Caregiver Preferences for AI-Supported Telemedicine in Pediatric Palliative Care: A Discrete Choice Experiment

BackgroundAsynchronous telemedicine may support home-based pediatric palliative care (PPC) by improving access to professional guidance and reducing caregiver uncertainty. Artificial intelligence (AI) may further enhance such services by supporting triage and workflow efficiency, yet evidence on how families prioritize specific features of AI-supported telemedicine remains limited.AimTo quantify primary caregivers' (PCGs) preferences for key characteristics of an asynchronous, AI-supported telemedicine program for children receiving home-based PPC.MethodsA discrete choice experiment (DCE) was conducted among PCGs of children enrolled in a tertiary PPC program. Participants completed 12 choice tasks involving trade-offs between telemedicine attributes: type of service (doctor- and nurse-supported telemedicine vs AI-supported telemedicine), response time to receive a reply from a clinician or nurse (6-48 h), and reduction in hospital visits. Preferences were analyzed using a mixed multinomial logit model.ResultsThirty-one PCGs completed the survey. Participation in a telemedicine service was preferred to the opt-out alternative. Response time to clinician or nurse feedback was the dominant driver of preferences, accounting for approximately 60% of decision-making. PCGs showed a modest but statistically significant preference for doctor- and nurse-supported telemedicine. Reduction in hospital visits was not a consistent driver of choices. Predicted uptake was high but declined markedly with longer response times.ConclusionPCGs value telemedicine in PPC primarily for timely access to trusted clinicians rather than efficiency alone. AI-supported telemedicine appears more acceptable when it augments clinicians and shortens the time to human response. Responsiveness and continuity of clinician relationships should inform the design of future digital services in PPC.