Feasibility of Post-hospitalization Telemedicine Video Visits for Children With Medical Complexity

Ming, David; Li, Tingxuan; Ross, Melissa H; Frush, Jennifer M; He, Jingyi; Goldstein, Benjamin A.; Jarrett, Valerie; Krohl, Natalie; Docherty, Sharron L.; Turley, Christine B.; Bosworth, Hayden B.

doi:10.1016/j.pedhc.2021.10.001

Cited by 9 publications

(1 citation statement)

References 44 publications

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“…Additionally, our inclusion criteria that study participants have existing internet access, a digital device, and an active web-based patient portal account may introduce barriers to research participation. Factors that could mitigate these barriers include national-level data that demonstrated that 81% of US adults own a smartphone [ 51 ] and data from our previously conducted digital health trial when parents were successfully recruited using similar technology requirements [ 52 ]. Finally, this study’s lack of randomization and effectiveness evaluation will limit the strength of conclusions.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of Implementation of a Mobile Digital Personal Health Record to Coordinate Care for Children and Youth With Special Health Care Needs in Primary Care: Protocol for a Mixed Methods Study

Ming¹,

Wong²,

Jones³

et al. 2023

JMIR Res Protoc

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Background Electronic health record (EHR)–integrated digital personal health records (PHRs) via Fast Healthcare Interoperability Resources (FHIR) are promising digital health tools to support care coordination (CC) for children and youth with special health care needs but remain widely unadopted; as their adoption grows, mixed methods and implementation research could guide real-world implementation and evaluation. Objective This study (1) evaluates the feasibility of an FHIR-enabled digital PHR app for CC for children and youth with special health care needs, (2) characterizes determinants of implementation, and (3) explores associations between adoption and patient- or family-reported outcomes. Methods This nonrandomized, single-arm, prospective feasibility trial will test an FHIR-enabled digital PHR app’s use among families of children and youth with special health care needs in primary care settings. Key app features are FHIR-enabled access to structured data from the child’s medical record, families’ abilities to longitudinally track patient- or family-centered care goals, and sharing progress toward care goals with the child’s primary care provider via a clinician dashboard. We shall enroll 40 parents or caregivers of children and youth with special health care needs to use the app for 6 months. Inclusion criteria for children and youth with special health care needs are age 0-16 years; primary care at a participating site; complex needs benefiting from CC; high hospitalization risk in the next 6 months; English speaking; having requisite technology at home (internet access, Apple iOS mobile device); and an active web-based EHR patient portal account to which a parent or caregiver has full proxy access. Digital prescriptions will be used to disseminate study recruitment materials directly to eligible participants via their existing EHR patient portal accounts. We will apply an intervention mixed methods design to link quantitative and qualitative (semistructured interviews and family engagement panels with parents of children and youth with special health care needs) data and characterize implementation determinants. Two CC frameworks (Pediatric Care Coordination Framework; Patient-Centered Medical Home) and 2 evaluation frameworks (Consolidated Framework for Implementation Research; Technology Acceptance Model) provide theoretical foundations for this study. Results Participant recruitment began in fall 2022, before which we identified >300 potentially eligible patients in EHR data. A family engagement panel in fall 2021 generated formative feedback from family partners. Integrated analysis of pretrial quantitative and qualitative data informed family-centered enhancements to study procedures. Conclusions Our findings will inform how to integrate an FHIR-enabled digital PHR app for children and youth with special health care needs into clinical care. Mixed methods and implementation research will help strengthen implementation in diverse clinical settings. The study is positioned to advance knowledge of how to use digital health innovations for improving care and outcomes for children and youth with special health care needs and their families. Trial Registration ClinicalTrials.gov NCT05513235; https://clinicaltrials.gov/study/NCT05513235 International Registered Report Identifier (IRRID) DERR1-10.2196/46847

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Section: Discussionmentioning

confidence: 99%

Feasibility of Implementation of a Mobile Digital Personal Health Record to Coordinate Care for Children and Youth With Special Health Care Needs in Primary Care: Protocol for a Mixed Methods Study

Ming¹,

Wong²,

Jones³

et al. 2023

JMIR Res Protoc

Self Cite

View full text Add to dashboard Cite

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Hospital-to-home transitions for children with medical complexity: part 1, a systematic review of reported outcomes

de Lange,

Alsem,

Haspels

et al. 2023

Eur J Pediatr

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Outcome selection to evaluate interventions to support a successful transition from hospital to home of children with medical complexity (CMC) may be difficult due to the variety in available outcomes. To support researchers in outcome selection, this systematic review aimed to summarize and categorize outcomes currently reported in publications evaluating the effectiveness of hospital-to-home transitional care interventions for CMC. We searched the following databases: Medline, Embase, Cochrane library, CINAHL, PsychInfo, and Web of Science for studies published between 1 January 2010 and 15 March 2023. Two reviewers independently screened the articles and extracted the data with a focus on the outcomes. Our research group extensively discussed the outcome list to identify those with similar definitions, wording or meaning. Consensus meetings were organized to discuss disagreements, and to summarize and categorize the data. We identified 50 studies that reported in total 172 outcomes. Consensus was reached on 25 unique outcomes that were assigned to six outcome domains: mortality and survival, physical health, life impact (the impact on functioning, quality of life, delivery of care and personal circumstances), resource use, adverse events, and others. Most frequently studied outcomes reflected life impact and resource use. Apart from the heterogeneity in outcomes, we also found heterogeneity in designs, data sources, and measurement tools used to evaluate the outcomes. Conclusion: This systematic review provides a categorized overview of outcomes that may be used to evaluate interventions to improve hospital-to-home transition for CMC. The results can be used in the development of a core outcome set transitional care for CMC. What is Known:• Studies on the effectiveness of interventions to support the hospital-to-home transition of CMC are numerous.•Heterogeneity in outcomes hamper comparisons across studies and therewith the ability to move research forward. What is New:•This systematic review summarizes and categorizes outcomes reported in publications that evaluated interventions to improve the hospital-to-home transition for CMC.•In total 172 reported outcomes were summarized to 25 unique outcomes that were assigned to six outcome domains.

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Telemedicine Visits After Hospital Discharge in Children With Medical Complexity

Simmers,

Teague,

Letzkus

et al. 2025

The Journal for Nurse Practitioners

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Feasibility of Post-hospitalization Telemedicine Video Visits for Children With Medical Complexity

Cited by 9 publications

References 44 publications

Feasibility of Implementation of a Mobile Digital Personal Health Record to Coordinate Care for Children and Youth With Special Health Care Needs in Primary Care: Protocol for a Mixed Methods Study

Feasibility of Implementation of a Mobile Digital Personal Health Record to Coordinate Care for Children and Youth With Special Health Care Needs in Primary Care: Protocol for a Mixed Methods Study

Hospital-to-home transitions for children with medical complexity: part 1, a systematic review of reported outcomes

Telemedicine Visits After Hospital Discharge in Children With Medical Complexity

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