Practice variation is widespread in pediatric care. Asthma has been the target of many quality improvement efforts. However, most attempts have been costly or hampered by the challenges of changing provider behavior. This randomized controlled trial aims to test the ability of a real-time computerized intervention to improve care for children with asthma in a cost-effective manner. The computerized asthma management system (CAMS) aims to change primary care providers' prescribing behavior and chronic disease management by delivering evidence-based guidelines and asthma management tools at the point of care. CAMS differs from other asthma interventions in three ways. First, it preserves clinician autonomy. Second, recommendations are driven by patient-specific data. Third, CAMS is easier to use than to ignore. Because it is automated, it involves potentially much lower costs than other quality improvement efforts. We will randomize providers in three diverse pediatric clinics to CAMS or usual care. We hypothesize that CAMS will result in improved care among providers randomized to receive it. Specifically, we hypothesize that CAMS providers will be more likely to prescribe controller medication when appropriate and to prepare written asthma care plans; and that children with asthma receiving care from CAMS providers will experience fewer symptom days. We further hypothesize that CAMS will result in no net cost increases to providers. We will assess the effectiveness of CAMS by prospectively collecting data on medication use, home care, symptom days, health status, utilization and satisfaction from computerized data and telephone interviews of 750 patients/parents.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL069670-03
Application #
6638839
Study Section
Health Care Quality and Effectiveness Research (HQER)
Program Officer
Taggart, Virginia
Project Start
2001-08-06
Project End
2005-05-31
Budget Start
2003-06-01
Budget End
2005-05-31
Support Year
3
Fiscal Year
2003
Total Cost
$461,602
Indirect Cost
Name
University of Washington
Department
Pediatrics
Type
Schools of Medicine
DUNS #
605799469
City
Seattle
State
WA
Country
United States
Zip Code
98195