Articles
Digital Health Adoption in Pediatric Respiratory Care in Italy: A National Survey and Machine Learning-Based Clustering Analysis
ABSTRACT
The integration of digital health technologies into pediatric respiratory care is growing, yet patterns of adoption and clinician readiness remain poorly understood.
This study explores the integration of digital technologies in pediatric respiratory care through the first nationwide survey officially supported by the Italian Pediatric Respiratory Society (IPRS/SIMRI). Conducted in January 2025, the survey collected responses from 132 clinicians and aimed to identify distinct profiles based on digital technology use, competencies, and perceived barriers. Using Random
Forest analysis and t-distributed Stochastic Neighbor Embedding, two main clusters emerged: “Users” (76.5%), primarily younger professionals working in tertiary settings and managing complex respiratory conditions, and “Non-Users” (23.5%), mainly older clinicians in primary or secondary care with no adoption of digital tools. The most commonly used technologies included electronic health records, telemedicine, and portable spirometry. Barriers reported by Users included lack of resources, high costs, and system complexity, despite a generally high level of digital skills. These findings provide a unique perspective on the current state of digital readiness and clinical integration in pediatric respiratory medicine. This nationwide survey is among the first to explore digital health adoption in pediatric respiratory care using machine learning techniques for pattern identification. Despite the limitations inherent to its cross-sectional design and possible self-selection bias, the study establishes a valuable foundation for developing targeted educational strategies, guiding health policy, and informing future longitudinal research.
IMPACT STATEMENT
This is the first study to provide a national overview of how pediatric respiratory clinicians in Italy engage with digital health technologies. By identifying distinct user profiles and mapping perceived barriers and benefits, the study highlights existing gaps in digital readiness and informs the development of targeted educational programs and infrastructure policies. These findings support a more equitable and effective integration of digital tools in pediatric respiratory care, aligning clinical innovation with real-world practice.
What is already known about this topic? Digital health tools, such as telemedicine and electronic health records, are increasingly used in pediatric medicine, but data on their adoption, perceived value, and barriers in pediatric respiratory care are limited. What does this article add to our knowledge? This study provides the first national overview of digital technology use in pediatric respiratory care, identifying two distinct clinician profiles, Users and Non-Users, and highlighting differences in age, care setting, clinical complexity, digital competencies, and perceived barriers. How does this study impact current management guidelines? By uncovering digital readiness gaps and the real-world use of technology, the findings support the need for targeted training and institutional investment. They inform future strategies aimed at integrating digital tools into routine pediatric respiratory care and aligning practice with innovation.
