Many patients request or receive ‘routine’ (but frequently unnecessary) medical tests. There are many reasons for this: the current fee-for-service payment model still predominantly in place in the United States; the lack of legal standing for a medical associations’ recommendations that can result in medical malpractice cases for not providing a particular screening; patient satisfaction and satisfaction scores; and the sheer inertia of “this is what we have been doing for years” and/or a feeling that testing meets a patient expected or “community standard” litmus test. Healthcare spending now accounts for over seventeen percent of the United States’ gross domestic product. Many consider this level of spending unsustainable. Unnecessary diagnostic and screening tests are a primary driver of this spending. In response to these sobering statistics, collaborating medical societies have identified lists of “top 5” tests or treatments that are commonly overused. The “Choosing Wisely” initiative, created by the American Board of Internal Medicine (ABIM) Foundation, has recruited over 70 medical societies, associations and partner groups to list common medical tests/procedures that are often clinically unnecessary. The American Academy of Family Physicians for example does not recommend imaging for low back pain in the first 6 weeks unless the patient has red flags. Guidance about these types of decisions can be found piecemeal via the Choosing Wisely Campaign website.
Choosing Wisely partnered with Consumer Reports to create a website as well as videos and downloadable materials for patients and providers covering most of the Choosing Wisely recommendations. Previously, we reviewed their app primarily designed for patients called, Making Healthy Choices. Additionally, they have launched a new iOS app called Choosing Wisely, primarily for providers to access these practice recommendations on the go.
Choosing Wisely contains the recommendations from the Choosing Wisely initiative of over 70 medical groups with a multitude of top-5 and top-10 lists of tests and procedures that may not be necessary or should be used more judiciously. The evidence behind the Choosing Wisely recommendations for primary care have previously come under fire so we recommend carefully reading each recommendation and check the level of evidence upon which it is based.
What providers would benefit from this App?
Patients, students, residents, mid-levels, physicians, nurses, any staff provider who is interested in improving patient care based on the Choosing Wisely initiatives.
Available for Download for iPhone.
iPad and Android “available soon” per Choosing Wisely website.
Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.
- The app brings the Choosing Wisely recommendations to providers and patients.
- Helpful videos and PDFs for various recommendations.
- Can view material via various filters—society, gender, age, etc.
- Significant overlap with Making Healthy Choices app.
- Many of the Choosing Wisely recommendations are expert opinion based.
- Not available for Android or iPad currently.
Choosing Wisely is a great addition to the app store as it brings the Choosing Wisely recommendations to mobile devices here in the US. Previously only the Choosing Wisely Canada recommendations were available as an app and the Making Healthy Choices app was predominantly patient focused. The app includes all of the various medical society recommendations in one place and provides patients and providers quality recommendations.
- Overall Score
- User Interface
Simple to use interface, but filtering of content could be easier.
- Multimedia Usage
Quality PDFs and videos (on some but not all) available for each recommendation to share with patients.
App is free.
- Real World Applicability
Finally, we have all of the Choosing Wisely recommendations in one place for providers to easily access on their mobile devices. It includes information for both provider and patients. It is slightly confusing that we have both Choosing Wisely and Making Healthy Choices apps since they contain similar information. It appears to me that Choosing Wisely is best for providers and Making Healthy Choices is best for patients, but the overlap of content/app structure muddies the waters. I will certainly encourage my fellow providers, residents and fellows to use it and share the PDFs with patients.
- Device Used For Review
iPhone 6S running iOS 10.0.2
- Available for DownloadiPhoneiPad