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ePss App Review: Medical Decision Support

Unveiled at the 2006 National Prevention Summit by the US Department of Health & Human Services Agency for Healthcare Research and Quality (AHRQ), the electronic Preventive Services Selector (ePSS) tool provides primary care clinicians and healthcare teams timely decision support regarding screening, counseling, and preventive services for their patients.

The ePSS is based on the current, evidence-based recommendations of the U.S. Preventive Services Task Force (USPSTF), the leading U.S. authority on preventive medical care guidelines. The USPSTF implements and publishes rigorous, impartial scientific evidence reviews of the effectiveness of preventive health care services (e.g., cervical cancer screening) for healthcare professionals and health systems.  

Available as both a Web-based selector and a downloadable application across mobile device platforms, the ePSS provides practical, point-of-service tools and relevant information for clinical preventive services.

 

Set Up

The ePSS is available as a free download across mobile devices, including iPhone, Android, iPad, Blackberry, PalmOS and Windows Mobile. Using the app does not require a subscription or registration nor are there any upgrade fees—all clinical content updates happen automatically in the background over Wi-Fi or cellular network.

Instructions for Use are provided under the “More” tab in the lower menu bar (on iPhone5, used for this review). Information provided within this tab includes: How to conduct a targeted search for specific recommendations; How to save and customize a search; How to filter criteria; How to browse recommendations by topic; How to email and bookmark results. Of particular importance is the explanation of the Search Display Results and the 5 grades level tabs (A, B, C, D & I).

 

Utility

A search begins with the START button in the upper right corner of the screen. This initiates a targeted search based on the criteria entered, (e.g., patient’s age, gender, pregnancy status, tobacco use status, sexual activity status). This search screen can be accessed from any other screen in the app by selecting the SEARCH icon in the menu.

The Search Result Display shows your current search criteria followed by a list of all recommendations that match the criteria. These recommendations are further grouped into 5 grade level tabs (A, B, C, D, I). Selecting one of the grade tabs then shows you only the criteria for that level:

  • Recommendations with Grades A or B are grouped under the Category Recommended (i.e., USPSTF recommends screening all adults for obesity).
  • Recommendations with Grade D corresponds with Category Not Recommended (i.e., USPSTF has concluded there is insufficient evidence to recommend for or against routine use of interventions to prevent a specific condition-e.g., back pain).
  • Recommendations with Grades C or I are grouped under the Category Uncertain. (i.e., evidence is insufficient for initiating screening or other preventative services for patients in the primary care setting).

Selecting a Recommendation from the Search Results shows you the Risk Factor Screen, allowing you to view additional details pertaining to Frequency, Counseling, Screening, Clinical Considerations, Rationale for Specific Recommendations, and additional Tools for learning more.

TIP: To quickly learn the Navigation for this App, it is helpful to go through the sequence the first time with a clinical case for which you are familiar with the preventive service recommendations. For example, a 43 y/o female, non-smoker who is not pregnant but is sexually active should have an annual cervical exam and regular blood pressure screening. Other screenings will be indicated based on what you know about the patient (e.g., has hyperlipidemia or is planning to get pregnant). Then you can navigate through the recommendations to learn more about what is offered in each screen.

In Practice: Who’s Using ePSS?

  • Primary care physicians and nurse practitioners at San Francisco General Hospital to provide evidence-based support to primary care providers on recommended preventive health services. More Info
  • Students at Wichita State University as a way to introduce and emphasize the importance of preventive and evidence-based medicine in the practice of medicine. More Info
  • Electronic Health Record vendors to improve its care processes by integrating the USPSTF recommendations into its patient workflow at Watson Clinic in Florida. More Info
  • The Office of Disease Prevention and Health Promotion in their myhealthfinder tool, which provides patients and consumers a searchable resource for information about preventive services.

Overall Key Features

  • Ability to link to HTML calculator pages within the app. For example, the app links to a Risk Assessment tool for estimating the 10-year risk of having a heart attack — based on the Framingham Heart study (see video from iMedApps).
  • Tools tab provides a variety of links to patient education PDF files, which can be sent to patients via email.
  • Patient-appropriate, evidence-based, graded screening USPSTF recommendations
  • Optional e-mail notifications of available updates
  • Interface is sharp and intuitive
  • Support Resources online
  • Free, including regular updates

What to Improve

  • Enhance search function to allow for more specific and comprehensive criteria

 

ePSS Web App Key Features

  • Compatible with major browsers: Internet Explorer 6.0 or later; Firefox 3.0 or later; Safari 4.0 or later; Opera 9.51; Google Chrome
  • User friendly interface
  • Print friendly format available

ePSS Mobile App Key Features

  • Full functionality of the USPSTF web application
  • Full mobility without the need for wireless or internet connectivity *
  • Compatible with Android, iPhone/iPod touch, BlackBerry, Palm OS/webOS, and Windows Mobile devices (access downloads for supported devices)
  • Scheduled update reminders: Windows XP/Vista users

*internet connection required for updates

Karen M. Rider, M.A. is a freelance writer who specializes in wellness, health psychology and healthcare news. In addition to writing for print and digital publications, Karen writes marketing content for healthcare and wellness practitioners across a variety of specialties. View Karen’s online portfolio. 

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