Resource Center Poster Session I

Building an Asthma Clinical Decision Support Tool to Improve Comprehensive Asthma Management and Support Patient Engagement
Tuesday, March 12, 2013: 12:00 PM - 07:30 PM, OAK, East Hall
Asthma is one of the most common chronic diseases in the US, accounting for a heavy burden on healthcare expenditures and quality of life for asthmatics and their family.  Asthma management requires cultural and linguistic sensitivity, as treatment options are complex due to the chronicity of the disease, the medication delivery mechanisms, and the exposure to multiple environmental asthma triggers. The latter is often hard for low-income families disproportionally affected by poor asthma outcomes due to their housing options.  Per evidenced based clinical guidelines, asthma patient education, a crucial component of asthma management, should incorporate asthma trigger assessment and reduction strategies that include language and cultural sensitivity

Patients with limited English proficiency, low health literacy and low literacy often do not benefit from written patient education materials.  Through an EPA funding asthma improvement project, the Association of Clinicians for the Underserved (ACU) worked with Alliance of Chicago, a health-center controlled network of 32 Community Health Centers in multiple states to develop a clinical decision support (CDS) tool for the electronic health record that integrates the 2007 NHLBI NAEPP Asthma guidelines and incorporates asthma trigger screening and control and patient self-management and education. Meaningful use of health information technology (HIT) can support clinician adherence to standardized clinical guidelines, improve collection of patient and population health data, and engage patients in education and self-management strategies.  This CDS tool is being pilot tested in 4 CHCs and plans to roll out the form to all 32 health centers are scheduled.

Asthma lends itself to non-written patient education. As part of this project, the ACU identified low literacy non-written multilingual education materials and patient self-management tools to be viewed during the clinical visit and/or with community health workers.

The challenges faced in this project included the time and cost in informatics form development, pilot testing and feedback analysis, limited ability at an early stage to provide outcome measurements, and resistance over utilizing clinician controlled computers for patient education.  This has been factored into the entire 4-year project, though federal budget cuts have impacted the ability to expand as quickly as planned.

Long-term outcomes include decreased number of patients with acute exacerbations of asthma, reduction in exposure to asthma triggers, improvement in management of patient with asthma, decreased in ED visits, and increased numbers of clinicians adhering to clinical guidelines.  An estimated 100 providers will receive tools and training to manage asthma patients’ triggers, an estimated 10,000 patients with asthma will benefit from the intervention and an estimated 20 clinical locations of care (each health center has multiple clinic sites) will be included in the intervention

Plans for replication of this project include sharing the tools at the GE Centricity Users Group and increasing the number of clinicians trained to use the tools included in this quality improvement program. Electronic reporting capabilities can measure the tool’s impact on asthma management, health outcomes, and disparities. This tool can serve as a prototype for other electronic clinical decision support tools, personal health record and mobile devices. 

 

Handouts
  • ACU_AsthmaPostcard_REV_hr.pdf (1.1 MB)
  • ACU_ProTrainFlyer_Asthma_new2.pdf (336.2 kB)
  • poster Diversity.pdf (435.4 kB)
  • Presentation Information:

    Program: Poster Presentations (Main Conference)
    Primary Category: Culturally Competent Care
    Subtopics: Community health education, Health literacy, Innovative uses of technology

    Region Addressed by Presentation: National
    Organization: Non-Profit Organization/Association



    Website: clinicians.org/our-issues/asthma/

    Lois Wessel, CFNP , Association of Clinicians for the Underserved (ACU), Tysons Corner, VA
      Associate Director for Programs
      Association of Clinicians for the Underserved (ACU)
      1420 Springhill Rd Suite 600
      Tysons Corner VA, USA 22102

      Phone: 301-213-6733
      Email Address: lois.wessel@gmail.com

      Biographical Sketch:
      Lois Wessel, RN, CFNP is the Associate Director for Programs at the Association of Clinicians for the Underserved (ACU). In that position, Ms. Wessel has developed and delivered training modules for community based clinics in the areas of asthma education, prevention of early childhood caries, health literacy, medication management for patients with limited English proficiency (LEP), and use of medical interpreters. As faculty at the Georgetown School of Nursing, Ms. Wessel lectures and mentors students on topics pertaining to providing culturally competent care to patients with LEP and low health literacy. Ms. Wessel also works clinically serving low-income patients at Community Clinic, Inc, a Federally Qualified Health Center. She is bilingual (English-Spanish) and is a trained medical interpreter and also teaches in interpreter training courses.