Barriers and Facilitators When Implementing Web-Based Disease Monitoring and Management as a Substitution for Regular Outpatient Care in Pediatric Asthma: Qualitative Survey Study.

Autor: van den Wijngaart LS; Department of Pediatric Pulmonology, Amalia Children's Hospital, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands., Geense WW; IQ Healthcare, Radboud Institute of Health Sciences, Radboud University Medical Centre, Nijmegen, Netherlands., Boehmer AL; Department of Pediatrics, Maasstad Hospital, Rotterdam, Netherlands., Brouwer ML; Department of Pediatrics, Canisius Wilhelmina Hospital, Nijmegen, Netherlands., Hugen CA; Department of Pediatric Pulmonology, Amalia Children's Hospital, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands., van Ewijk BE; Department of Pediatrics, Tergooi Hospital, Blaricum, Netherlands.; Department of Pediatrics, Tergooi Hospital, Hilversum, Netherlands., Koenen-Jacobs MJ; Department of Pediatrics, Maas Hospital Pantein, Boxmeer, Netherlands., Landstra AM; Department of Pediatrics, Rijnstate Hospital, Arnhem, Netherlands., Niers LE; Department of Pediatrics, Maxima Medical Center, Veldhoven, Netherlands., van Onzenoort-Bokken L; Department of Pediatrics, Maxima Medical Center, Veldhoven, Netherlands., Ottink MD; Department of Pediatrics, Medical Spectrum Twente Hospital, Enschede, Netherlands., Rikkers-Mutsaerts ER; Department of Pediatric Pulmonology, Leiden University Medical Center, Leiden, Netherlands., Groothuis I; Department of Pediatric Pulmonology, Juliana Children's Hospital, Haga Hospital, The Hague, Netherlands., Vaessen-Verberne AA; Department of Pediatrics, Amphia Hospital, Breda, Netherlands., Roukema J; Department of Pediatric Pulmonology, Amalia Children's Hospital, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands., Merkus PJ; Department of Pediatric Pulmonology, Amalia Children's Hospital, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands.
Jazyk: angličtina
Zdroj: Journal of medical Internet research [J Med Internet Res] 2018 Oct 30; Vol. 20 (10), pp. e284. Date of Electronic Publication: 2018 Oct 30.
DOI: 10.2196/jmir.9245
Abstrakt: Background: Despite their potential benefits, many electronic health (eHealth) innovations evaluated in major studies fail to integrate into organizational routines, and the implementation of these innovations remains problematic.
Objective: The purpose of this study was to describe health care professionals' self-identified perceived barriers and facilitators for the implementation of a Web-based portal to monitor asthmatic children as a substitution for routine outpatient care. Also, we assessed patients' (or their parents) satisfaction with this eHealth innovation.
Methods: Between April and November 2015, we recruited 76 health care professionals (from 14 hospitals). During a period of 6 months, participants received 3 questionnaires to identify factors that facilitated or impeded the use of this eHealth innovation. Questionnaires for patients (or parents) were completed after the 6-month virtual asthma clinic (VAC) implementation period.
Results: Major perceived barriers included concerns about the lack of structural financial reimbursement for Web-based monitoring, lack of integration of this eHealth innovation with electronic medical records, the burden of Web-based portal use on clinician workload, and altered patient-professional relationship (due to fewer face-to-face contacts). Major perceived facilitators included enthusiastic and active initiators, a positive attitude of professionals toward eHealth, the possibility to tailor care to individual patients ("personalized eHealth"), easily deliverable care according to current guidelines using the VAC, and long-term profit and efficiency.
Conclusions: The implementation of Web-based disease monitoring and management in children is complex and dynamic and is influenced by multiple factors at the levels of the innovation itself, individual professionals, patients, social context, organizational context, and economic and political context. Understanding and defining the barriers and facilitators that influence the context is crucial for the successful implementation and sustainability of eHealth innovations.
(©Lara S van den Wijngaart, Wytske W Geense, Annemie LM Boehmer, Marianne L Brouwer, Cindy AC Hugen, Bart E van Ewijk, Marie-José Koenen-Jacobs, Anneke M Landstra, Laetitia EM Niers, Lonneke van Onzenoort-Bokken, Mark D Ottink, Eleonora RVM Rikkers-Mutsaerts, Iris Groothuis, Anja A Vaessen-Verberne, Jolt Roukema, Peter JFM Merkus. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 30.10.2018.)
Databáze: MEDLINE
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