Asthma is currently the leading pediatric chronic illness around the world, increasing steadily in children under 6 years. The increased prevalence of asthma means that more pediatricians will encounter more patients with asthma. Treating asthma in children aged 5 to 11 years old requires some specialized techniques. Caring for children and adolescents with asthma in a pediatric specialty setting requires tools, educational modules, and templates for great asthma care. It is essential that each child is properly assessed for asthma symptoms and is well-treated and controlled using these elements.
Essentials for successful Pediatric asthma care
The key to caring for pediatric asthma patients is that the most appropriate medication of the right dosage must be prescribed. It is important to keep in mind that the child has to take their medication on time.
1. Asthma Action Plans (AAP)
An Asthma Action Plan is a written treatment plan developed collaboratively by the health care professional and the patient. The purpose is to empower patients for self-management and maintenance of their asthma symptoms. Accurate and successful AAPs contain information for the patient regarding asthma triggers, and medication names, doses, and frequency of use. Additionally, the AAP educates the patient to identify signs indicating worsening asthma. It also has information for the patient about what changes to make in treatment when asthma symptoms change.
Pediatric patients that use an action plan can reduce asthma-related visits to clinics and reduce the time missed at school. The majority of Pediatricians suggest incorporating the asthma action plan into the asthma patient’s EHR to improve the dissemination.
No matter what EHR you use, all Asthma Action Plans should have the following components:
- Estimated doses and frequencies of daily medications for asthma.
- Instructions on how to adjust medicines at home in response to particular signs, symptoms, and peak flow measurements.
- Listing of the patient’s Peak Expiratory Flow levels, including personal best PEF, and calculated PEF zones for better asthma control.
- List of symptoms indicating the need for closer monitoring or acute care.
- Emergency telephone numbers for the doctor, emergency department, options for rapid transportation, and family/friends for support.
- A list of triggers that may cause an asthma attack, to inform others and the patient of what triggers to avoid.
These key components of personalized AAPs within their chart in EHR are helping people with asthma to understand their condition. It also helps them to respond early enough to prevent potentially life-threatening complications.
iPatientcare Pediatric EHR provides real-time access to information about the child’s asthma plan and care. Its additional features include:
- Lists of children with asthma to schedule office visit dedicated to respiratory care or proactively reach out to parents to discuss medication adherence.
- Care reminders to prompt pediatricians when patients with asthma need preventive care, screenings, or immunizations.
- Encourage pediatric compliance with asthma care plans and guidelines.
- Manage asthma medications using active medication lists and e-Prescribing
- Better share pediatric asthma education resources with patients and parents enabling them to take ownership of their health and health care
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2. The Childhood Asthma Control Test (C-ACT)
The Childhood Asthma Control Test (C-ACT) is a patient-focused assessment tool used to determine asthma control in children aged 4 -11. This tool is used to assess the pediatric patient’s asthma symptoms over the past 4 weeks. C-ACT works as a crucial element in determining what course of treatment needs to be implemented, maintained or adjusted. The benefit of the C-ACT is that it gives pediatricians a baseline number and assessment of how the child patient is doing. It’s a great tool for them to compare at each visit.
A structured approach to improving asthma care
Early Identification of Pediatric Asthma – Given the rapid adoption of pediatric electronic health record systems, early identification of childhood asthma can be achieved utilizing –
- Asthma ascertainment criteria leveraging relevant clinical information embedded in EHR and
- Innovative informatics approaches such as natural language processing (NLP) algorithms for asthma ascertainment criteria to enable such a strategy.
Assess Asthma severity – The concept of severity remains important for determining:
- The initial level or step of asthma therapy
- Initiating communication and providing education to children and parents
- Selecting the immediacy of follow-up.
The assessment of severity continues to be important for the initial diagnosis, assessment of the disease process, and treatment decisions.
The tools available in a clinical practice setting can be classified as subjective and objective. Subjective includes patient reporting while objective consists of physiologic and inflammatory measures. A considerate combination of measures from each category may be needed to optimally assess asthma control.
Initiate medication and demonstrate use – In most cases, the optimal use of medication can help patients control symptoms and reduce the risk for future morbidity. Some children may need adjustment in their medications, refinement in their technique, or demonstrations for proper administration.
Develop an Asthma Action Plan – The action plan uses peak flow measurements and symptoms to categorize the child’s asthma into zones. The zones are categorized as the green zone, yellow zone and red zone corresponding to well-controlled symptoms, somewhat-controlled symptoms, and poorly controlled symptoms. This makes tracking the child’s asthma much easier.
Educate – Education and training regarding asthma and its management should be provided, taking into consideration the patient’s personal preference and goals. There are six topics that the provider should educate asthmatic children and/or their families on. These six topics include asthma as a chronic disease, environmental triggers, rescue medications, controller medications, usage of peak flow meters, and spacers.
Schedule follow-up appointment – Pediatric asthma’s symptoms and triggers are likely to change over time. Symptoms need to be observed and work with the doctor to adjust the medications as and when needed. Follow-up every 2-6 weeks is initially necessary (when gaining control of the disease) and then every 1-6 months thereafter.
To improve the quality of asthma care, clinicians need to be equipped with streamlined care planning tools, an electronic medical record system, and personalized care. Parents and clinicians prioritized features including collecting parent and child concerns and goals; symptoms, side effects, medication adherence tracking with decision support; and accessible educational materials. These elements all improve the patient’s quality of life and prevent hospitalizations.
Technological Tools and Services to Support Asthma Care
1. Patient Portal
Patient Portal is an integrated solution of the pediatric electronic health record system. It provides a platform to the parents, from which they can access educational content, track asthma symptoms over time, identify concerns and goals, and share this information with the child’s doctor or asthma care team. The availability and use of this tool will potentially reduce the need for acute hospital visits for asthma exacerbations.
2. Telemedicine
A telemedicine platform connects the Pediatricians to the children and their caregivers into the virtual consultations. This enables them to give many more “touches,” and many more chances to identify triggers, track changes and adjust care plans. And possibly save a few lives. Telemedicine visits have the potential to achieve comparable degrees of asthma control compared to in-person visits.
Top 5 Information Technologies to Support Pediatric Practices
3. Care Coordination
Care is coordinated and integrated across the clinical practice setting and facilitated by information technology including asthma registries. Care coordination includes referrals to specialty care if needed, and eventual transitions to adult care.
4. Chronic Care Management
Chronic Care Management is a critical component of pediatric asthma care. It contributes to better health and care for the children. Services included in CCM are:
- Organized records of the pediatric patient’s health information
- Maintaining a comprehensive electronic asthma action plan
- Managing transitions of care and other care management services
- Coordination and sharing patient health information within and outside the practice
5. Wearable Devices
Wearable devices for children collect data, transmit it to the cloud, and then feed the information into the child’s EHR. Such devices also store data from past asthma attacks, helping providers and caregivers predict potential attacks and pinpoint triggers.
iPatientCare is a full suite of innovative healthcare products and value-added services that helps pediatric clinics in improving the health of their patients, enhancing patient care through care management/coordination/analytics, and reducing costs of care delivery.
Hope this information helped you. To know how you can implement these tools and services in your practice, reach us on sales@iPatientCare.com or 732.607.2400 and get live consultation with our experts.
