Health Maintenance Visit Checklists App, guidelines for primary care residents and students

All healthy adults are recommended to visit their healthcare provider from time to time, even if they feel fine. Feeling healthy doesn't necessarily mean that there is no potential problem that could be found during regular checkups. For example, a lot of people with high blood pressure don't even know that they have it. Same applies for people who have high blood sugar or high cholesterol, because both conditions often do not produce any symptoms until the advanced stages of the disease. The only way to find out if you have any health problem is to have yourself checked regularly.

Annual physical was considered to be a long time standard, but this type of "top-to-toe" physical examination has never been proven to be effective in decreasing illness or discomfort, especially for patients without symptoms.
Healthcare practices recommend health maintenance visits (or evaluations) instead, which should offer better detection of health problems, better management and prognosis.

Besides regular screenings for diseases, health maintenance evaluation also include checking patient's personal and family health history in order to identify the risk of future medical problems. They may require providers to perform focused exams if appropriate, and allow them to obtain screening tests at the right intervals.

Health maintenance visits also encourage healthy lifestyle in patients, in order to maximize their health. This type of visits helps maintain a relationship between provider and patient, which is very important, especially in the case of illness.

Healthcare providers can schedule these checkups during an office visit specifically devoted to health maintenance evaluation, or they may perform them during regular visits for other concerns.

However, these health maintenance visits are not just for adults. As a resident or student on a rotation in primary care or family medicine, you'll have to provide healthcare to patients of various ages. You'll see 7 month well-child, 11 year-old tween, 35 year-old well-man, OB patients with different gestation ages, patients in their 60s or 70s visiting for their "annual physical." 

All these patients require different care. You can peek into mobile apps that could make your day easier, but the problem is that these apps are also different. Having all the information in one place would be really great. 

Fortunately, Dr Joshua Steinberg saves the (really busy) day by making another useful app. We already reviewed his OB Wheels app, a mobile calendar calculator to determine pregnancy due date.

While he usually makes his apps alone, this time he teamed up with two other doctors, Paula Dygert from Spokane and James Crosby from New York, to create a quick reference medical app for primary care students and residents, named Health Maintenance Visit Checklists.

When you open the app, you'll see that it has the same layout as OB Wheels, with white grids on blue background. But, don't let its simplicity fools you. It's highly useful solution for medical providers, helping them to with variety of things during health maintenance visits. These visit grids offer information for various age groups, from prenatal care, children, tweens to adults.

Below the grids, you may get more info, which elaborates on grid content, i.e. different age groups, except on child checkups and prenatal visits, which are both currently empty.

You can also have a word from Dr Joshua Steinberg on main principles and objectives of health maintenance and how to make it "high yield."

He also included an online video lecture, which offers a full detailed dynamic discussion of what to get done at health maintenance visits. Both written principles and online lecture have great educational value.

In the app footer, you may also check disclaimer, stating that some of the information provided in this app is evidence-based, drawn from guideline sources, while some information is based on authors' expertise, and advising users to use the grids only as ideas and prompts, not the definite lists.

Most of the information comes from US Preventive Services Task Force, Bright Futures and Institute for Clinical Systems Improvement (for prenatal care), which are listed in Reference section.

The sections within grids are very easy to use. Basically, they're modified PDF documents providing exhaustive information in the tables, which include checklists of screening for disease, health counseling and education, and chemoprophylaxis. The information for each age group is divided within the sections to further age sub-groups, i.e. for well-child from birth to 4 months there are five columns for Birth, 1-2 weeks, 1 month, 2 months and 4 months children. Also, for adults 20-80+, each decade has its own column with guidelines for that specific age.

Checklists may seem a bit crowded, but you can always zoom in, so there is no problem with viewing the tables even on smaller screens.

Despite its simple interface and "unimpressive design", Health Maintenance Visit Checklists is very useful app for primary care residents and students on rotations in primary care or family medicine, mostly because it gathers all the exhaustive information in one place, which other similar apps may be lacking.

We only hope to see Dr Joshua Steinberg would start making apps for Android too.

Benefit: Primary Care and Family Medicine residents and students, as well as any other provider who performs health maintenance visits.