Provider adoption of an online ADHD 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 re-credentialing, 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%). 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.

Conclusions: 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.