iPhone Apps for the Clinic: Part 2

I hope everybody is keeping warm this winter. I can tell you it certainly has been unusually colder than normal this year in central Florida. Take that Mr. Gore! I'm going to once again address one of the more popular posts on this blog, iPhone apps. As of January 27, 2010 Apple reports there being more than 140,00 available apps at the iTunes App Store with more than 3 billion apps downloaded as of the same date. That's BILLION with "B". Apple only reports selling 33 million iPhones as of the 4th quarter of 2009. So that means that each iPhone user has downloaded roughly 90 apps, give or take. Some people have probably downloaded a heck of a lot more than that due to what is being referred to app addiction, and the process has been termed "apping". So bearing all this mania in mind we can safely say this device is going to be around for a while longer. It certainly bears consideration for use in the rehab clinic as well as when you are considering recommendations for your clients. It also bears mentioning that many of these apps will work on the iTouch. So if you’re not interested in getting a new cell phone and potentially more expensive cell phone bills consider purchasing the iTouch to get the device without the phone.

MedAlert

$ 0.99

For those of you seeing patients for medication management or adults with ADHD this is one app you can recommend. You can add multiple users with complex dosing schedules. The app will schedule alerts and then notify via device alarms as to the person, the medication and the dose.

 

 

soundAMP

Prive Varies by Features

soundAMP is a series of apps by Gingerlabs that comes in three different versions which are designed to turn the iPhone into a “quality hearing device”. The app uses the phone’s microphone to listen to the environment and process the sound, cleaning it up for better comprehension by the user. One might think that if you can afford an iPhone, why don’t you just buy a hearing aid. But in actuality, many folks are in the in-between stage of actually needing HA’s full time vs. use in special circumstances. soundAMP 2.0 ($4.99) and soundAMP R ($6.99) include a user-tunable dynamic equalizer to achieve optimal sound quality. Verson 2.0 records the last 30 seconds while version R recording is only limited by the empty space on your device. soundAMP Lite has no recording feature or equilizer, but is only $0.99. Not bad for a pair of Magic Ears. Consider this for children and adults with sensory processing disorders that affect listening.

Locabulary

Free

Okay, I showed this one to my SLP and she thought it was cool too. This app was designed to “combine location and vocabulary to produce efficient communication.” It is a compact and inexpensive alternative to augmentative communication devices that is customized to work in situations like McDonald’s and Starbucks. The interface allows sentence construction as wells as single word or short phrase choices. Quickly snap off a “Dude”, “Hello” or “Sweet” as well as order that wicked Mocha Frappachino. Did I mention that this FREE! ACC’s that do stuff like this run in the thousands of dollars! Also worth checking out is iConverse ($9.99) and the very powerful Proloquo2Go ($189.99) which is still a bargain.

Accessibilty

If we’re going to assume persons with disabilities will be using this device, then we need to consider accessibility. Not  everybody is going to be able to interact with this doodad using their fingertip. Therefore, that brings us to the trusty stylus. A few choices are available now running in price from $4.99 for a fingertip stylus to $14.99 for a pen-like stylus with a soft tip that comes with a travel clip to attach it to the device.

New for the iPhone 3GS is the VoiceOver screen reader that has been utilized on the Mac for while now. Users can hear a description of whatever item is under their finger. Very cool. It speaks 21 languages and will also incorporate features like entering text and specific application interaction. I really have to say I’m disappointed that Apple didn’t include this feature for older models in an OS upgrade. That’s “Operating System” for you guys out there rolling it old school style. Check out the Apple Accessibility page for more information on features for hearing and physical and motor skill impairments as well.

Islet – Diabetes Assistant

$2.99

Help clients take charge of their diabetes by letting them enter blood glucose, insulin injection, carb intake and exercise data. Additionally, you can graph your data which is great for showing to the doc during office visits so he can spot trends. You can also customize insulin types. In between office visits? Email your data to your doctor. The app’s author, a Princeton undergrad, recently received a $100,000 grant from the Center for Integration of Medicine and Innovative Technology (CIMIT) to build a more in-depth online portal for the app. Keep an eye on this kid.

So that’s it for this time folks. Please comment on any of these apps if you have experience with them. Also, please feel free to suggest any personal favorites you might already be using that I might have missed. With over 140,000 apps in the store I’m bound to miss a few. One thing Apple has yet to do is devise a really good way of sorting through the stinky apps. Oh yeah, there’s a lot ‘em.

Aging Parents

I was all set to start my next blog, which was to be about taking care of aging parents. I was researching for the first article when I came upon Dale Carter's website Transition Aging Parents. After reviewing the content of this site I promptly deleted the blog I had started in shame for I was not worthy of the excellent effort put forth by Ms. Carter. I highly recommend ALL occupational therapists become familiar with the material on her website. I found some things there for the first time myself. There are invaluable tools for navigating the system as well as insight into the people that care for their own parents as Ms. Carter also cares for her own mother via long distance. Ms. Carter makes some fine points about what one should consider before even thinking about putting a loved one in a nursing home. Another excellent link is one to the National Council on Aging Benefits Checkup Tool. I found myself emailing that one to my in-laws.

Anybody Want An OT?

Okay. After three and a half years of watching my company drive itself into the ground and taking the quality of patient care with it I am finally ready for something different, I think.

I have developed a fondness for the place that I work in after all this time and the people that live and work there. I just can't stand the people that run the joint. I have watched as the company has changed one policy after the other, broken one promise after another and driven each employee over the brink. I have watched as the rehab department has experienced a nearly 200% turnover and twice that for nursing. I have watched 5 department managers and 2 regional managers come and go, each cursing the company as they left. I have watched as standards of care have dropped and "efficiency" requirements have risen.

What have I gotten out of this experience? I'm now on medication for depression, anxiety and sleep. I'm in a constant state of turmoil over giving my patients the level of care that they need and giving my company the productivity it requires because other therapists leave while I remain.

So, where does that leave me? Do I find another SNF and start this whole idiotic process over again? Or do I try to find another field and probably face a major pay cut? (note: I've got three young kids to worry about) Or in these economic times should I just keep my mouth shut and be glad that have a job at all?

I have given it some thought and decided upon investigating returning to hand therapy, getting trained in functional capacity evals and find that kind of work or just hanging out my own shingle and going at it alone. I would appreciate ANY comments or suggestions from anyone out there that might be going through similar experiences or have in the past. Because to be honest, I really don't know what to do. I am really reconsidering why I became a therapist in the first place. Maybe I should just go to law school at night? Do lawyers have anything like PPS?! Sorry for the purge! :(

Challenge to OT Bloggers

Image via Wikipedia

I would like to put forth a challenge to my fellow OT bloggers out there. I have recently become aware of a useful private organization called Health On the Net Foundation. This organization exists to "[promote] and [guide] the deployment of useful and reliable online health information, and its appropriate and efficient use." HON has a code, the HONcode as it is called, that it has created in order to promote a standard of excellence in regards to published online health information. According to the HON website, the HONcode is currently used by more than 6,800 certified websites in more than 118 countries. HON provides a HONcode Accreditation to "any health or medical web site, intended for patients, health workers or the general public, whether or not it has a strictly health or medical focus." Potential sites must apply for certification, after which they are reviewed by HON committee members which are made up from "medical professionals." Once approved by HON, which is not guaranteed, a site must submit to continuing review without notice to ensure continuing compliance. 

Back to my challenge. I suggest that my fellow bloggers review the HONcode, and after attempting to ensure that their posts conform to this standard, apply for certification. I think that this is a system that is long overdue on the web. It has been tried in several, mostly unsuccessful forms that I know of. WebMD is one successful model that uses an "independent medical review committee." However, until now, there hasn't been a unifying code for us little guys who publish privately, mostly for members of our own community. Most occupational therapists are, at least, introduced to the methodology behind research and scientific and technical writing. We now have a standard for web publishers to follow.

Off topic: I would like to ask, in follow up to my article from a few months back, if any of you iPhone users have come across any additional applications that might be useful to occupational therapists. I am putting together another list of apps since that seemed to be such a popular topic. Please feel free to post any of your favorites to the comments that fo

Review: Business Fundamentals for the Rehabilitation Professional

If you only stick your head up once in a while to take in the scent of current events, then you know that a lot of people in the rehab profession are concerned about the direction events are taking in Washington. For many us in the skilled nursing practice area things are starting to look a lot like what happened in the late nineties when the executive branch of the U.S. government decided to take a more active role in health care reform. That culminated in many therapists being laid off as managers rushed to cut skyrocketing costs of providing care in a post-PPS environment. One of the biggest expenses for rehab employers was therapist salaries which had steadily risen throughout the nineties as the growing elderly population sought more attention to address their growing needs. Here we are twelve years later, after salaries have had plenty of time to slowly return to similar levels prior to 1997 and we have another administration with designs on health care reform. Except this time they mean to reform more than just Medicare.

More than ever, it's a good time to reassess your priorities and take stock of yourself and what you want to accomplish as a therapist. For many, the answer might be to stop working for a rehab company and start their own. A career is just like motion sickness; when you're in control of where you're going, you're less likely to get nauseated.

In comes Business Fundamentals for the Rehabilitation Professional. This book, which was written to be a textbook (most likely for OTD courses focusing on private practice) is written for occupational or physical therapists. In fact, the two principal authors represent both disciplines, although Tami Richmond, an OT, seems to have provided most of the substance of the book.

The book starts off with assessments designed to make you think about the who, what, where, when, why and how of opening your own private practice. This is extremely important as many therapists don't give enough thought to this before diving in. Heck, most small business owners don't even consider this enough. The book defines some of the most important first steps one must take before taking the leap.

Subsequent chapters begin to delve into structuring the business to take advantage of tax savings and protection from liability. What you're left with is a very thorough task list to guide you through these first critical steps. It was good to see the attention to detail to things such as properly researching a business name and creating a comprehensive business plan.

Advice to properly research your market is prominent and precedes excellent marketing strategies and worksheets. Financial management, which is a subject many therapists might have missed in school, is given its own chapter and covers the basics of accounting as well as risk management, billing and reimbursement. Contributions to this chapter come from a financial manager as well and the advice is nicely customized for rehab professionals. Worth mentioning are the special considerations for the rehab professional sprinkled throughout the text which specifically relate all of the chapter's major points to the specific needs and concerns of therapists and their companies.

This book is thoroughly readable and if you are very serious about starting out on your own you will find it engrossing and an indispensable resource that will no doubt be filled with side notes and dog-eared pages throughout. Be sure to make use of the book's associated website for resources that include downloadable forms and self assessments as well as websites referenced by chapter.

Thank you to Slack, Inc. for providing a review copy.

Words of Wisdom

¿Puede funcionar en español? (Can you function in Spanish?)

Many of my colleagues at work and via this blog have written to me in the last several weeks since my last post. While they were interested in what the iPhone had to offer, especially Medical Spanish, many requested an old fashion resource made of paper that I would recommend for use now with their Spanish speaking clients. One of the therapists I work with, recently let me borrow her copy of No More Spanglish!!: English-Spanish guide for Occupational and Physical therapists in Adult rehab settings. The title pretty much lays it all out for you. There is a section devoted to ADL and questions asked during eval's and treatments. The book copy I was lent had pages that were laminated to prevent damage from the fluids we tend to encounter in adult rehab settings. A quick glance at the website for the book reveals that the author, who happens to be an occupational therapist, is selling the book for $20.50 via PayPal. It's a really great reference to keep in the clinic. That's not to say that it's a replacement for taking a Spanish class. You still need to be somewhat familiar with the language. After all, you have to understand what the client is going to say back to you. For those of us who have had Spanish at one time or another when in school, this book will help bring back a lot of the stuff we "purged" during OT school.