Adoption of a portal for the primary care management of pediatric asthma: a mixed-methods implementation study

Alexander G. Fiks, Nathalie Du Rivage, Stephanie L. Mayne, Stacia Finch, Michelle E. Ross, Kelli Giacomini, Andrew Suh, Banita McCarn, Elias Brandt, Dean Karavite, Elizabeth W. Staton, Laura P. Shone, Valerie McGoldrick, Kathleen Noonan, Dorothy Miller, Christoph U. Lehmann, Wilson D. Pace, Robert W. Grundmeier

Research output: Contribution to journalArticle

Abstract

Background: Patient portals may improve communication between families of children with asthma and their primary care providers and improve outcomes. However, the feasibility of using portals to collect patient-reported outcomes from families and the barriers and facilitators of portal implementation across diverse pediatric primary care settings have not been established. Objective: We evaluated the feasibility of using a patient portal for pediatric asthma in primary care, its impact on management, and barriers and facilitators of implementation success. Methods: We conducted a mixed-methods implementation study in 20 practices (11 states). Using the portal, parents of children with asthma aged 6-12 years completed monthly surveys to communicate treatment concerns, treatment goals, symptom control, medication use, and side effects. We used logistic regression to evaluate the association of portal use with child characteristics and changes to asthma management. Ten clinician focus groups and 22 semistructured parent interviews explored barriers and facilitators of use in the context of an evidence-based implementation framework. Results: We invited 9133 families to enroll and 237 (2.59%) used the portal (range by practice, 0.6%-13.6%). Children of parents or guardians who used the portal were significantly more likely than nonusers to be aged 6-9 years (vs 10-12, P=.02), have mild or moderate/severe persistent asthma (P=.009 and P=.04), have a prescription of a controller medication (P

Original languageEnglish (US)
Article numbere172
JournalJournal of Medical Internet Research
Volume18
Issue number6
DOIs
StatePublished - Jun 1 2016
Externally publishedYes

Keywords

  • Asthma
  • Electronic health records
  • Health information technology

ASJC Scopus subject areas

  • Health Informatics

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    Fiks, A. G., Rivage, N. D., Mayne, S. L., Finch, S., Ross, M. E., Giacomini, K., Suh, A., McCarn, B., Brandt, E., Karavite, D., Staton, E. W., Shone, L. P., McGoldrick, V., Noonan, K., Miller, D., Lehmann, C. U., Pace, W. D., & Grundmeier, R. W. (2016). Adoption of a portal for the primary care management of pediatric asthma: a mixed-methods implementation study. Journal of Medical Internet Research, 18(6), [e172]. https://doi.org/10.2196/jmir.5610