Pediatricians' Expectations on Telehomecare: A qualitative study of Job Demands, Control and Support.

The rise of telemedicine is transforming healthcare, enabling remote medical care. However, integrating these technologies into clinical practice poses new challenges for healthcare professionals. Understanding their expectations and concerns on telemedicine is crucial to ensure its effective integration. This study examines pediatricians’ expectations regarding job demands, control, and support in the context of adopting Tytocare, a telehomecare device for early discharge. Semi-structured interviews were conducted with all hospital pediatricians involved in a pilot study using Tytocare (n=13). Thematic analysis was performed using the Job Demand-Control-Support model via MAXQDA. Pediatricians anticipated that remote consultations could increase workload, intensifying time pressure. Many expressed the belief that a paradigm shift in patient discharge timing would be necessary. Indeed, while Tytocare enables earlier discharges through remote monitoring, some pediatricians expressed discomfort with releasing patients before being fully assured of their readiness. Additionally, pediatricians felt a lack of involvement in the change related to Tytocare adoption, due to a top-down approach used. They also foresaw a potential reduction in control over critical patient information as clinical assessments would be delegated to parents at home. Despite these concerns, some expected that telemonitoring through Tytocare could ultimately enhance their oversight of patients' conditions. Instrumental support from colleagues was crucial for effectively learning to use the device. These findings suggest that, to ensure successful integration of telemedicine into clinical practices and support its long-term sustainability, the adoption process should include adequate training and meaningful involvement of professionals in the decision-making process.