A mobile custom app that prompts clinicians to follow evidence-based guidelines when deciding on treatment and documenting care plans makes nurses significantly more likely to diagnose patients with chronic health issues such as obesity, smoking and depression during routine exams, according to a study from Columbia University School of Nursing published in the November/December 2014 issue of the Journal for Nurse Practitioners.
“What clinicians need is decision support tools that fit into their workflow and remind them of evidence-based practices,” lead study author Suzanne Bakken, PhD, RN, FAAN, FACMI, alumni professor of nursing and professor of biomedical informatics at Columbia Nursing in New York City, said in a news release.
The study evaluated diagnosis rates for tobacco use, adult and pediatric depression, and obesity during 34,349 patient exams conducted by 363 RNs enrolled in nurse practitioner programs at Columbia Nursing. Students were randomly assigned to use mobile apps with or without decision support for guideline-based care, according to the release.
For each of the health issues studied, mobile apps with decision support features resulted in significantly higher diagnosis rates than apps with only bare-bones tools for recording results from a patient exam, according to the release.
The app may have worked because, unlike software aimed at physicians that focuses more on diagnostic codes needed for medical billing, it prompted nurse practitioners to follow evidence-based clinical guidelines to screen, diagnose and manage specific conditions, and encouraged detailed conversations with patients about their health, Bakken said in the release.
For tobacco screening, for example, the app prompted nurses to ask not just about cigarettes but also about other products such as chewing tobacco, and while diagnosing patients who are overweight or obese, the app calculated body-mass-index to quickly pinpoint people who might benefit from weight-loss counseling and other interventions. With depression, the app prompted nurses to ask a series of questions to make it easier to identify patients with depressive symptoms, according to the release.
The paper is titled “The Effect of a Mobile Health Decision Support System on Diagnosis and Management of Obesity, Tobacco Use, and Depression in Adults and Children.” Associate professors Haomiao Jia, PhD, and Rita John, DNP, EdD, of Columbia Nursing were co-authors of the study.
Funding for the study was provided by the National Institute of Nursing Research.