# Feasibility Study of a Mobile Digital Personal Health Record for Family-Centered Care Coordination for Children and Youth with Special Healthcare Needs

> **NIH AHRQ R21** · DUKE UNIVERSITY · 2022 · $158,379

## Abstract

1 ABSTRACT
 2
 3 Coordinating care across a complex web of providers and services on their own is
 4 stressful and isolating for families of children and youth with special healthcare needs
 5 (CYSHCN); thus, better care coordination solutions are critically needed. Digital personal health
 6 records (PHR) that allow families to securely access, manage, and share their child’s health
 7 data across multiple information and electronic health record (EHR) systems are promising
 8 solutions. Central to digital PHRs being able to fulfill their promise are Fast Healthcare
 9 Interoperability Resources (FHIR) – updated data standards that facilitate secure data access
10 and sharing between third party mobile applications (apps) and EHRs. Despite their importance,
11 FHIR technologies have yet to be widely adopted. A FHIR-enabled digital PHR mobile app
12 (Caremap) was co-designed with families and clinicians to coordinate care for CYSHCN and
13 has been positively reviewed by families in preliminary testing. Implementation and evaluation of
14 the Caremap mobile app in real-world setting is now the critical next step forward.
15 We will conduct a single group, non-randomized, feasibility study with 40 families (adult
16 parents/caregivers) of CYSHCN in pediatric primary care clinics to use the digital PHR mobile
17 application as a tool for coordinating their child’s care over a 6-month period. The primary study
18 outcome of overall feasibility will include measures of technical feasibility (FHIR-enabled
19 integration of the mobile app with the EHR) and implementation outcomes in real-world clinical
20 environments. Using a convergent mixed methods design, we will merge quantitative feasibility
21 data and two qualitative data sources (semi-structured interviews with families and providers;
22 family stakeholder engagement panels) to identify implementation barriers and facilitators.
23 Using pre/post analyses of baseline and 6-month family-reported survey measures, we will
24 explore associations between level of family app adoption and family-reported outcomes.
25 This proposal is highly innovative because it will be the first FHIR-enabled digital PHR
26 mobile app implemented to enhance care coordination for CYSHCN via secure access and
27 sharing of EHR data and family-reported health insights. The findings will be highly significant
28 because they will support a future multi-site pragmatic, cluster randomized trial to evaluate the
29 effectiveness of enhanced care coordination with a digital PHR mobile app compared to usual
30 care coordination. Due to similarities in needs between CYSHCN and adults with multiple
31 chronic conditions, the study’s findings will inform improvements in family-centered care
32 coordination that will be highly impactful for complex populations across the age spectrum.

## Key facts

- **NIH application ID:** 10489792
- **Project number:** 5R21HS028699-02
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** David Y Ming
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2022
- **Award amount:** $158,379
- **Award type:** 5
- **Project period:** 2021-09-30 → 2024-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10489792

## Citation

> US National Institutes of Health, RePORTER application 10489792, Feasibility Study of a Mobile Digital Personal Health Record for Family-Centered Care Coordination for Children and Youth with Special Healthcare Needs (5R21HS028699-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10489792. Licensed CC0.

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