mHealth App Doubled Screenings at Family, Internal Medicine Practices

A self-administered screening on a tablet device is a highly effective method for identifying patients with depression, risk of injurious falls, or intimate partner violence, research from Wake Forest University revealed.

The study, published in JAMA Network Open, included 23,026 patients, all of whom were older than 18 years and received care between June 2019 and February 2020. This population was about 57.9 percent female and about 80.5 percent non-Hispanic White.

The Wake Forest University Health Sciences institutional review board created a screening app called mPATH, accessible to all patients through a tablet.

Researchers implemented this app at six practices, of which three specialized in family medicine and three in internal medicine. They encouraged practices to use the app, which included screening questions for depression, fall risk, and intimate partner violence. 

Among the six participating clinics, the use of the app varied from 10.3 to 60.5 percent. Despite this inconsistency, researchers found that the number of patients who reported thoughts of self-harm, injurious falls, or violence with their partner doubled.

A factor that could contribute to this significant increase is the feeling of privacy that tablet-based communication can provide, the study states.

Although the study revealed helpful information, some limitations could have affected the results.

These include the fact that patients from a single health system and a mainly white population made up the study participants. There was also a lack of randomization and a lack of validation regarding the intimate partner violence screening questions.

Previous research has shown that smartphone or tablet apps are a highly effective and reliable method for increasing patient engagement.

For example, a large portion of the American population heavily relies on patient portal applications, especially for scheduling and bill payment features. It is also largely effective in maintaining the confidentiality of patient information. 

A study published in CJASN also revealed that a mHealth app used to manage chronic kidney disease drove a high level of engagement and medication adherence. The app, known as eKidneycare, reduced medication discrepancies and increased the number of monthly medication reviews.

Further, an mHealth app, developed by the University of Pittsburgh Medical Center (UPMC), helped identify pregnant people at-risk for preeclampsia and increased prophylactic low-dose aspirin intake by improving patient-provider communication, a study shows. The app offers educational content, a contraction timer, opportunities for patients to document experiences, and routine screenings to check for symptoms and risks. It also uses patient-provided data and high-risk criteria responses to identify risk factors that are then communicated to clinicians through the Epic EHR.