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

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

Protection of Human and Animal Subjects

The study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects and was reviewed and approved by the Cincinnati Children's Hospital Medical Center Institutional Review Board. All providers provided written informed consent to participate in the study.

Publication History

Received: 04 November 2024

Accepted: 18 March 2025

Accepted Manuscript online:
19 March 2025

Article published online:
16 July 2025

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