Reporting of asthma mobile health data for clinical practice: a qualitative study of pediatric provider perspectives.

OBJECTIVE: Mobile health (mHealth), defined as the use of mobile phones or applications in healthcare, has been developed to enhance asthma care; yet implementation is inconsistent, and few studies have focused on provider perspectives on use in daily practice. The purpose of this study was to explore primary care pediatric provider perspectives regarding mHealth use in clinical practice for children with asthma. METHODS: A qualitative, descriptive approach was utilized to perform semi-structured interviews on asthma mHealth use with providers caring for children with asthma. Interview transcripts were coded by two independent investigators and any differences were reconciled. Interviews continued until thematic saturation was achieved. RESULTS AND CONCLUSIONS: Seventeen pediatric providers were recruited and interviewed. Three themes identified included implementation benefits, implementation barriers, and reporting desires, with 11 subthemes. Many subthemes were consistent across providers (e.g. self-management benefits and electronic medical record integration), while others such as provider clinical burden and approach to integrating mHealth data reports into daily workflow demonstrated variability. Provider perspectives highlight the potential of mHealth applications in asthma self-management while offering challenges related to clinical burden and suggestions for reporting and workflow integration. These results provide valuable perspectives on mHealth use and reporting to ensure provider efficiency and technology-enhanced asthma care. This study investigates pediatric provider perspectives on asthma mobile health use and reporting in daily practice, a topic that has not sufficiently been explored within the literature. Results can guide best practices, encourage more consistent use, and maximize the benefits of asthma mHealth tools by providers.

A Communication Model to Bridge Adolescent Patients, Caregivers, and Physicians in Transitions of Care.

A transition of care (TOC) process from pediatric to adult medicine ensures that adolescents receive ongoing care into young adulthood, a time of high risk for preventable morbidity and mortality. We explored patient, caregiver, and physician perspectives on ways to improve TOC communication with healthy adolescents. Two researchers conducted key informant interviews with healthy 12- to 18-year-old adolescents, their caregivers, and primary care physicians working in pediatric, internal, and family medicine. Data saturation was reached after interviewing 12 adolescents, 10 caregivers, and 36 physicians. Three themes were identified: perceptions of TOC; effective communication among the triad of adolescents, caregivers, and providers; and early communication about TOC preparation. From these themes, a model of communication was identified and adapted, outlining the communication skills and responsibilities for physicians and patients during TOC. Physicians must understand how to use strong, consistent, adolescent-centered communication to execute effective TOC.

Improving Transitions of Care for Healthy Adolescents and Young Adults.

OBJECTIVES: To explore the gaps in care within the transition process from pediatric to adult medicine for healthy and noncomplex adolescents and young adults and to highlight the importance of identifying and adapting interventions to improve transitions for this population. METHODS: Three researchers independently completed searches in PubMed, PsychINFO, and CINAHL Complete. The review used the following inclusion criteria: English-language original research articles published between January 2007 and January 2018 involving care transitions for male and female patients ages 13 to 24 years with diagnoses that may be managed only by a primary care provider. Studies were excluded if they were reviews or commentaries, included only specialist providers, or primarily investigated children with special healthcare needs. The articles selected based on these inclusion and exclusion criteria, as well as those identified through review of references of included articles and known articles not found through those searches, were analyzed for suitability. RESULTS: Nine studies were included in the review. Limited consensus existed on how transitions of care should be approached for healthy and noncomplex adolescents, despite the 2002, 2011, and 2018 policy statements and clinical reports providing guidelines on transition processes. Perceptions about when to initiate the process, what to discuss about transitions, and how to approach those conversations varied among providers. CONCLUSIONS: The literature is limited regarding transitions of care from pediatric to adult medicine for healthy and noncomplex adolescents and young adults. Areas for intervention were identified from these studies and have yet to be explored. Additional research is needed to overcome transition obstacles and to tailor interventions to help healthy and noncomplex adolescents and young adults at this vulnerable time of their lives.