At the National Prevention Summit in 2006, the US Department of Health & Human Services’s Agency for Healthcare Research and Quality (AHRQ) unveiled the electronic Preventive Services Selector (ePSS) tool for healthcare professionals.
AHRQ ePSS was designed to help primary care clinicians choose the appropriate preventive services for their patients, to help “create a culture of wellness; a society that thinks of staying healthy rather than simply being treated once we’re sick,” in the words of then-HHS Secretary Mike Leavitt.
Since 2006, this emphasis on preventive care services has surged among healthcare professionals, the lay public, and the federal government under the leadership of President Obama and HHS Secretary Kathleen Sebelius.
Read below the jump to learn how the AHRQ ePSS App, which appeared on our Top 20 Free iPhone Apps for Healthcare Professionals List, is helping emphasize preventive care services.
The information in ePSS is based on the current recommendations of the US Preventive Services Task Force (USPSTF). The USPSTF, for those unaware, consists of an independent panel of non-Federal experts in preventive and evidence-based medicine, which is composed of primary care providers (internists, pediatricians, obstetricians-gynecologists, family physicians, etc.) appointed and funded by the AHRQ.
The USPSTF carries out rigorous and impartial scientific evidence reviews of the effectiveness of preventive health care services (colorectal cancer screening, for example), and publishes their recommendations for healthcare professionals and health systems. Simply put, the USPSTF is a leading US authority on preventive medicine guidelines.
While AHRQ ePSS is available both as a web application and a mobile application, here we review the mobile application for the iPhone. The AHRQ ePSS iPhone App contains five functions along the index bar—Search, Browse, Tools, Update, and More.
The search function allows users to perform a targeted search for recommendations for a particular patient. As shown here, parameters include age, gender, pregnancy status, sexual activity, and tobacco use, but all of these fields are optional (i.e., if no parameters are entered then all of the recommendations in the ePSS database will appear).
Here, we use a hypothetical 51-year-old female patient who is a tobacco user but is neither pregnant nor sexually active. The search results (recommendations that match our entered criteria) are grouped by the grading of these recommendations along the top of the screen, and clicking on a grade tab displays the appropriate recommendations.
Of note, the USPSTF assigns grades to its recommendations for convenient grouping, with associated “suggestions for practice.” Here is a table briefly explaining what each grade represents along with its associated suggestion for clinical practice:
Clicking on a particular recommendation (here, colorectal cancer screening) displays additional information on that topic. Topical information includes extensive and well-written synopses on frequency of screening, clinical considerations, rationale for screening, and tools (links to screening tools, patient brochures, etc.), all organized via the tabs located on the top bar.
Of note, applicable recommendations include risk factor information. Here, clicking on the HIV screening recommendation allows for the ability to learn more about the evidence-proven risk factors for HIV.
The Browse tab displays the ePSS’s full spectrum of topics, sortable by counseling, preventive medications, and screening.
Clicking on a topic here displays the same well-written wealth of information seen earlier from the search results. For example, here we see that the USPSTF recommends against screening for bacterial vaginosis in asymptomatic pregnant women who are at low risk for preterm delivery. We can explore this topic further into clinical considerations as well as the evidence-based rationale for this recommendation.
The Tools function displays a list of valuable questionnaires, calculators, and assessments to assist with preventive care. These links all open within the app for easy access. Here, for example, we show the link to the AUDIT, CAGE, and T-ACE screening tools for alcohol misuse.
As another example, we show the Zung Self-Rating Depression Scale within the app. Assessments like the Zung Scale can be quickly performed at the clinic visit or bedside with the help of the app.
As the USPSTF frequently updates its guidelines, the information on ePSS can be easily updated from within the app with one touch. Moreover, users can subscribe for optional ePSS e-mail notifications of updates.
- The AHRQ ePSS app is offered for free by the US Department of Health & Human Services.
- Patient-appropriate, evidence-based, graded screening recommendations from the USPSTF
- Easily keep up-to-date with the most recent USPSTF guidelines (with optional e-mail notifications of available updates)
- The user interface is clean and intuitive
Dislikes/Future Updates I’d Love to See:
- The app’s collection of tools is somewhat limited, and a large fraction of the tools are merely PDF versions of the USPSTF recommendations
- To be honest, there’s not much to dislike about this free, well-designed, evidence-supported app. If anything, the app becomes less useful the more one uses it, as they become increasingly comfortable with preventive care guidelines. For example, I relied on the AHRQ ePSS app extensively during my first couple months of residency in my weekly half-day continuity clinic, but screening guidelines and counseling recommendations have became so second-nature that I rarely find myself opening up the app in clinic anymore.
- The AHRQ ePSS App developed by the US Department of Health & Human Services represents an invaluable resource for primary care physicians, internal medicine residents, and medical students for its patient-appropriate, evidence-based screening recommendations from the USPSTF.
- In short, the AHRQ ePSS App is a MUST-HAVE program for its ability to facilitate the practice of optimal preventive care, an increasingly vital element of good medicine.