PT  - JOURNAL ARTICLE
AU  - Lindsay Kuhn
AU  - Kelly Reeves
AU  - Yhenneko Taylor
AU  - Hazel Tapp
AU  - Andrew McWilliams
AU  - Andrew Gunter
AU  - Jeffrey Cleveland
AU  - Michael Dulin
TI  - Planning for Action: The Impact of an Asthma Action Plan Decision Support Tool Integrated into an Electronic Health Record (EHR) at a Large Health Care System
AID  - 10.3122/jabfm.2015.03.140248
DP  - 2015 May 01
TA  - The Journal of the American Board of Family
                Medicine
PG  - 382--393
VI  - 28
IP  - 3
4099  - http://www.jabfm.org/content/28/3/382.short
4100  - http://www.jabfm.org/content/28/3/382.full
SO  - J Am Board Fam Med2015 May 01; 28
AB  - Introduction: Asthma is a chronic airway disease that can be difficult to manage, resulting in poor outcomes and high costs. Asthma action plans assist patients with self-management, but provider compliance with this recommendation is limited in part because of guideline complexity. This project aimed to embed an electronic asthma action plan decision support tool (eAAP) into the medical record to streamline evidence-based guidelines for providers at the point of care, create individualized patient handouts, and evaluate effects on disease outcomes. Methods: eAAP development occurred in 4 phases: web-based prototype creation, multidisciplinary team engagement, pilot, and system-wide dissemination. Medical record and hospital billing data compared frequencies of asthma exacerbations before and after eAAP receipt with matched controls. Results: Between December 2012 and September 2014, 5174 patients with asthma (∼10%) received eAAPs. Results showed an association between eAAP receipt and significant reductions in pediatric asthma exacerbations, including 33% lower odds of requiring oral steroids (P < .001), compared with controls. Equivalent adult measures were not statistically significant. Conclusions: This study supports existing evidence that patient self-management plays an important role in reducing asthma exacerbations. We show the feasibility of leveraging technology to provide guideline-based decision support through an eAAP, addressing known challenges of implementation into routine practice.