JMIR Publications

ABSTRACT

Background:

Use of synchronous digital health technologies for care delivery to children with special healthcare needs (CSHCN) and their families at home has shown promise for improving outcomes and increasing access to care for this medically fragile and resource-intensive population. However, a comprehensive description of the various models of synchronous home digital health interventions does not exist, nor has the impact of such interventions been summarized to date.

Objective:

Using scoping review methodology, we describe the various models of synchronous home digital health that have been used in pediatric populations with special healthcare needs, their outcomes, and implementation barriers.

Methods:

A systematic scoping review of the literature was conducted, guided by the Arksey and O’Malley Scoping Review Framework. MEDLINE, CINAHL and EMBASE databases were searched from inception to June 2018, and the reference lists of included systematic reviews and high impact journals were hand-searched.

Results:

A total of 38 articles were included in this review. Interventional articles are described as feasibility studies, studies that aim to provide direct care to CSHCN, and studies that aim to support family members to deliver care to CSHCN. End-user involvement in the design and implementation of studies is evaluated using the Human Centred Design Framework and factors affecting the implementation of digital health programs are discussed in relation to technological, human, and systems factors.

Conclusions:

The use of DH to care for CSHCN presents an opportunity to leverage the capacity of technology to connect patients and their families to much needed care from expert healthcare providers, while avoiding the expenses and potential harms of the hospital-based care system. Strategies to scale and spread pilot studies-- such as involving end-users in the co-design techniques-- are needed in order to optimize digital health programs for CSHCN.