Integrating clinical practice guidelines within a mobile tablet app

Mobile tablets can offer physicians enhanced mobility and access to key information about patients. Compared to smartphones, mobile tablets offer larger screens that are ideal for displaying clinical information during patient encounters. Apps can be customized for different clinical specialties by using clinically relevant content. Large numbers of clinical practice guidelines for different diseases and conditions are available for physicians, allowing clinicians to choose the best treatment alternatives for patients. However, many commercially available healthcare apps lack scientific backing. Conditions such as syncope (fainting) can be challenging for physicians, as physicians have to differentiate syncope due to benign conditions from syncope due to severe cardiac, neurologic or metabolic conditions. In this study, an iPad app based on clinical practice guidelines for syncope was developed, with an emphasis on usability. The app facilitates clinical evaluation using structured, pre-populated items and unstructured free-text narratives. Customized views for capturing vital statistics and physical examination findings are also available in the app, which was evaluated by medical students, residents and fellowship candidates. These participants also compared the app with a paper chart version, and gave the app an above average rating for usability. While testing the app in a controlled environment, participants recorded more 'structured' than 'unstructured' data. Further studies are needed to determine the level of detail of clinical information that should be presented in mobile tablet apps for optimum usability.