DIGICOMP KIDS: CO-DESIGN AND USABILITY TESTING OF A HOSPITAL-TO-HOME INTERVENTION FOR CHILDREN WITH MEDICAL COMPLEXITY

Abstract

Background. Advances in healthcare have resulted in a growing population of Children with Medical Complexities (CMC). Medical management of the complex needs of CMC has traditionally taken place in hospital settings, such as clinics, emergency departments, and hospital wards, by specialized teams of healthcare clinicians. While access to expert-level care is necessary, the hospital-based model of care is expensive and inconvenient and has resulted in harms such as medical errors conferred upon CMC. Models of care that allow for expert-delivered hospital-to-home care for CMC are needed. The aim of this dissertation was to investigate the needs, performance, and perceptions of CMC families and clinicians when using a hospital-to-home digital health system called DigiComp Kids. Methods. This study was guided by A Holistic Framework to Improve the Uptake and Impact of eHealth Technologies, which attends to technological, human, and contextual variables influencing virtual care. A scoping review was conducted to provide an overview of how digital healthcare has been used with medically fragile children, before co-designing the DigiComp Kids system with CMC family members and clinicians. Usability testing of DigiComp Kids was conducted measuring user effectiveness, efficiency, satisfaction, and experiences. Results. Across studies in this dissertation, technological, human, and contextual factors each played a role in the usability of digital health systems, including DigiComp Kids. In the scoping review, these factors influenced the acceptability, accessibility, and implementation success of digital healthcare systems for CMC. During DigiComp Kids co-design and usability testing, participants emphasized how these factors affected their willingness to engage with the system, how it fit into their lives and workflows, and where improvements could be made. Conclusions. This study highlights the importance of engaging with end-users as well as attending to technological, human, and contextual factors when designing and testing digital health systems.