App review: UpToDate earns high marks for accessibility

February 6, 2019

In the first installment in a new series, Spyridon Basourakos, MD, and Alexis E. Te, MD, review the UpToDate app.

UpToDate is one of the most trusted medical reference tools with evidence-based clinical information for daily practice. UpToDate, a Wolters Kluwer brand, initially started as a web-based nephrology resource in 1992 and has since been broadened to encompass multiple specialties, including urology. In recent years, UpToDate has become more readily accessible with the development of a mobile app for smartphones and tablets.

After downloading the UpToDate app, providers will be prompted to sign in with appropriate credentials, obtained through personal or institutional subscriptions, to obtain access.

 

Design of the user interface

The home screen of the UpToDate app has a search box at the top and a menu of other features, such as My UpToDate, Calculators, Contents, Drug Interactions, and Settings (figure 1).

Search box. As users enter queries into the search box, the app automatically provides a list of relevant topics related to the search term(s). Once a topic is selected, the app subcategorizes the content into Adult, Pediatric, and Patient Education sections. Patient education materials enhance patient-provider rapport by involving patients in the management of their medical conditions.

Next:"Content can also be bookmarked for ease of future access"Content can also be bookmarked for ease of future access. For instance, when one inputs “UTI” into the search box, multiple UpToDate articles related to urinary tract infection appear (figure 2) and can be filtered based on the categories described above. For each topic, there is a basic outline that includes introduction, clinical manifestations, diagnosis, and treatment with access to pictures, tables, and algorithms (figure 3).

The top of the page contains information about the authors, editors, and disclosures. Furthermore, the dates of the last literature review and the last update to a given topic are provided (figure 4). Hyperlinks to other relevant topics are provided in each article (figure 5).

My UpToDate. This tab tracks search history and bookmarks, which allows the user to easily revisit and organize favorite topics.

Contents. This section comprises a list of topics organized by medical specialty and also contains “Practice Changing UpDates” and “What’s New” tabs, include recent updates in practice guidelines, FDA approvals, and groundbreaking medical advances.

Calculators. The UpToDate app facilitates the acquisition of clinically relevant numerical data by providing calculators for commonly used formulas. Calculators are organized either alphabetically or by specialty.

Next:Drug interactions, CMEDrug Interactions. This tab is a recent addition to the app. It offers access to a database with drug-drug interactions, which improves patient safety in daily practice. This feature is offered in collaboration with Lexicomp, an online electronic drug reference solution.

Continuing Medical Education (CME). UpToDate has been accredited by Accreditation Council for Graduate Medical Education. Providers can earn CME credits as they review clinical topics while logged into UpToDate. Credit can be redeemed at no extra cost and without additional testing.

 

Future directions 

UpToDate Advanced is a new feature of the UpToDate website released in early 2018. It allows the physician to receive patient-tailored recommendations through algorithms. Physicians input their patients’ symptoms and history into an interactive algorithm that can guide medical decisions. In addition, a lab interpretation feature helps physicians better understand unusual or challenging test results by providing differential diagnoses. Although only available on the UpToDate website thus far, it would be a valuable asset to the mobile app.

 

Spyridon Basourakos, MD

Alexis E. Te, MD

Dr. Basourakos is a urology resident at Weill Cornell Medicine/New York-Presbyterian Hospital, and Dr. Te is professor of urology, Weill Medical College of Cornell University, Weill Cornell Medicine/New York-Presbyterian Hospital, New York.