Development of clinical-guideline-based mobile application and its effect on head CT scan utilization in neurology and neurosurgery departments

Abstract

Background There is little evidence regarding the adoption and intention of using mobile apps by health care professionals (HCP) and the effectiveness of using mobile apps among physicians is still unclear. To address this challenge, the current study seeks two objectives: developing and implementing a head CT scan appropriateness criteria mobile app (HAC app), and investigating the effect of HAC app on CT scan order. Methods A one arm intervention quasi experimental study with before/after analysis was conducted in neurology & neurosurgery (N&N) departments at the academic hospital. We recruited all residents' encounters to N&N departments with head CT scan to examine the effect of HAC app on residents' CT scan utilization. The main outcome measure was CT scan order per patient for seven months at three points, before the intervention, during the intervention, after cessation of the intervention -post-intervention follow-up. Data for CT scan utilization were collected by reviewing medical records and then analyzed using descriptive statistics, Kruskal-Wallis, and Mann-Whitney tests. A focus group discussion with residents was performed to review and digest residents' experiences during interaction with the HAC app. Results Sixteen residents participated in this study; a total of 415 N&N encounters with CT scan order, pre-intervention 127 (30.6%), intervention phase 187 (45.1%), and 101 (24.3%) in the post-intervention follow-up phase were included in this study. Although total CT scan utilization was statistically significant during three-time points of the study (P = 0.027), no significant differences were found for CT utilization after cessation of the intervention (P = 1). Conclusion The effect of mobile devices on residents' CT scan ordering behavior remains open to debate since the changes were not long-lasting. Further studies based on real interactive experiences with mobile devices is advisable before it can be recommended for widespread use by HCP.

Evaluating the Quality of a Clinical Mobile App for Physicians’ CT Scan Ordering Using the MARS Rating Scale

“…Sixteen medical interns evaluated the quality of the HAC app using the MARS tool from March to June 2021. HAC app was developed during the former study with the collaboration of experts at KAUMS to assist medical interns and residents in head CT scan ordering [8]. It enables end-users to seek appropriate CT scans based on diseases, signs & symptoms, and modalities, e.g., CT, CTA, and MRI (Figure 1).…”

Usability Assessment of an Electronic Medical Record-Embedded Clinical Decision Support System for Arterial Blood Gas Interpretation

“…However, previous literature debated HCPs do not frequently use CDSS due to poor usability [5]. The adoption of CDSSs depends on the provision of an understandable justification of the clinical decision-making process, fully interaction to respond to physicians' questions and to provide feedback and interpretation [6]. Evidence suggested that clinicians require help for ABG tests interpretation, a challenging task due to facing physicians with six values [7].…”