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Understanding clinicians' attitudes toward a mobile health strategy to childhood asthma management: A qualitative
Jessica P Hollenbach1, Anna Cushing2, Emilie Melvin3
1a Department of Pediatrics , University of Connecticut School of Medicine, Asthma Center, CT Children's Medical Center , Hartford , CT , USA.
Insights
Pediatric clinicians desire mobile health technology for asthma care, seeking inhaler adherence and technique data. However, primary care and pulmonologists have differing information needs for effective patient management.
Area of Science:
- Pediatric healthcare
- Digital health interventions
- Respiratory medicine
Background:
- Mobile technology offers real-time data for improving childhood asthma management.
- Understanding clinician needs for real-time adherence data is crucial for effective digital health tools.
- Previous research has not fully explored clinician perspectives on mobile asthma interventions.
Purpose of the Study:
- To assess pediatric primary care and pulmonary clinicians' perceived usefulness of a sensor-based mobile intervention for asthma care.
- To identify the types of real-time adherence information clinicians desire and how they would utilize it.
- To determine if mobile health data meets the clinical needs of healthcare providers managing pediatric asthma patients.
Main Methods:
- Focus groups were conducted with 41 pediatric primary care and pulmonary clinicians in Hartford, CT.
- Participants reviewed a demonstration of a sensor-based mobile asthma intervention.
- Open-ended questions explored desired data types, frequency, and format for inter-visit patient information.
Main Results:
- Clinicians desired data on inhaler therapy adherence and technique, with a preference for receiving it during scheduled visits.
- Inter-visit alerts for excessive rescue therapy use were also requested.
- Pulmonologists valued inter-visit lung function data from a mobile spirometer, while pediatricians did not express the same need.
- Concerns included data accuracy, shared inhaler use, smartphone access, and health information privacy.
Conclusions:
- Clinicians perceive mobile asthma health technology as a valuable tool for enhancing patient-centered medical homes.
- Pediatric primary care providers and pulmonologists have distinct information requirements from mobile asthma applications.
- Tailoring mobile health data delivery to specific clinical specialties is essential for optimal adoption and utility.
Objectives:
Mobile technology for childhood asthma can provide real-time data to enhance care. What real-time adherence information clinicians want, how they may use it, and if the data meet their clinical needs have not been fully explored. Our goal was to determine whether pediatric primary care and pulmonary clinicians believe if a sensor-based mobile intervention is useful in caring for patients with asthma.
Methods:
We recruited participants from 3 urban, primary care and 1 pulmonary practice from July to September 2015 in Hartford, CT. Forty-one participated in four focus groups, which included a demonstration of the technology. Participants were probed with open-ended questions on the type, frequency, and format of inter-visit patient information they found useful.
Results:
41 participants (mean age 49 (±13.7) years) were board-certified clinicians (41% MDs and 20% mid-level practitioners), practiced medicine on an average of 19 (±14) years, were primarily white (59%) and women (78%). Clinicians wanted 1) adherence to prescribed inhaler therapy and 2) data on inhaler technique. Clinicians wanted it at the time of a scheduled clinic visit but also wanted inter-visit alerts for excessive use of rescue therapy. Pulmonologists liked the mobile spirometer's provision of inter-visit lung function data; pediatricians did not share this view. Concerns with data accuracy were raised due to families who shared inhalers, access to smartphones, and protection of health information.
Conclusions:
Overall, clinicians view an asthma mobile health technology as enhancing the patient-centered medical home. Pediatric primary care clinicians and pulmonologists want different information from a mobile app.
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