"[O]ur project is an attempt to allow primary care physicians to seamlessly implement the guidelines really in their everyday practice.… [M]anagement decisions and follow-up decisions and patient education are all prompted in the online tool."
Michael Schatz, M.D., M.S., Past President, American Academy of Allergy, Asthma & Immunology (Milwaukee, WI) and Member, National Asthma Education and Prevention Program (NAEPP) Coordinating Committee and NAEPP Expert Panel
Michael Schatz, M.D., American Academy of Allergy, Asthma & Immunology, introduces the ASTHMA IQ for Primary Care decision-support tool.
To help asthma specialists achieve greater efficiency in tracking and managing patient care, the American Academy of Allergy, Asthma & Immunology (AAAAI) used evidence-based information from the National Asthma Education and Prevention Program's (NAEPP) Third Expert Panel Report: Guidelines for the Diagnosis and Management of Asthma (EPR-3) to develop a Web-based "Asthma Specialist Tool to Help Manage Asthma and Improve Quality" (ASTHMA IQ). Then, AAAAI teamed with the American Academy of Family Physicians' (AAFP) National Research Network to adapt, test, and disseminate AAAAI's Web-based ASTHMA IQ for primary care use. The adapted tool took into account the clinical, practice improvement, and administrative needs of primary care providers.
The resulting ASTHMA IQ for Primary Care—available free of charge at www.asthmaiq.org—is a HIPAA-compliant clinical decision-support tool. It helps clinicians learn about and integrate the EPR-3 and the six priority messages from its companion Guidelines Implementation (GIP) Report into the workflow of their busy practices. It also allows users to collect, review, graph, and report performance and quality improvement measures.
ASTHMA IQ for Primary Care includes a Practice Improvement Module approved by the American Board of Internal Medicine and American Board of Pediatrics for credit towards Maintenance of Certification, Part IV. Further, it offers continuing medical education credit for its educational module on the EPR-3 guidelines.
Develop a step-by-step approach to aid busy primary care practices in diagnosing and managing asthma.
Provide clinical-decision support driven by the EPR-3 guidelines and six priority GIP messages.
Demonstrate improved outcomes for patients using pay-for-performance measures.
Desire LaTempa (left), HHC Woodhull, and Lauri Sweetman, AAAAI, at a NACI meeting in Baltimore, MD.
Challenges & Solutions
Challenge: Integrate ASTHMA IQ with electronic medical records (EMR) systems. ASTHMA IQ and ASTHMA IQ for Primary Care are online tools that help physicians learn about and apply the NAEPP's EPR-3 guidelines in everyday practice. However, for those physicians already using one or more EMR systems, utilizing ASTHMA IQ's functions and customizable reports required re-entering asthma visit data.
Solution: Add bridging software. Since physicians use a variety of EMR systems, AAAAI decided to address this challenge by incorporating software that allows the export of all data entered into ASTHMA IQ into an existing EMR through a Continuity of Care Record function. This software was effective in connecting ASTHMA IQ with EMRs. In most cases, however, the uploaded data are not searchable within the EMR system. AAAAI is working to enable this additional function for the uploaded data.
AAAAI added information on practice assessment tools to the Asthma IQ for Primary Care electronic Performance Improvement Module to help users conduct a systems analysis of their practice processes and identify areas that may be affecting their current performance.
AAAAI promoted the availability of both versions of ASTHMA IQ at its AAAAI Annual Meeting, including a workshop on using EMR and ASTHMA IQ to enhance outcomes and reimbursement.
Romelia Rodriguez Walters (left), AE-C, Asthma Allies, and Sheila Heitzig, J.D., M.N.M., AAAAI, converse at a NACI meeting in Baltimore, MD.
AAAAI shared and collaborated with other NACI-funded projects to advance asthma care best practices. For example:
Medical Society of Virginia Foundation, another NACI Demonstration Project, provided guidance to Mission on working with primary care provider and family practice offices to address disparities in the implementation of the asthma guidelines.
To help meet its project goals, AAAAI used online training and practice improvement.
Other NACI-funded projects using AAAAI-type approaches are: