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. 2017 Apr 28;6(4):e71.
doi: 10.2196/resprot.7074.

Protocol of a Pilot Study of Technology-Enabled Coproduction in Pediatric Chronic Illness Care

Heather C Kaplan  1   2 , Sunny Narendra Thakkar  1 , Lisa Burns  3 , Barbara Chini  3 , Dana Mh Dykes  4 , Gary L McPhail  3 , Erin Moore  1 , Shehzad Ahmed Saeed  5 , Ian Eslick  6 , Peter A Margolis  1 , Lisa Opipari-Arrigan  1   7
Affiliations

Protocol of a Pilot Study of Technology-Enabled Coproduction in Pediatric Chronic Illness Care

Heather C Kaplan et al. JMIR Res Protoc. .

Abstract

Background: Pediatric chronic illness care models are traditionally organized around acute episodes of care and may not meet the needs of patients and their families. Interventions that extend the patient-clinician interaction beyond the health care visit, allow for asynchronous and bidirectional feedback loops that span visits and daily life, and facilitate seamless sharing of information are needed to support a care delivery system that is more collaborative, continuous, and data-driven. Orchestra is a mobile health technology platform and intervention designed to transform the management of chronic diseases by optimizing patient-clinician coproduction of care.

Objective: The aim of this study is to assess the feasibility, acceptability, and preliminary impact of the Orchestra technology and intervention in the context of pediatric chronic illness care.

Methods: This study will be conducted in the cystic fibrosis and inflammatory bowel disease clinics at Cincinnati Children's Hospital Medical Center. We will enroll interested patients and their caregivers to work with clinicians to use the Orchestra technology platform and care model over a 6-month period. In parallel, we will use quality improvement methods to improve processes for integrating Orchestra into clinic workflows and patient/family lifestyles. We will use surveys, interviews, technology use data, and measures of clinical outcomes to assess the feasibility, acceptability, and preliminary impact of Orchestra. Outcome measures will include assessments of: (1) enrollment and dropout rates; (2) duration of engagement/sustained use; (3) symptom and patient-reported outcome tracker completion rates; (4) perceived impact on treatment plan, communication with the clinical team, visit preparation, and overall care; (5) changes in disease self-efficacy and engagement in care; and (6) clinical outcomes and health care utilization.

Results: Participant recruitment began in mid-2015, with results expected in 2017.

Conclusions: Chronic disease management needs a dramatic transformation to support more collaborative, effective, and patient-centered care. This study is unique in that it is testing not only the impact of technology, but also the necessary processes that facilitate patient and clinician collaboration. This pilot study is designed to examine how technology-enabled coproduction can be implemented in real-life clinical contexts. Once the Orchestra technology and intervention are optimized to ensure feasibility and acceptability, future studies can test the effectiveness of this approach to improve patient outcomes and health care value.

Keywords: chronic disease; cystic fibrosis; inflammatory bowel disease; mobile applications; physician-patient relationship.

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Conflict of interest statement

Conflicts of Interest: Orchestra was developed via a joint effort between Vital Labs, Inc. (Chief Executive Officer Ian Eslick, PhD) and CCHMC. Dr. Eslick, Dr. Opipari-Arrigan, Dr. Margolis, and Dr. Kaplan are coinventors of Orchestra and could be entitled to proceeds from the successful commercialization of the technology in the future. These individuals were involved in the preparation of the manuscript and study design as members of the research team. The other individuals involved in this proposed research have not reported any other interests or activities related to the Vital Labs or the Orchestra platform.

Figures

Figure 1
Figure 1
Study Procedures.
See this image and copyright information in PMC

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