10:15 - 10:35 amSunday, September 18
LK 102
Decreased hospitalizations and emergency visits for asthma: the use of analytics for population health
LK 102
Decreased hospitalizations and emergency visits for asthma: the use of analytics for population health
Kaiser Permanente
In the US, nine patients die every day from asthma. Asthma costs $56 billion annually in the US and is a leading cause of school days lost among children. Overall, two million emergency visits and nearly... Read more

Description

In the US, nine patients die every day from asthma. Asthma costs $56 billion annually in the US and is a leading cause of school days lost among children. Overall, two million emergency visits and nearly half a million hospitalizations from asthma occur per year in the US.

Globally, there are 300 million asthmatics in 2004, with another 100 million anticipated new cases by 2025. There are 250,000 premature deaths from asthma annually in the world, and nearly all are avoidable.

An analytics program generates a list of patients at risk for emergency department visits and hospitalization for asthma based on patterns of medication use and pertinent risk factors. Areas of focus include the ratio of controller to rescue medication use, a quality measure validated nationally by the NCQA, the date of the last emergency visit or hospitalization for asthma, smoking status, and the date the last asthma medication was ordered versus filled. This enables risk stratification by identifying patients who have poorly controlled asthma, engage in behavior that puts them at risk for future exacerbations, or are not adherent with prescribed medications. The primary physicians are updated with the names of patients at risk and can prioritize by contacting patients who need immediate attention. The list of at risk patients is automatically and regularly updated. A treatment plan is generated for consideration and individualized one-on-one discussions are available.

Changing patient and physician behavior was facilitated by information technology and physician education. A computerized algorithm, showing optimal doses for asthma medications by age group, helps physician decision making. We generate automated reminders to patients to follow up with their primary physicians or specialists. An asthma specialist provides guidance to physicians with a focus on meeting patient needs, champions best practices and evaluates referrals for difficult to treat asthma. For example, montelukast, a generic medication shown to be effective for treating asthma, is discussed as an option for cost-conscious patients.

Asthma hospitalizations decreased more than 50% after using the analytics program plus physician education as part of quality improvement. This finding was seen for three consecutive years, compared to the average number of asthma hospitalization for the previous six years. Emergency department visits decreased by more than 20%, and more than nine hundred fewer office visits office per year for asthma was noted. Further analytics to optimize asthma treatment is in progress.

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