Barriers and Enablers Affecting Successful Implementation of the Electronic Health Service Sisom: Multicenter Study of Child Participation in Pediatric Care

Svedberg, Petra; Arvidsson, Stefan; Larsson, Ingrid; Carlsson, Ing‐Marie; Nygren, Jens M.

doi:10.2196/14271

Cited by 26 publications

(27 citation statements)

References 41 publications

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“…Children and parents embraced home-monitoring as was shown in the high participation rate and high adherency. However, for long-term asthma care the home-monitoring tool should be lean, non-obtrusive and proportional to the severity of the disease to maximize usability, engagement and minimize the burden to the child [ 48 ]. Such a tool could be a stepping stone to better follow the fluctuations of the asthma status and timely anticipate on signalled changes in asthma control.…”

Section: Discussionmentioning

confidence: 99%

WEARCON: wearable home monitoring in children with asthma reveals a strong association with hospital based assessment of asthma control

Kamp

Klaver

Thio

et al. 2020

BMC Med Inform Decis Mak

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Background: Asthma is one of the most common chronic diseases in childhood. Regular follow-up of physiological parameters in the home setting, in relation to asthma symptoms, can provide complementary quantitative insights into the dynamics of the asthma status. Despite considerable interest in asthma home-monitoring in children, there is a paucity of scientific evidence, especially on multi-parameter monitoring approaches. Therefore, the aim of this study is to investigate whether asthma control can be accurately assessed in the home situation by combining parameters from respiratory physiology sensors. Methods: Sixty asthmatic and thirty non-asthmatic children were enrolled in the observational WEARCON-study. Asthma control was assessed according to GINA guidelines by the paediatrician. All children were also evaluated during a 2-week home-monitoring period with wearable devices; a physical activity tracker, a handheld spirometer, smart inhalers, and an ambulatory electrocardiography device to monitor heart and respiratory rate. Multiple logistic regression analysis was used to determine which diagnostic measures were associated with asthma control. Results: 24 of the 27 uncontrolled asthmatic children and 29 of the 32 controlled asthmatic children could be accurately identified with this model. The final model showed that a larger variation in pre-exercise lung function (OR = 1.34 95%-CI 1.07-1.68), an earlier wake-up-time (OR = 1.05 95%-CI 1.01-1.10), more reliever use (OR = 1.11 95%-CI 1.03-1.19) and a longer respiratory rate recovery time (OR = 1.12 95%-CI 1.05-1.20) were significant contributors to the probability of having uncontrolled asthma. Conclusions: Home-monitoring of physiological parameters correlates with paediatrician assessed asthma control. The constructed multivariate model identifies 88.9% of all uncontrolled asthmatic children, indicating a high potential for monitoring of asthma control. This may allow healthcare professionals to assess asthma control at home.

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Section: Discussionmentioning

confidence: 99%

WEARCON: wearable home monitoring in children with asthma reveals a strong association with hospital based assessment of asthma control

Kamp

Klaver

Thio

et al. 2020

BMC Med Inform Decis Mak

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“…The pediatricians in the intervention group were more focused on the children and seemed to be more aware of their own behavior when interacting with the child, which is important for the children to have positive experiences with care [ 67 , 68 ]. The use of an eHealth service for children has the potential of facilitating transition towards more trustful and supportive behavior from health care professionals [ 37 , 38 , 69 , 70 ].…”

Section: Discussionmentioning

confidence: 99%

“…Based on the children's answers, the health care professionals can talk to the children about how they perceive their situation and how they think about different health care–related and social issues. It has been shown that communication between children, their parents, and health care professionals is improved when using Sisom [ 37 , 38 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of an Electronic Health Service on Child Participation in Pediatric Oncology Care: Quasiexperimental Study

Gilljam¹,

Nygren²,

Svedberg³

et al. 2020

J Med Internet Res

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Background For children 6-12 years old, there is a shortage of electronic Health (eHealth) services that promote their participation in health care. Therefore, a digital communication tool, called Sisom, was developed to give children a voice in their health care. Children with long-term diseases want to be more involved in their health care and have the right to receive information, be listened to, express their opinions, and participate in decision making in health care. However, the outcomes of using Sisom in practice at pediatric oncology clinics have not been investigated. Objective The aim of this study was to investigate children’s participation during appointments with pediatricians at pediatric oncology clinics, with or without the use of the eHealth service Sisom. Methods A quasiexperimental design with mixed methods was used. We analyzed 27 filmed appointments with pediatricians for 14 children (8 girls and 6 boys) aged 6-12 years (mean 8.3 years) with a cancer diagnosis. The intervention group consisted of children who used Sisom prior to their appointments with pediatricians at a pediatric oncology clinic, and the control group consisted of children who had appointments with pediatricians at 4 pediatric oncology clinics. Data from observations from the videos were quantitatively and qualitatively analyzed. The quantitative analysis included manual calculations of how many times the pediatricians spoke directly to the children, the proportion of the appointment time that the children were talking, and levels of participation by the children. For the qualitative analysis, we used directed content analysis to analyze the children’s levels of participation guided by a framework based on Shier’s model of participation. Results Pediatricians directed a greater proportion of their discussion toward the child in the intervention group (731 occasions) than in the control group (624 occasions), but the proportion of the appointment time the children talked was almost the same for both the intervention and control groups (mean 17.0 minutes vs 17.6 minutes). The levels of participation corresponded to the first three levels of Shier’s participation model: children were listened to, children were supported to express their views, and children’s views were taken into account. The results showed an increased level of participation by the children in the intervention group. Several codes that were found did not fit into any of the existing categories, and a new category was thus formed: children received information. Conclusions This study shows that the eHealth service Sisom can increase children’s participation during appointments with health care professionals. Further studies employing a randomized control design focusing on the effects of eHealth services on children’s health outcomes, perceived participation, and cost-effectiveness could make a significant contribution to guiding the implementation of eHealth services in pediatric care.

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“…A recent study suggested that a key factor for the successful implementation of eHealth is the alignment of the needs, values, goals, and urgency of both the patients and the healthcare professionals within the specific healthcare system (16). The COVID-19 crisis testified on the importance of these factors as conversion to distant care could be rapidly implemented once societal and individual goals were aligned and a sense of urgency had evolved.…”

Section: Discussion Implementation Considerations: What Covid-19 Taugmentioning

confidence: 99%

COVID-19: Technology-Supported Remote Assessment of Pediatric Asthma at Home

et al. 2020

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The COVID-19 crisis has pressured hospital-based care for children with high-risk asthma as they have become deprived of regular clinical evaluations. However, COVID-19 also provided important lessons about implementing novel directions for care. Personalized eHealth technology, tailored to the individual and the healthcare system, could substitute elements of hospital care and facilitate early and appropriate medical anticipation in response to imminent loss of control. This perspective article discusses new approaches to the clinical, organizational, and scientific aspects of the use of eHealth technology in pediatric asthma care in times of COVID-19, as illustrated by a case report of an acute asthma exacerbation possibly caused by COVID-19 infection.

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Barriers and Enablers Affecting Successful Implementation of the Electronic Health Service Sisom: Multicenter Study of Child Participation in Pediatric Care

Cited by 26 publications

References 41 publications

WEARCON: wearable home monitoring in children with asthma reveals a strong association with hospital based assessment of asthma control

WEARCON: wearable home monitoring in children with asthma reveals a strong association with hospital based assessment of asthma control

Impact of an Electronic Health Service on Child Participation in Pediatric Oncology Care: Quasiexperimental Study

COVID-19: Technology-Supported Remote Assessment of Pediatric Asthma at Home

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