JMIR Publications

ABSTRACT

Background:

Mobile health (mHealth) technology has potential to make pediatric chronic care more collaborative, continuous, data driven and thus, more effective.

Objective:

This study evaluated the feasibility, acceptability and short-term impact of Orchestra, an electronic health record-linked technology platform and delivery system intervention supporting patient and clinician collaboration through real-time, bi-directional data sharing.

Methods:

We conducted a 6-month prospective pre-post pilot of Orchestra among patients and parents in the Cincinnati Children’s Hospital inflammatory bowel disease (IBD) and cystic fibrosis (CF) clinics. Participants and clinicians used Orchestra during and between visits to complete and view patient-reported outcome (PRO) measures and Pre-Visit Plans. Surveys completed at baseline, 3- and 6-month follow-up visits plus data from the platform were used to assess outcomes including PRO completion rates, weekly platform use, disease self-efficacy and impact on care. Analyses included descriptive statistics, pre-post comparisons, Pearson correlations and, if applicable, effect sizes.

Results:

We enrolled 92 participants (n=52 CF; n=40 IBD) and 73% completed the study. Average PRO completion was 61% and average weekly platform use was 80%. Participants reported improvement in self-efficacy from baseline to 6-months (7.90 to 8.44, p=0.006). At 6-months, most participants reported the platform was useful (90%) and had a positive impact on their care including improved visit quality (83%), visit collaboration (88%), visit preparation (78%). PRO completion was positively associated with multiple indicators of care impact at 3- and 6-months.

Conclusions:

Use of Orchestra to support collaboration and real-time data sharing is feasible, acceptable, and shows promise as a strategy for improving pediatric chronic illness management.