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Technological barriers to providing pediatric mental and behavioral healthcare in emergency departments
Mitali Shrikant Bhosekar1, Kapil Chalil Madathil1, Anjali Joseph2
1Department of Industrial Engineering, Clemson University, United States.
Insights
Pediatric mental and behavioral health (MBH) emergencies in US emergency departments (EDs) face technology barriers. Key issues include poor data management, communication, and usability, hindering effective care for children.
Area of Science:
- Emergency Medicine
- Pediatric Healthcare
- Health Informatics
Background:
- Approximately 5% of pediatric Emergency Department (ED) visits are for mental and behavioral health (MBH) emergencies.
- Current EDs are often inadequately equipped to manage pediatric MBH emergencies, leading to extended stays and potential harm.
- Technological limitations significantly impede the delivery of safe and effective care for pediatric MBH patients in ED settings.
Purpose of the Study:
- To investigate the technological barriers impacting the delivery of safe and effective pediatric mental and behavioral healthcare within emergency departments.
- To identify specific technology-related challenges encountered by medical professionals in diverse ED settings.
Main Methods:
- Observational studies and semi-structured interviews were conducted with 55 medical professionals.
- Participants represented four distinct ED settings: a dedicated pediatric MBH unit, a general pediatric ED, and two adult EDs.
- Thematic analysis was employed to identify recurring barriers related to technology use.
Main Results:
- Twelve major themes of technological barriers were identified.
- Key issues included limitations in electronic medical record (EMR) data management, ineffective communication systems within the ED, and usability problems with existing technologies.
- Other identified barriers encompassed inadequate infrastructure, lack of streamlined processes, inefficient technology integration, insufficient training, and patient reluctance towards telepsychiatry.
Conclusions:
- Technological barriers significantly compromise the quality and safety of pediatric MBH care in EDs.
- Addressing issues in EMRs, communication, technology usability, infrastructure, and training is crucial.
- Future research should prioritize developing integrated technological solutions to overcome these barriers and improve care delivery for pediatric MBH patients in emergency settings.
Abstract:
In the United States, about 5% of pediatric Emergency Department (ED) visits involve mental and behavioral health (MBH) emergencies, and EDs are often ill-equipped to provide timely, appropriate care, leading to prolonged stays and increased risks of trauma and harm for these children and their families. This study investigated technological barriers affecting safe and effective pediatric mental and behavioral healthcare in emergency departments through observational studies and semi-structured interviews with 55 medical professionals across four ED settings: pediatric MBH unit, pediatric ED, and adult ED. A total of 12 barrier themes were identified through the thematic analysis of the interviews relating to technology use that impacts the care of pediatric MBH patients. The major themes include issues due to limited electronic medical record data management, ineffective communication in the ED, and usability issues with ED technologies. Other concerns included inadequate infrastructure, absence of streamlined processes, unsafe and inefficient integration of technology, and lack of training. Challenges stemming from patients' reluctance to accept telepsychiatry further complicate providing effective care in these settings. Future research needs to focus on designing systems and solutions to eliminate the barriers, thereby supporting the caregiving process of pediatric MBH in EDs.
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