Mobile apps can help doctors that use them order laboratory tests for patients quicker and in the process make a better diagnosis, says new research from Baylor College of Medicine.
“There are increasingly more physician-focused health apps available, and while physicians are becoming more comfortable using these apps, they don’t necessarily know which ones can help with diagnosis because they haven’t been evaluated,” says Ashley Meyer, assistant professor of medicine at Baylor and researcher in the Houston Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety .
In a recent study, researchers from Baylor and the Centers for Disease Control and Prevention evaluated whether a mobile app improves diagnostic and test ordering decisions of physicians for certain coagulation and bleeding disorders.
“Our first step was figuring out how to rigorously evaluate an app that aimed to improve physician decision-making and then to use our methodology to evaluate the app,” Meyer says.
Baylor researchers selected a mobile app developed by the Centers for Disease Control and Prevention that doctors use to diagnose certain bleeding disorders. Baylor signed up 47 physicians from seven different healthcare institutions for the research and gave each doctor eight real and simulated situations to use the app to diagnose a patient with a coagulation or bleeding condition.
For the study doctors used the app as an aid to treat four patients and four more using a traditional clinical decision support system.
A clinical decision support system is a health information technology system that is designed to provide physicians and care givers with access to a medical conditions database to assist with comparing and making decisions related to patient treatment.
The research results showed that that when physicians used the app, the accuracy of their diagnosis and testing decisions was 13% higher than when they used usual clinical decision support. Additionally, using the app helped physicians come to a diagnosis about 51 seconds faster than when they used clinical decision support system—a reduction in time of 22%, Baylor says.
“Apps that add value to physician decision-making will be much easier to integrate with physician workflow and help impact clinical practice and reduce misdiagnosis,” says Dr. Hardeep Singh, chief of the Health Policy, Quality and Informatics program at the Veterans Affairs Houston facility and professor of medicine at Baylor.
The mobile app gave physicians faster access to useful information in diagnosing the right conditions for patients with rashes, easy and frequent bruising or swollen joints. Getting the diagnosis right and ordering the right blood test to determine the underlying condition can be tricky.
Primary care physicians are uncertain about what tests to order in nearly 1 in 7 patients, Baylor says. Patients with bleeding or thrombosis often need a more sophisticated evaluation from a hematologist, which may not always be available.
The Apple app tested by Baylor assists physicians with interactive step-by-step test ordering and diagnostic decision making related to certain types of coagulation and bleeding disorders. “We found that using the app increased diagnostic accuracy, which is a good step forward given that we previously found 5% of U.S. adults are misdiagnosed every year,” Meyer says.
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