Provider Adoption of an Online Attention Deficit Hyperactivity Disorder eHealth Care Application

Jeffery N. Epstein; William B. Brinkman; Tanya E. Froehlich; Constance A. Mara; John O. Simon; Andrew F. Beck; Suzanne Emmer

doi:10.1055/a-2562-1161

Applied Clinical Informatics, Table of Contents

Appl Clin Inform 2025; 16(03): 652-661
DOI: 10.1055/a-2562-1161

Research Article

Provider Adoption of an Online Attention Deficit Hyperactivity Disorder eHealth Care Application

Jeffery N. Epstein

¹Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States

²Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States

,

William B. Brinkman

¹Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States

³Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States

,

Tanya E. Froehlich

¹Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States

⁴Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States

,

Constance A. Mara

¹Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States

²Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States

,

John O. Simon

²Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States

,

Andrew F. Beck

¹Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States

³Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States

,

Suzanne Emmer

⁵Department of Child Health Finance and Quality, American Academy of Pediatrics, Itasca, Illinois, United States

› Author Affiliations

Abstract

Objectives

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.

Methods

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.

Results

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.

Conclusion

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.

Keywords

digital health - medical informatics applications - telemedicine - implementation science - quality improvement - pediatrics - ADHD

Full Text

References

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Supplementary Material

Supplementary Material