Tablets as part of e-health - a safe bridge between the hospital and the home of the newly operated child?

Background: At the pediatric surgeon in Lund, we operate on new-born children with malformations in the gastrointestinal tract, urinary tract and genitals. Many parents describe a great uncertainty about how they will take care of their newly operated infant after discharge from the hospital. Via e-health via tablet, a so-called e-tablet, we now give parents the opportunity to communicate with highly specialized healthcare staff via chat, pictures and video after discharge. The parents take the e-tablet home with them, and use it when they want contact and support, e.g., regarding the child's well-being, wound healing, etc. Communication is done in encrypted form so that even sensitive images can be sent securely. The contact via the e-plate takes place on the families' terms.

Purpose: The purpose of the studies is to investigate the parents' experience of communicating with healthcare professionals via e-pad after their child's surgery. We also examine how the parents' use of the e-tablet looks over time, which subjects are communicated via it, patient safety with the e-tablet, and whether the number and type of return visits to the hospital are affected. In addition, we study the effects of the e-tablet on the work of the healthcare staff and their experiences with the e-tablet. The ultimate aim is to interweave the views of parents and staff on how e-health in children's healthcare can take place in a safe way.

Research methods: Both qualitative, quantitative and mixed methods were used through questionnaires, interviews and automatic digital recording of the communication flow over the e-plate.

The project is part of the FORTE-funded research program eChildhealth.



Results: In the research project we have so far shown that:

* 87% of the parents who used the e-plate after advanced pediatric malformation surgery 2018-2022 indicated that they were satisfied/very satisfied with the e-plate.

* The greatest satisfaction with the e-tablet was that the parents were given the opportunity to ask questions and concerns via chat to healthcare staff when it suited them, as well as being able to send photos of surgical areas digitally securely.

* The parents' satisfaction with the e-tablet co-varied with how often they used the e-tablet, but not with what background knowledge they had in e-health and technology or how satisfied they were with their child's healthcare.

* Parents who received an e-plate experienced a high level of accessibility to highly specialized pediatric surgical healthcare in the form of easily accessible and good support from healthcare professionals who knew their children.

* The parents who did not have an e-tablet also experienced relatively good support from the healthcare system during telephone contact and visits, but that it was difficult from home to get in touch with staff who knew their child. They also said that they lacked communication between BVC and the highly specialized care.

* Both parents with and without an e-plate had some misgivings about digital information security when communicating via e-health, even though the healthcare service guaranteed this.

Ongoing: In studies where results are expected to be completed during 2024-2026, we are examining, among other things,

* which subjects the parents seek information about via chat questions

* if the healing process of skin after operations can be safely followed via photo documentation sent by the parents

* if and how the e-plate can be introduced as a contact route to the pediatric surgeon for teenagers who will start practicing their own communication with the healthcare system.