App with guidelines helps nurses increase diagnosis rates

Nurses using mobile devices loaded with a custom app prompting evidence-based guidelines were significantly more likely to identify health issues such as obesity, smoking, and depression during routine exams.

In a study published in the Journal for Nurse Practitioners, researchers from the Columbia University School of Nursing evaluated diagnosis rates for tobacco use, adult and pediatric depression, and obesity during 34,349 patient exams conducted by 363 registered nurses enrolled in nurse practitioner programs at Columbia. Students were randomly assigned to use mobile apps with or without decision support for guideline-based care.

Use of mobile apps with decision support features resulted in up to 44 times more diagnosis rates than apps with just simple tools for recording results from a patient exam. That high rate was for pediatric depression (4.6 percent v. 1.1 percent) and diagnosis of obese and overweight patients increased seven-fold from 4.8 percent to 33.9 percent; diagnosis of tobacco use increased five times from 2.3 percent to 11.9 percent; and diagnosis of pediatric depression increased four-fold from 1.1 percent to 4.6 percent.

The researchers theorized that the app worked because it focused on guidelines to screen, diagnose and manage specific conditions rather than much of the software geared to physicians focusing on the diagnostic codes needed for billing.

"What clinicians need is decision support tools that fit into their work flow and remind them of evidence-based practices," said lead author Suzanne Bakken, RN, PhD. "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.”

Read the study.