Using Computers to Assist in the Treatment of Asthma in a Pediatric Setting

Objectives: Improve physician adherence to four recommendations of the NHLBI asthma treatment guidelines:

1. Improve case detection of asthma among patients with pulmonary symptoms,
2. Grade all asthma patients asthma, identifying those with persistent versus intermittent asthma,
3. Improve rates of use of controller medications - particularly inhaled steroids - among patients with persistent asthma,
4. Provide an asthma treatment plan for all asthma patients.

Design: This will be a randomized controlled trial. Patients registering for appointments at the PCC Pediatric clinic will be randomized to an intervention or control arm. Patients in the intervention arm, and the physicians who see them, will receive the full intervention. Patients in the control arm will receive usual care.

Intervention: The CHICA computer system has been in regular use at the PCC Pediatrics clinic since November 4, 2004. At patient check-in, CHICA produces a health survey that parents complete in the weighting room. The survey is scanned into CHICA before the physician encounter. CHICA produces a worksheet for the physician that includes prompts and reminders based date from the health survey and the electronic medical record. The completer worksheet is scanned back into CHICA. Intervention and control groups will continue to use this system

In the intervention group, CHICA will include a question asking for the presence of asthma or asthma symptoms on the health survey. If the family responds that asthma or symptoms of asthma are present, CHICA will: