Call to focus on digital health technologies in hospitalized children's pain care: clinician experts' qualitative insights on optimizing electronic medical records to improve care

Pope, Nicole; Candido, Ligyana Korki de; Crellin, Dianne; Palmer, Greta M; South, Mike; Harrison, Denise

doi:10.1097/j.pain.0000000000002863

Cited by 3 publications

(12 citation statements)

References 37 publications

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“…2,3,23 That said, there is also increasing evidence regarding EMR notification fatigue and how it affects clinician wellness 58 and pain care practices. 44 Similarly, in this study, participants were concerned that portal alerts, such as prompts reminding patients to enter pain information, could be burdensome. They also worried about the potential repercussions of portals on clinician workloads, mirroring clinicians' (n = 94) preimplementation concerns about a portal disrupting their workflows in one pediatric setting, which did not materialize.…”

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 94%

“…Similarly, youth and parents using the iCanCope Post-op app regard tracking pain trends and goal setting as essential features to support realistic, individualized postoperative recovery. 5 Finally, in line with clinician concerns, 13,44 participants acknowledged the potential burden of too much information, raising questions about how portal designs could ensure that families can control the timing and content of the information they access. Future investigations should explore best practices regarding patient-family access to pain-related portal data and the repercussions of portal information sharing on pediatric and parental pain-related outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Our team recently examined the perspectives of pediatric pain experts regarding hospital EMR designs that support optimal pain care practices. 44 Experts advocated for patient-facing digital health technologies, particularly inpatient portals, to support patient engagement in pain care, enhance shared decision-making and optimize pain outcomes. 44 This study builds on that research through interviews generating qualitative insights into the perspectives of primary caregivers (PCGs) of hospitalized children and of hospitalized youth.…”

Section: Introductionmentioning

confidence: 99%

“…44 Experts advocated for patient-facing digital health technologies, particularly inpatient portals, to support patient engagement in pain care, enhance shared decision-making and optimize pain outcomes. 44 This study builds on that research through interviews generating qualitative insights into the perspectives of primary caregivers (PCGs) of hospitalized children and of hospitalized youth. The aim was to explore consumers' perspectives on the establishment and role of using an inpatient portal in supporting patient and family engagement in pain care during hospitalization.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

“Seeing the light in the shade of it”: primary caregiver and youth perspectives on using an inpatient portal for pain care during hospitalization

Pope,

Jones,

Crellin

et al. 2023

Pain

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Studies from multiple countries report that most hospitalized children, especially the youngest and sickest, experience pain that is often severe yet inadequately treated. Evidence suggests this can lead to immediate and lifelong consequences affecting children, families, and communities. Partnership and shared decision-making by children, families, and clinicians is the ideal pediatric healthcare model and can improve care quality and safety, including pain care. A growing evidence base demonstrates that inpatient portals (electronic personal health record applications linked to hospital electronic medical or health records) can improve child and family engagement, outcomes, and satisfaction during hospitalization. This study examined the perspectives of caregivers of hospitalized children and of hospitalized youth about using an inpatient portal to support their engagement in pain care while in hospital. A qualitative descriptive study design was used and 20 participants (15 caregivers and 5 youth) with various painful conditions in one pediatric hospital participated in semistructured interviews. The authors applied a reflexive content analysis to the data and developed 3 broad categories: (1) connecting and sharing knowledge about pain, (2) user-centred designs, and (3) preserving roles. These findings outlined caregiver and youth recommendations for portal configurations that deeply engage and empower children and families in pain care through multidirectional knowledge sharing, supporting caregiver and clinicians' roles without burdening, or replacing human interaction implicit in family-centered pain care. Further research should measure the impact of portals on pain-related outcomes and explore the perspectives of clinicians.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

“Seeing the light in the shade of it”: primary caregiver and youth perspectives on using an inpatient portal for pain care during hospitalization

Pope,

Jones,

Crellin

et al. 2023

Pain

View full text Add to dashboard Cite

show abstract

An Australian survey of health professionals’ perceptions of use and usefulness of electronic medical records in hospitalised children’s pain care

Pope,

Keyser,

Crellin

et al. 2024

J Child Health Care

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Pain in hospitalised children is common, yet inadequately treated. Electronic medical records (EMRs) can improve care quality and outcomes during hospitalisation. Little is known about how clinicians use EMRs in caring for children with pain. This national cross-sectional survey examined the perceptions of clinician-EMR users about current and potential use of EMRs in children’s pain care. One hundred and ninety-four clinicians responded ( n = 81, 74% nurses; n = 21, 19% doctors; n = 7, 6% other); most used Epic ( n = 53/109, 49%) or Cerner ( n = 42/109, 38%). Most ( n = 84/113, 74%) agreed EMRs supported their initiation of pharmacological pain interventions. Fewer agreed EMRs supported initiation of physical ( n = 49/113, 43%) or psychological interventions ( n = 41/111, 37%). Forty-four percent reported their EMR had prompt reminders for pain care. Prompts were perceived as useful ( n = 40/51, 78%). Most agreed EMRs supported pain care provision ( n = 94/110, 85%) and documentation ( n = 99/111, 89%). Only 39% ( n = 40/102) agreed EMRs improved pain treatment, and 31% ( n = 32/103) agreed EMRs improved how they involve children and families in pain care. Findings provide recommendations for EMR designs that support clinicians’ understanding of the multidimensionality of children’s pain and drive comprehensive assessments and treatments. This contribution will inform future translational research on harnessing technology to support child and family partnerships in care.

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“Making Data the Drug”: A Pragmatic Pilot Feasibility Randomized Crossover Trial of Data Visualization as an Intervention for Pediatric Chronic Pain

Boerner,

Desai,

Luu

et al. 2023

Children

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Data tracking is a common feature of pain e-health applications, however, viewing visualizations of this data has not been investigated for its potential as an intervention itself. We conducted a pilot feasibility parallel randomized cross-over trial, 1:1 allocation ratio. Participants were youth age 12–18 years recruited from a tertiary-level pediatric chronic pain clinic in Western Canada. Participants completed two weeks of Ecological Momentary Assessment (EMA) data collection, one of which also included access to a data visualization platform to view their results. Order of weeks was randomized, participants were not masked to group assignment. Objectives were to establish feasibility related to recruitment, retention, and participant experience. Of 146 youth approached, 48 were eligible and consented to participation, two actively withdrew prior to the EMA. Most participants reported satisfaction with the process and provided feedback on additional variables of interest. Technical issues with the data collection platform impacted participant experience and data analysis, and only 48% viewed the visualizations. Four youth reported adverse events not related to visualizations. Data visualization offers a promising clinical tool, and patient experience feedback is critical to modifying the platform and addressing technical issues to prepare for deployment in a larger trial.

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Call to focus on digital health technologies in hospitalized children's pain care: clinician experts' qualitative insights on optimizing electronic medical records to improve care

Cited by 3 publications

References 37 publications

“Seeing the light in the shade of it”: primary caregiver and youth perspectives on using an inpatient portal for pain care during hospitalization

“Seeing the light in the shade of it”: primary caregiver and youth perspectives on using an inpatient portal for pain care during hospitalization

An Australian survey of health professionals’ perceptions of use and usefulness of electronic medical records in hospitalised children’s pain care

“Making Data the Drug”: A Pragmatic Pilot Feasibility Randomized Crossover Trial of Data Visualization as an Intervention for Pediatric Chronic Pain

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