Availability of E-Health Tools for Pediatric Pain Assessment and Management: Barriers, Facilitators, Costs, and Design

Many eHealth tools to help assess and manage children's pain have been developed and evaluated with promising results. Although considerable resources are spent developing and evaluating these tools with the rationale that they will increase access to care, they are rarely made available to end users (i.e. the target population they are designed for), reducing their impact and creating research waste. This study extends previous work by examining barriers and facilitators to tool availability, development and evaluation costs, and relationships between user-centered design and availability. A systematic review was conducted to identify papers describing eHealth tools for pediatric pain assessment/management published in English in the past 10 years. Corresponding authors of included papers (one per tool) were then invited to complete an online survey about barriers/facilitators to tool availability, grant funding used, and a measure of how user-centered the tool design process was. Ninety papers describing 53 tools met inclusion criteria. Twenty-six survey responses were received; 13 described available tools (5 to the general public; 8 to patients of particular clinics/systems). Commonly endorsed facilitators of availability included beliefs in benefits to target population and research field. Barriers included lack of infrastructure and time. An average of $398,006.72 CAD was spent on developing/evaluating each unavailable tool. Available tools scored significantly higher than unavailable tools on user-centered design. Systemic changes to academic and funding structures are needed to support tool availability and reduce research waste. This research contributes to improving health delivery systems by highlighting gaps in implementation of evidence-based eHealth tools, providing initial information on barriers and facilitators that may contribute to this situation, and providing recommendations for improving the availability of eHealth tools for children's pain.