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.
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