, de Vries Robbé P, Overbeke A. Answers to Questions Posed During Daily Patient Care Are More Likely to Be Answered by UpToDate Than PubMed. J Med Internet Res. 2008;10(4):e29. doi:10.2196/jmir.1012.
  4. Sayyah Ensan L, Faghankhani M, Javanbakht A, Ahmadi S, Baradaran H. To Compare PubMed Clinical Queries and UpToDate in Teaching Information Mastery to Clinical Residents: A Crossover Randomized Controlled Trial. PLoS ONE. 2011;6(8):e23487. doi:10.1371/journal.pone.0023487.
  5. Krause R, Moscati R, Halpern S, Schwartz D, Abbas J. Can Emergency Medicine Residents Reliably Use the Internet to Answer Clinical Questions?. Western Journal of Emergency Medicine. 2011;12(4):442-447. doi:10.5811/westjem.2010.9.1895.
  6. BONIS P, PICKENS G, RIND D, FOSTER D. Association of a clinical knowledge support system with improved patient safety, reduced complications and shorter length of stay among Medicare beneficiaries in acute care hospitals in the United States. International Journal of Medical Informatics. 2008;77(11):745-753. doi:10.1016/j.ijmedinf.2008.04.002.
  7. Ellsworth M, Homan J, Cimino J, Peters S, Pickering B, Herasevich V. Point-of-Care Knowledge-Based Resource Needs of Clinicians. Appl Clin Inform. 2015;6(2):305-317. doi:10.4338/aci-2014-11-ra-0104.
  8. Duran-Nelson A, Gladding S, Beattie J, Nixon L. Should We Google It? Resource Use by Internal Medicine Residents for Point-of-Care Clinical Decision Making. Academic Medicine. 2013;88(6):788-794. doi:10.1097/acm.0b013e31828ffdb7.
  9. Fiander M, McGowan J, Grad R, Pluye P, Hannes K, Labrecque M, Roberts NW, Salzwedel DM, Welch V, Tugwell P. Interventions to increase the use of electronic health information by healthcare practitioners to improve clinical practice and patient outcomes. Cochrane Database of Systematic Reviews 2015, Issue 3. Art. No.: CD004749. DOI: 10.1002/14651858.CD004749.pub3.
  10. Cook D, Enders F, Linderbaum J, Zwart D, Lloyd F. Speed and Accuracy of a Point of Care Web-Based Knowledge Resource for Clinicians: A Controlled Crossover Trial. Interact J Med Res. 2014;3(1):e7. doi:10.2196/ijmr.2811.

 

 

 

 

 

 

"While seasoned medical providers have the benefit of years of experience to help identify and diagnose these atypical presentations, for those of us just entering the field these cases pose increasing diagnostic challenges." Guest blogger R. Logan Jones discusses the integration of clinical support resources in modern medical education.

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