Web System for Engaging Families & Doctors in Continuous Asthma Quality Improveme

DESCRIPTION provided by applicant Asthma affects of US children and is a leading cause of ED visits hospitalization missed school suffering and death It disproportionately affects low income minorities This proposal seeks to overcome health care delivery barriers to implementation of national asthma guidelines both clinician failures to provide guideline based care and patient adherence when appropriate treatments are offered This project will develop and then test effectiveness of an innovative web based decision support system CHADIS to support teaming doctors and patients in parallel processes of continuous quality improvement of asthma care for doctors and engagement of parents and children in their own care CHADIS engages parents in completing pre visit questionnaires which trigger patient specific decision support for doctors for use in the visit Patients will complete the Pediatric Asthma Control andamp Communication Instrument PACCI a questionnaire of asthma symptoms recently validated across a range of demographics by one of the co investigators online via CHADIS pre visit and between visits Doctor interaction with CHADIS decision support during the visit results in both documentation for recertification credit and triggering of individualized parent education to appear in an enticing website for each child called the Memory Book Care Portal Patient adherence is addressed through Problem Solving Counseling by the clinician prompted by the pre visit data on symptoms and barriers Patients also are provided tailored default messages and alerts in the Care Portal which can also be monitored by a remote coach Monitoring of asthma symptoms between visits is expected and CHADIS uses multiple forms of automated communication texting email and phone to prompt completion of the PACCI In addition parents are encouraged to do questionnaires through multimodal reinforcements including the Memory Book coupons for free products and andquot gamificationandquot i e entertaining videos and quiz games for individualized patient education In Phase I the system is built with professional and patient feedback and piloting and presented to medical specialty boards for formal QI MOC certification In Phase II the system is further refined and then tested for effectiveness in improving asthma control by a large intervention study using a cluster randomized control design The Phase III product will have market value as it improves and documents care for Quality Improvement Maintenance of Certification credit meaningful use clinical quality measurement pay for performance and Medical Home efforts Asthma affects of US children and is a leading cause of ED visits hospitalization missed school suffering and death disproportionately affecting low income minorities This proposal seeks to overcome health care delivery barriers to implementation of national asthma guidelines by developing and then testing effectiveness of an innovative Asthma Module product in a web based decision support system CHADIS to support teaming doctors and patients in parallel processes of continuous quality improvement of asthma care Patients will complete the Pediatric Asthma Control andamp Communication Instrument PACCI online via CHADIS pre visit and between visits clinicians will use tailored decision support specific to PACCI results for Problem Solving Counseling during the visit and results will trigger individualized alerts and gamified patient education to appear in an enticing website for each child called the Memory Book Care Portal which can also be monitored by remote coaches