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Development and Utilization of a Diagnostic Support Tool for Asthma within the Electronic Medical Record
Prateek J Shukla1, Piper Sandel2, Gurpreet Phull3
1Department of Pediatrics, MedStar Georgetown University Hospital, Washington, DC, USA.
Insights
A new electronic tool improved the precision of childhood asthma severity classification in community clinics. This supports better asthma management by helping providers follow National Heart, Lung, and Blood Institute guidelines.
Area of Science:
- Pediatric Pulmonology
- Clinical Informatics
- Healthcare Quality Improvement
Background:
- Childhood asthma is a prevalent, costly chronic condition requiring quality care for effective management.
- National Heart, Lung, and Blood Institute (NHLBI) guidelines provide a gold standard for pediatric asthma diagnosis and management.
- Primary care providers face challenges in precisely applying NHLBI guidelines, hindering optimal asthma care.
Purpose of the Study:
- To enhance the precision of pediatric asthma severity classification in community healthcare settings.
- To develop and implement an electronic asthma decision support tool (eADST) integrated into electronic health records.
- To guide healthcare providers toward accurate asthma classification and appropriate therapy based on NHLBI guidelines.
Main Methods:
- Developed an algorithm for the eADST to align with NHLBI asthma guidelines.
- Collaborated with electronic health record informatics teams for tool development and revision.
- Launched the eADST in three academic community clinics and compared asthma classification precision pre- and post-implementation.
Main Results:
- Demonstrated a significant improvement in the precision of asthma severity classification after the eADST launch.
- The eADST facilitated more accurate application of NHLBI guidelines in a community healthcare setting.
- This improvement in classification precision is a critical initial step toward enhancing pediatric asthma care.
Conclusions:
- The developed eADST effectively improved the precision of pediatric asthma severity classification.
- This tool addresses a key barrier in primary care for implementing evidence-based asthma management.
- Future research will assess the impact of this improved classification on actual asthma outcomes.
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.
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