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

被引:18
作者
van den Wijngaart, Lara S. [1 ]
Geense, Wytske W. [2 ]
Boehmer, Annemie L. M. [3 ]
Brouwer, Marianne L. [4 ]
Hugen, Cindy A. C. [1 ]
van Ewijk, Bart E. [5 ,6 ]
Koenen-Jacobs, Marie-Jose [7 ]
Landstra, Anneke M. [8 ]
Niers, Laetitia E. M. [9 ]
van Onzenoort-Bokken, Lonneke [9 ]
Ottink, Mark D. [10 ]
Rikkers-Mutsaerts, Eleonora R. V. M. [11 ]
Groothuis, Iris [12 ]
Vaessen-Verberne, Anja A. [13 ]
Roukema, Jolt [1 ]
Merkus, Peter J. F. M. [1 ]
机构
[1] Radboud Univ Nijmegen, Radboud Inst Hlth Sci, Amalia Childrens Hosp, Dept Pediat Pulmonol,Med Ctr, Geert Grootepl 10, NL-6500 HB Nijmegen, Netherlands
[2] Radboud Univ Nijmegen, Radboud Inst Hlth Sci, IQ Healthcare, Med Ctr, Nijmegen, Netherlands
[3] Maasstad Hosp, Dept Pediat, Rotterdam, Netherlands
[4] Canisius Wilhelmina Hosp, Dept Pediat, Nijmegen, Netherlands
[5] Tergooi Hosp, Dept Pediat, Blaricum, Netherlands
[6] Tergooi Hosp, Dept Pediat, Hilversum, Netherlands
[7] Maas Hosp Pantein, Dept Pediat, Boxmeer, Netherlands
[8] Rijnstate Hosp, Dept Pediat, Arnhem, Netherlands
[9] Maxima Med Ctr, Dept Pediat, Veldhoven, Netherlands
[10] Med Spectrum Twente Hosp, Dept Pediat, Enschede, Netherlands
[11] Leiden Univ, Dept Pediat Pulmonol, Med Ctr, Leiden, Netherlands
[12] Juliana Childrens Hosp, Dept Pediat Pulmonol, Haga Hosp, The Hague, Netherlands
[13] Amphia Hosp, Dept Pediat, Breda, Netherlands
关键词
asthma; barriers and facilitators; eHealth; pediatric; Web-based monitoring; HEALTH INFORMATION-TECHNOLOGY; ADOPTION; TELEMEDICINE; EHEALTH;
D O I
10.2196/jmir.9245
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
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.
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页数:12
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