Abstract
Asthma in childhood is a common and costly chronic disease. Quality asthma care can lead to better control of asthma thus decreasing use of health services. The gold standard for pediatric asthma diagnosis and management is the National Heart, Lung and Blood Institute (NHLBI) guidelines for Diagnosis and Management of Asthma which center on precisely establishing the severity of asthma, as this precise classification delineates appropriate therapy. However, navigating these guidelines is a challenge for primary care providers that creates a barrier to providing quality care. We aim to improve precision in asthma severity classification in the community healthcare setting through the development of an electronic asthma decision support tool (eADST) incorporating NHLBI guidelines embedded within the electronic health record system. We developed an algorithm for the eADST to guide the health care provider to the appropriate classification and subsequent therapy. We engaged our health system’s electronic health record informatics team and together developed and revised the tool. We launched the tool in three academic community clinics and measured precision in asthma classification in the twelve months prior to the availability of the tool and the twelve months following the launch. We found a significant improvement in precision of asthma severity classification following the launch, a necessary first step in improvement of asthma care. The next step will be to evaluate the impact of the tool on asthma outcomes.
Abbreviations
- NHLBI:
-
National Heart, Lung and Blood Institute
- GINA:
-
Global Initiative for Asthma
- Eadst:
-
Electronic Asthma Decision Support Tool
- HCP:
-
Healthcare provider
- ABPI:
-
Asthma Best Practice Initiative
- EMR:
-
Electronic medical record
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Acknowledgements
Health IT development and support by MedStar Medical Group Informatics. Statistical assistance by the Biostatistics and Biomedical Informatics Department, MedStar Health Research Institute.
Funding
Funding provided in part by Breathe DC and CVS Health.
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Dr. Shukla conceptualized and designed the tool, analyzed and interpreted the data, drafted the initial manuscript, and approved the final manuscript as submitted. Dr. Sandel conceptualized and designed the tool, critically reviewed and revised the manuscript, and approved the final manuscript as submitted. Dr. Phull conceptualized and designed the tool, critically reviewed and revised the manuscript, and approved the final manuscript as submitted. Dr. Rethy conceptualized and designed the tool, coordinated and supervised data collection, drafted the initial manuscript, and approved the final manuscript as submitted. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
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Shukla, P.J., Sandel, P., Phull, G. et al. Development and Utilization of a Diagnostic Support Tool for Asthma within the Electronic Medical Record. J Med Syst 46, 65 (2022). https://doi.org/10.1007/s10916-022-01858-4
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DOI: https://doi.org/10.1007/s10916-022-01858-4