Electronic Communication Between Pediatric Caregivers & Healthcare Teams: impact on perceived quality of care

Parental caregivers of the 1 percent of children in the United States with complex chronic conditions increasingly depend on electronic communication (e-communication) through modes such as patient portal secure-messaging, personal text messaging, and e-mail with the child’s healthcare team in the periods between in-person, face-to-face medical encounters for coordinated, safe management and support. Due to the high-risk and long-term nature of cancer care that requires high-quality communication, pediatric cancer caregivers represent an ideal population for studying e-communication in healthcare. The relational coordination theory, which proposes that optimal care is most effectively carried out through frequent, timely, accurate, problem-solving communication among key project-partners, including caregivers, supported by relationships of shared goals, shared knowledge, and mutual respect, can be applied to healthcare structures to systematically and reliably improve the quality of patient-centered e-communication. While e-communication is becoming widespread, little is known about its quality or impact on care, and evaluation methods are limited. The purpose of this multi-method study is to investigate the quality of e-communication between the caregivers of children with cancer and their healthcare teams by addressing the following specific aims: 1: Compare the frequency and mode of e-communication of caregivers of children aged 0-13 undergoing active cancer treatment with caregiver characteristics to assess differences in use (N=134) 2: Compare surveyed relational coordination scores and satisfaction scores among these caregivers to evaluate the association of e-communication quality and caregiver satisfaction, and further assess whether caregiver characteristics or e-communication mode influence scores (same sample) 3: Explore caregivers’ experiences with e-communication with their child’s healthcare team between episodes of care, focusing on its impact on perceived quality of care (N=20). The proposed study will use quantitative surveys and qualitative caregiver interviews to address knowledge gaps by identifying critical themes of asynchronous e-communication between episodes of in-person medical care. Univariate analysis and multivariate regression modeling will test associations among differences in e-communication utilization, mode, access, relational coordination, satisfaction, literacy, caregiver demographics, and cancer characteristics. Semi-structured qualitative descriptive interviews, guided by the Relational Coordination Theory, will explore the impact of e-communication on perceived quality of care. This research provides a foundation to understand high-risk e-communication, aiming to enhance caregiver-team communication.