Digital Health Adoption in Pediatric Respiratory Care in Italy: A National Survey and Machine Learning-Based Clustering Analysis

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 nation-wide 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.