Apps that include clinical decision support tools are four to 44 times more successful in helping clinicians diagnose chronic health issues, according to a recent study by the Columbia University School of Nursing.
The study, which was published in the Journal for Nurse Practitioners, concluded that custom apps that enable clinicians to use evidence-based guidelines to make treatment decisions and document care plans give those clinicians a much greater chance of identifying serious health issues during routine exams.
The study reinforces the concept of using mHealth to give clinicians access to more tools at the point of care.
"What clinicians need is decision support tools that fit into their workflow and remind them of evidence-based practices," Suzanne Bakken, PhD, RN, Alumni Professor of Nursing and Professor of Biomedical Informatics at Columbia Nursing and lead author of the study, said in a release. "Our app focused specifically on the work that nurse practitioners do to identify health problems, counsel patients and coordinate care plans, resulting in higher diagnosis rates and more opportunities for intervention."
The study examined diagnosis rates for more than 34,000 patient exams undertaken by 363 registered nurses at Columbia, focusing on obesity, smoking and depression. For those using apps with CDS capabilities, diagnosis rates jumped from 4.8 percent to 33.9 percent for obesity (a seven-fold increase), 2.3 percent to 11.9 percent for tobacco use (a five-fold increase), 0.2 percent to 8.8 percent for adult depression (a whopping 44-fold increase) and 1.1 percent to 4.6 percent for pediatric depression (a four-fold increase).
According to Bakken, the apps may have worked better because they encouraged nurses to screen, diagnose and manage specific conditions and paved the way for detailed conversations between patients and their doctors, rather than simply giving the nurses a CPT code for billing purposes.
The study, "The Effect of a Mobile Health Decision Support System on Diagnosis and Management of Obesity, Tobacco Use and Depression in Adults and Children," was co-authored by Columbia Nursing School Associate Professors Haomiao Jia, PhD, and Rita John, DNP, EdD.
