Epstein Jeffery N, Brinkman William B, Froehlich Tanya E, Mara Constance A, Simon John O, Beck Andrew F, Emmer Suzanne
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States.
Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States.
Appl Clin Inform. 2025 May;16(3):652-661. doi: 10.1055/a-2562-1161. Epub 2025 Mar 19.
To assess what practice-, provider-, and patient population-level predictors predict adoption of an ADHD ehealth technology in community pediatric settings, pediatric providers nationwide were recruited and offered free use of an evidence-based mental health-focused ehealth quality improvement intervention (mehealth for ADHD). Practice-, provider-, and patient population-level factors predicting provider's adoption of the intervention were studied. We hypothesized that providers who were younger, nearing recredentialing, having more patients with ADHD, working at larger practices, serving socioeconomically deprived patient populations, and using an electronic health record (EHR) with mehealth integration would predict higher rates of adoption.A variety of recruitment strategies were attempted. Providers completed a baseline survey, were given free access to mehealth, and then had their software adoption recorded (i.e., account activation, rate of patients registered, completion of Plan-Do-Study-Act cycles). Multiple regressions examined what practice-, provider-, and patient population-level variables predicted provider's adoption of the software.A total of 1,612 providers at 813 practices across 48 states and the District of Columbia consented to the study. The most common ways that providers heard about the research study was through word-of-mouth (37%), advertising (23%), and through professional affiliation (11%). A total of 1,210 (75.1%) providers activated their mehealth provider account and 446 (36.8%) registered at least 1 patient. Over 4.5 years, 21,804 patients were registered on the platform. Being able to access mehealth within their EHR predicted provider account activation, provider rate of patients registered, and the practice's completion of Plan-Do-Study-Act cycles. In addition, having a lower proportion of Medicaid patients predicted higher rates of patients being registered on the software.Getting providers to consider, try, and adopt new evidence-based assistive technologies is challenging. Making ehealth software easier for providers' to access through EHR integration appears critical to adoption.
为评估哪些机构层面、提供者层面和患者群体层面的预测因素能预测社区儿科环境中多动症电子健康技术的采用情况，我们招募了全国的儿科提供者，并为他们提供了一项以循证心理健康为重点的电子健康质量改进干预措施（多动症的移动电子健康）的免费使用权。我们研究了机构层面、提供者层面和患者群体层面预测提供者采用该干预措施的因素。我们假设，年龄较小、即将重新获得资格认证、有更多多动症患者、在规模较大的机构工作、服务于社会经济贫困患者群体且使用与移动电子健康集成的电子健康记录（EHR）的提供者，其采用率会更高。我们尝试了多种招募策略。提供者完成了基线调查，获得了移动电子健康的免费使用权，然后记录他们的软件采用情况（即账户激活、患者注册率、计划-实施-研究-改进循环的完成情况）。多元回归分析考察了哪些机构层面、提供者层面和患者群体层面的变量能预测提供者对软件的采用情况。
来自48个州和哥伦比亚特区813家机构的1612名提供者同意参与该研究。提供者了解该研究的最常见方式是口口相传（37%）、广告宣传（23%）和通过专业协会（11%）。共有1210名（75.1%）提供者激活了他们的移动电子健康提供者账户，446名（36.8%）至少注册了1名患者。在超过4.5年的时间里，有21804名患者在该平台上注册。能够在其电子健康记录中访问移动电子健康可预测提供者账户激活、提供者患者注册率以及机构计划-实施-研究-改进循环的完成情况。此外，医疗补助患者比例较低预示着软件上注册患者的比例较高。
让提供者考虑、尝试并采用新的循证辅助技术具有挑战性。通过电子健康记录集成使电子健康软件更便于提供者访问似乎对采用至关重要。
