I bought my first PDA in self-defense.

You see, as a program director for a Physician Assistant program, I found that all my students seemed to have one. In time, I purchased my first handheld to see what all the fuss was about.

Of all the applications my students used in their rotations, two stood out as must haves—Epocrates Rx Pro and Griffith's 5MCC. These applications truly changed my clinical practice.

I was thrilled when Epocrates made them available in one integrated package called Epocrates Essentials.

Epocrates Essentials is an all-in-one mobile guide to drugs, diseases and diagnostics. It combines Epocrates Rx Pro (premium drug reference), Epocrates Dx (disease reference based on 5MCC) and Epocrates Lab (a new diagnostic reference) in an easy to use, updateable and integrated format. In short, it is everything a medical professional needs in the palm of my hand.

Epocrates Lab
The newest reference in Epocrates Essentials is called Lab, which covers hundreds of diagnostic tests and panels. This section enables me to look up information based on the lab test, specimen type or specific panel. Information includes the basics of the selected lab, reference ranges, interpretations, and even the appropriate prep/collection method and associated ICD-9 codes.

The Lab database is important to my practice because I see a number of residents from our "group" home for developmentally delayed individuals. A lot of these patients suffer from multiple medical problems in addition to their mental retardation. And many of these medical problems require lab tests that are not always very common.

Can't remember the significance of Burr cells on your CBC? Wonder what the importance of that high Ammonia level is? Epocrates Lab lets me view the normal ranges as well as a number of potential diagnoses for an abnormal value, with suggested follow-up. I can then click on a particular disease process or possible drug cause and I'm launched automatically into Epocrates Dx or Epocrates Rx.

Epocrates Dx
Epocrates Dx is based on content provided by Griffith's 5MCC, which I have used from a standalone platform as well as in hard cover versions, but unlike any other edition of 5MCC, Epocrates Dx is frequently updated and expanded.

Epocrates Dx delivers access to over 1,200 topics. Arranged alphabetically or by body system, the topics are extremely easy to search. I frequently use it to refresh my memory prior to seeing a patient.

For example, say I'm about to see a patient with sarcoidosis and she is having a flare in symptoms. Epocrates Dx lets me review basic knowledge, differential diagnosis, treatment options, and medications options. I can go straight from Epocrates Dx to Epocrates Rx by simply selecting the medication I wish to prescribe. I can return to Epocrates Dx just as easily.

Epocrates Rx Pro
The references and tools within Epocrates Rx Pro are indispensable to my day-to-day practice. They include the Epocrates Rx drug database with alternative (herbal) medicines with a built-in weight-based dosing calculator, Epocrates ID (an infectious disease treatment guide), Tables and MedTools—all of which are tabbed in the application for quick access.

Epocrates Rx Pro delivers immediate access to information on virtually any drug or herbal medicine on the market. It allows me to find adult and pediatric dosing schedules, with an integrated weight-based dosing calculator that lets me calculate accurate dosing without leaving the drug monograph.

Other drug information includes adverse reactions, drug interactions, and pregnancy/lactation safety. Estimated cost of the drug is another wonderful feature of Epocrates Rx—many of my patients are on fixed incomes or have no health insurance.

So being able to give them an estimate on the cost of a medication before they leave the office increases the likelihood that they will be able to afford it, and that they will indeed take it. No sense in writing a prescription for that expensive new medicine if your patient can't afford it.

One of my favorite features in Epocrates Rx is MultiCheck, which checks up to 30 drugs or herbal medicines against each other for potential drug to drug or drug to herbal interactions. Can you imagine how long it would take to cross-reference each medication or herbal individually in several different publications? MultiCheck performs this task in seconds.

The ID section is also a tremendous resource. It is one of the main reasons I use the premium version (Epocrates Rx Pro) versus the free version (Epocrates Rx). This section lets me search for infectious disease treatments by (Body) "System", "Bug" or "Drug". For example, if I select "GI" from the Body Systems menu and select "Diverticulitis", I then have a choice of inpatient or outpatient treatment. I can then select empiric vs. specific treatment. I select empiric treatment and find the treatment of choice is metronidazole and either a fluoroquinolone or trimethoprim/sulfamethoxazole. Selecting any one of these medications launches me into the corresponding drug monograph without having to change tabs or applications manually.

The Tables section provides a wealth of easily accessible clinical tables and guidelines ranging from ACLS protocols to Lipid Lowering Agents to Vaccinations. If I select H. pylori Treatment, I am immediately presented with numerous treatment options for eradicating H. pylori.

Finally, the MedTools section includes MedMath with more than 30 convenient medical calculators, such as BMI and Peak Flow.

Summary
Although I have used Epocrates on both a Palm IIIC and Sony Clié without any difficulty, it is also compatible with Pocket PC PDAs and phones. Applications run smoothly and load quickly, the amount of data included in each section (tab) is impressive, and you can seamlessly move between sections.

I've yet to see a patient who isn't impressed with the amount of information I can look up about their medications, interactions and reactions with Epocrates. If you are looking for that one clinical program that will make your clinical practice more streamlined, look no further than Epocrates Essentials.