title: Pediatric palliative care and eHealth opportunities for patient-centered care.
abstract: BACKGROUND
  Pediatric palliative care currently faces many challenges including unnecessary pain from insufficiently personalized treatment, doctor-patient communication breakdowns, and a paucity of usable patient-centric information. Recent advances in informatics for consumer health through eHealth initiatives have the potential to bridge known communication gaps, but overall these technologies remain under-utilized in practice.
  
  
  OBJECTIVE
  This paper seeks to identify effective uses of existing and developing health information technology (HIT) to improve communications and care within the clinical setting.
  
  
  METHODS
  A needs analysis was conducted by surveying seven pediatric oncology patients and their extended support network at the Lombardi Pediatric Clinic at Georgetown University Medical Center in May and June of 2010. Needs were mapped onto an existing inventory of emerging HIT technologies to assess what existing informatics solutions could effectively bridge these gaps.
  
  
  RESULTS
  Through the patient interviews, a number of communication challenges and needs in pediatric palliative cancer care were identified from the interconnected group perspective surrounding each patient. These gaps mapped well, in most cases, to existing or emerging cyberinfrastructure. However, adoption and adaptation of appropriate technologies could improve, including for patient-provider communication, behavioral support, pain assessment, and education, all through integration within existing work flows.
  
  
  CONCLUSIONS
  This study provides a blueprint for more optimal use of HIT technologies, effectively utilizing HIT standards-based technology solutions to improve communication. This research aims to further stimulate the development and adoption of interoperable, standardized technologies and delivery of context-sensitive information to substantially improve the quality of care patients receive within pediatric palliative care clinics and other settings.
authors.affiliation: Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 3300 Whitehaven Street NW, Washington, DC 20007, USA. sm696@georgetown.edu
authors.forename: Subha
authors.initials: S
authors.lastname: Madhavan
authors.forename: Amy E
authors.initials: AE
authors.lastname: Sanders
authors.forename: Wen-Ying Sylvia
authors.initials: WY
authors.lastname: Chou
authors.forename: Alex
authors.initials: A
authors.lastname: Shuster
authors.forename: Keith W
authors.initials: KW
authors.lastname: Boone
authors.forename: Mark A
authors.initials: MA
authors.lastname: Dente
authors.forename: Aziza T
authors.initials: AT
authors.lastname: Shad
authors.forename: Bradford W
authors.initials: BW
authors.lastname: Hesse
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D008490:Medical Informatics / Q000458:organization & administration*; D008495:Medical Oncology / Q000458:organization & administration; D020380:Needs Assessment; D009369:Neoplasms / Q000628:therapy*; D010166:Palliative Care / Q000458:organization & administration*; D010353:Patient Education as Topic / Q000458:organization & administration; D018802:Patient-Centered Care / Q000458:organization & administration*; D010372:Pediatrics / Q000379:methods; D010817:Physician-Patient Relations; D011446:Prospective Studies; D011787:Quality of Health Care; D055815:Young Adult