JMIR Publications

ABSTRACT

Background:

Sepsis, a life-threatening condition resulting from a dysregulated immune response to infection, disproportionately affects populations in low and middle-income countries (LMICs). Septic children in LMICs face high mortality rates, with early detection and clinical monitoring posing a significant challenge to effective management. There is great potential for digital technologies, such as wearable devices and mobile clinical decision support (CDS) tools, to enable closer monitoring and more prompt recognition of children at risk of advanced sepsis and death. However, little is known about healthcare providers’ (HCPs) perceptions of introducing new digital health tools for pediatric sepsis care in LMICs.

Objective:

The objective of this study was to assess HCPs’ understanding, perceptions, and recommendations regarding the design and implementation of digital CDS tools for pediatric sepsis care in Bangladesh.

Methods:

Between February and May 2024, 18 individual semi-structured in-depth interviews were conducted with HCPs (nurses and physicians) at three urban Bangladeshi hospitals. The data was transcribed, translated from Bangla to English, and analyzed using a Framework Matrix Analysis approach. Participants were asked about familiarity with digital health tools, feedback on tool design, perceptions of the tool’s utility, and barriers and facilitators to use of similar tools in clinical settings in Bangladesh.

Results:

Participants reported overall positive perceptions toward the potential implementation of wearable and digital tools for pediatric sepsis care in Bangladesh. Some key priorities for the design of a digital, wearable CDS tool were durability, reusability, cost considerations, and reliability and accuracy. Clinicians desired the tool to also have customizable alarm parameters and include additional functions such as glucose monitoring. Many favored audio (ringtone) or visual (light) alarms to alert changes in captured vital signs. HCPs believed these tools could enhance patient care by allowing greater staff capacity to monitor patients, reducing management time, and aiding in faster clinical decision-making, with some suggesting it could lower mortality rates. Concerns regarding implementation included internet availability, affordability of the wearable devices, and trust in the CDS tools’ outputs compared to expert clinician judgement.

Conclusions:

These findings highlight HCP’s perceptions towards the potential of CDS tools to improve pediatric sepsis outcomes in LMICs, while highlighting the need to address implementation challenges to ensure their effective integration into healthcare systems.