Can Android teach EKG interpretation? An overview of three popular Android EKG apps

[Android medical app review]

by Brett Einerson

on 06/08/10

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Repetition, repetition, repetition.  Most of the information I retained from the first few years of medical school is what I learned by repetition.  Unless I use some bit of knowledge regularly, I tend to forget it.  Reading an EKG is one of those skills in medicine that requires a lot of background knowledge, the ability to recognize patterns, and the clinical experience to know what looks “okay” and what looks “definitely not okay.”  While no app or textbook can replace the practical skills that one acquires through months or years of interpreting real EKGs and seeing patients, it helps to have a quick reference of ground rules and basic pattern descriptions to refresh one’s mind on the basic reading rules of EKGs.
Medical students and residents have been carrying around pocket-sized EKG manuals for decades.  But over the past several months a few ECG/EKG apps have cropped up on the Android Market, hoping to fill the need for an electronic alternative.
Here I take a look at three EKG interpretation and learning tools for Android mobile devices: EKGdroid, EKG:Advanced, and EKG Calipers.  Can Android really replace those pocket manuals and teach the next generation of doctors to read EKGs?

EKGdroid ($2.99) by Webpatient.net
EKGdroid is not a flashy app, but it has many of basic tools needed to interpret an EKG..  The interface is very basic in comparison to iPhone apps we have reviewed (ECG guide, Instant ECG, ECG Interpreter).  But the learning curve to navigate the app is essentially zero.  The user selects among the common normal and abnormal rhythms, and a zoom-able rhythm strip appears.  The user can navigate among the sub-menus to learn about characteristics of that rhythm.

This app is good for students who are already familiar with the basic theory of EKG.  The app will be useful to a 3rd or 4th year medical student or junior resident trying to refresh their memory on the basics of various rhythms and their causes.
This app is not good for students who want to learn “from scratch” how to read EKGs.  This app lacks information on basic EKG principles, like determining axis and rate.  In general, the app does not teach how to understand EKGs, but rather how to identify common patterns of pathology on EKGs.  This point might seem subtle, but trying to read EKGs without a basic understanding of the theory is an exercise in futility.
Finally, let it be known that EKGdroid is not an exhaustive manual of EKG interpretation.  Only the most basic information about each rhythm is presented.
EKG: Advanced ($1.99) by simpaddico
For those who love flash cards, EKG:Advanced is a great app for a quick quiz of EKG knowledge.  Like EKGdroid, this app is extremely easy to use and navigate.  The app uses the Q&A style and quick-feedback that physical flashcard lovers enjoy.  A Main Deck of cards contains all of the available questions, and the Faves menu allows the user to store wrongly-answered questions (or any set of cards) in another Faves Deck, which can be “flipped” through later.  Alternatively, the Ignore function will remove cards from the deck.  The Search function is useful – searching both questions and answers for the search term.  Settings allow the user to shuffle the decks, or view the answers to each card first (presumably to guess the question – like Jeopardy?).  I am still trying to figure out how one might use the Index.
Surprisingly, and unlike EKGdroid, there are no rhythm strips in this deck of flash cards.
In future versions, I would love to see a “make your own flashcard” function.

This app is good for flashcard buffs or students who know something about EKGs and want to test their knowledge of EKG with random questions.
This app is not good for an organized approach to learning EKGs.  The Main Deck is arranged in a seemingly random order, which is no way to learn EKG principles for the first time.
EKG Calipers ($0.99) by HC Dev
Trouble determining the heart rate on an EKG?  EKG Calipers is a simple app that can be calibrated to estimate heart rate by holding the edge of the phone to an EKG.  I guess the theory is that a caliper app reduces the need for (and cost of) another tool in the white coat.

This app may not be useful for health care providers and students who (1) trust the rate given on the electronic readout, or (2) trust in their own ability to calculate the rate on a EKG readout.  But for 99 cents, it might be worth a download.
Summary: Can Android teach EKG interpretation?
In short… not yet.  As compared to the iPhone apps we reviewed (see above links), these Android apps, as a group, fall short in three major areas.
1. No organized approach to learning EKG physiology, anatomy, and theory.  None of these apps individually (or as a group) teach the basics of EKG interpretation in an organized manner.  Without a great deal of prerequisite reading or background lectures to form a foundation of understanding, students will find these apps to be of little use.
2. Lacking depth.  The information on these apps is, as you would expect from the price, only superficial, and does not compare to pocket EKG manuals or iPhone EKG apps.
3. Aesthetically blah.  Like many of the medical apps currently available on the Android Market, these apps favor function over form.  While not unattractive, these apps look… well… bland compared to the polish and prim of the iPhone competition.
So for now, Android users who want to use their mobile device to learn how to read an EKG have a few options: (1) buy an EKG textbook (or pocket manual), (2) call the nicest Cardiology fellow you know when reading EKGs, or (3) hope for further development of these and other EKG apps in the Android Market.