Description

In order to teach and to learn from those who treat asthma patients in rural areas, the University of Kansas Medical Center's (KUMC) Asthma Center connected with asthma stakeholders throughout Kansas by means of an asthma teleECHO program. This quality improvement project focused on:

• Continuing education and professional development
• Decreasing unplanned asthma-related healthcare usage
• Improving practice adherence to guidelines for the diagnosis and treatment of asthma
• Developing a toolkit for providers who don't have access to the most current national guidelines

Services offered

The asthma teleECHO program, which officially began in the fall of 2016, facilitated four weekly sessions over the course of a month. In these sessions, participating clinics picked and presented an asthma-related case, and everyone in the session could provide input. The teleECHO program was made possible through collaborations with KUMC's rural education program and the telemedicine/telehealth department. KUMC's teleECHO program coordinator initiated contact with community-based practices serving asthma patients. Rural medical education preceptor sites served as points of contact for the community partnerships.

The Kansas Asthma Initiative also provided community engagement, often in the form of health fairs and site visits to hospitals. These events were open to the public, so teachers, school nurses, coaches, families of asthma patients, and other groups could learn more about treatment options.

The Kansas Asthma Initiative also worked on a type of patient-centered medical home (PCMH) model where the KU Asthma Center connected with respiratory therapists who discussed asthma self-management with patients via a simple telehealth connection in their homes.

In addition, the KU Asthma Center worked with nearby colleges such as the University of Kansas, Kansas State University, and the University of Central Missouri to screen for exercise-induced bronchoconstriction (EIB) in their student-athletes.

Results

Initially, members of the Kansas Asthma Initiative wanted to better understand the perceptions and needs of family practice providers for providing asthma care. They were able to receive surveys from 63 rural physicians in the summer of 2015. This survey focused on the perception and use of asthma guidelines by rural family practice providers.

Challenges

The guidelines for asthma care are neither simple nor user-friendly. Reading 440-some pages of guidelines is unrealistic for doctors during a routine clinic day. In addition, rural healthcare providers often cannot specialize in one area like asthma, since they are needed to fill many roles in their communities. The partnership focused on pooling its knowledge of the guidelines with other healthcare providers.

Despite being one of three key components of the guidelines for asthma care, the use of spirometry is not very common in rural family practice. The educational partnership facilitated a better understanding of spirometry interpretation as well as reimbursement for spirometry and asthma self-management clinic services.

Replication

At first, the Kansas Asthma Initiative traveled to different communities in Kansas. As the demand for education and collaboration grew, however, the KU Asthma Center, with the University of Kansas Center for Telemedicine & Telehealth, offered teleECHO sessions instead of face-to-face visits. TeleECHO allowed the partnership to reach more rural healthcare providers without needing to travel all over the state.

Collaboration is key. The point of the Kansas Asthma Initiative was not for one organization to act as an expert but for all healthcare providers to share their experiences and advice.

Interested healthcare providers can become Asthma Educator Specialists through the National Board for Respiratory Care.

Contact Information

Dave Burnett, PhD, Cofounder and Director
KU Asthma Center
respiratory@kumc.edu