Supplemental Materials
Semi-structured interview guide
My name is [Insert study investigator name]. Thank you for participating in our research. As mentioned in the information you received, this is the first study of a larger project
exploring recommendations and practice using EMRs and patient portal systems in
hospitalized children’s pain care. You have been invited to participate in this study because you are a paediatric clinician with expertise caring for children with pain, and currently working in a children’s hospital that uses EMRs.
As this session will be audio recorded and to make it easier for transcribing, can I kindly ask to switch mobile phones to silent. If at any time you wish to withdraw from the interview, please feel free to do so. Also, please refrain from disclosing any personal or identifiable information related to any patients, families, or colleagues. Do you still consent to have this interview recorded?
Thanks again for offering your time and sharing your expertise. The purpose of today’s discussion is to understand your perspectives about how EMRs can be used to facilitate best pain care for hospitalized children. There are no right or wrong answers to the questions I am about to ask.
I want to try and understand a bit about how clinicians in your organization record and
access clinical data regarding the assessment and management of children’s pain and this
might vary for different disciplines, so can I ask you to focus on how a you might engage
with the EMR.
Interview script Key topics for exploration (not direct questions)
A cc e ss
Let’s start by you telling me about how pain-related data is recorded in the EMR
Can information be added at the patient’s bedside?
Does the EMR integrate with other systems to capture pain data, e.g., are other things integrated such as monitors
Can children or families enter their own pain data into the EMR directing using an interface?
A ssessme n t
I would now like to focus on pain assessment. Can you tell me about how clinicians use EMR to undertake a pain assessment and enter pain assessment data?
We know that sometimes capturing other aspects of pain in pain assessment, beyond the physical symptoms, can be difficult. Can you tell me a little about how/if clinicians can enter psychosocial aspects of pain, such as anxiety, stress, fear – in the EMR?
What pain data can be entered into the EMR?
How are pain assessment tools accessed in the EMR?
Are there any prompts or reminders to guide clinicians to undertake a pain assessment using a pain assessment tool?
Can you describe how these work?
Do you think prompts help guide clinicians to undertake a pain assessment and guide interventions
Can pain assessment be documented in any other way besides using a tool?
How does the EMR allow for biopsychosocial assessment of pain, are there prompts to remind staff to consider these aspects of pain assessment?
Given your experience using EMRs, do you think that the EMR could be optimised in any way to enhance the way clinicians assess children’s pain?
What might improve the way clinicians access pain assessment tools?
What might improve the frequency of pain assessment?
What might improve the way clinicians assess other aspects of pain beyond physical symptoms?
Interventions
Can you tell me about how clinicians use the EMR in ordering and providing interventions for pain?
Are there prompts and reminders to guide clinicians in the prescription of pharmacological interventions? Can you describe how this works?
Are there prompts and reminders to guide clinicians in prescribing non-pharmacological interventions (physical and psychological
interventions)? Can you describe how these work?
Are there prompts and reminders to guide clinicians to offer/provide/administer pharmacological and non-pharmacological interventions? Can you describe how these work?
We know that sometimes children miss out on non-pharmacological
interventions. Do you have any
suggestions on how an EMR might help clinicians to consider non-
pharmacological measures
What might improve the way clinicians provide pain intervention?
What might help clinicians to consider using non- pharmacological measures
Decision support
Can you think of any clinical decision support functions of your hospital’s EMR that help clinicians provide pain care to children and drive improvement in care?
How are clinical practice guidelines embedded in the EMR?
Are any other decision supports embedded into the EMR?
Collaborative decision making
I want to move on to learn about how children and families are involved in their pain care in your hospital, with a particular focus how the EMR or related system. Can children and families use the EMR or a portal to be involved in their pain care?
How does your EMR allow patients and families to be involved in pain assessment, intervention decisions, and re-assessment?
How might the EMR system be optimized to meet clinical and consumer needs?
How might the EMR system be optimized to enable collaborative decision-making between HCP and families better?
Use of data I would like to now move on to the use
of EMR pain data. Can you tell me how/if the pain data entered in the EMR is used for any quality improvement activities?
How do you use EMR pain-related data?
Is EMR data used in quality improvement – how?
EMR impact
Thank you. So, nearing the end of my questions, now. I want to learn about how you think EMRs have impacted pain care practices in your hospital?
What impact do you think EMR has had on pain practices?
How do you see the future of EMRs in pain care for hospitalized children
Can you think of any barriers relevant to your hospital that impact how clinicians use EMRs to manage pain?
