1. Chapter Quality Network (CQN) Asthma Pilot Project Team Progress Presentation State Name: Alabama Practice Name: Dothan Pediatric Clinic Team Members: Dr. Lee Scott, Amy Marshall, Kelli Watson, Carlotta McCallister and Haley Smith

3. Asthma Progress Before we started the asthma project the percentage of asthma action plans given was 5%. Since the beginning of the asthma project the number of asthma action plans given has jumped to 90%. We have 11 doctors and 3 nurse practitioners and they are all doing encounter forms and are utilizing asthma action plans in patient care. By the end of the pilot project, our goal is to have completed an encounter form and utilized an asthma action plan on 90% of our asthma patients. Since the beginning of the pilot we have doubled the number of spirometry tests performed. As a part of the asthma project we are awaiting incorporation of Reach My Doctor into our EMR through the BCBS Medical Home project. This registry includes data tracking and reporting options that will offer providers easier and more efficient ways to monitor individual patient progress and assess how the clinic’s overall asthma patient population is improving.

4. Obtain spirometry measurements every 1-2 years

5. Spirometry

6. Spirometry Flow Graph

7. Spirometry Data

8. Provide/review current Asthma Action Plan at every visit

9. Optimal Asthma Care

10. Recommend annual flu shot

11. TEST 1 What:: Computerize encounter form Who (executes): BJ Where: Dothan Pediatric Clinic When: September 2009 PD SA TEST 2 What:: Test encounter form Who (population): Dr. Scott’s asthma patients Who (executes): Dr. Scott Where: Dothan Pediatric Clinic When: September 2009 PD SA TEST 3 What:: Implement encounter form Who (population): all asthma patients Who (executes): All doctors Where: Dothan Pediatric Clinic When: October 2009 PD SA TEST 1 What:: Develop Asthma action plan Who (executes): Dr. Scott and BJ Where: Dothan Pediatric Clinic When: September 2009 PD SA TEST 2 What:: Finalize asthma action plan Who (executes): All Dothan Pediatric Clinic doctors Where: Dothan Pediatric Clinic When: September 2009 PD SA TEST 3 What:: Implement asthma action plan Who (population): All asthma patients Who (executes): All Dothan Pediatric Clinic doctors Where: Dothan Pediatric Clinic When: October 2009 PD SA TEST 1 What:: Research Registry Who (executes): BJ Where: Dothan Pediatric Clinic When: November 2009 PD SA TEST 2 What:: Training about Reach My Doctor Who (executes): Dr. Scott, Dr. Ramsey, BJ, Haley Where: Dothan Pediatric Clinic When: December 2009 PD SA TEST 3 What:: Implement Reach My Doctor Who (executes): BJ and Haley Where: Dothan Pediatric Clinic When: April 2009 PD SA CQN Encounter FormAsthma Action PlanRegistry PDSA Ramps

13. Parent Encounter Form

14. Physician Encounter Form

15. Key Learnings  With good motivation and education the group was quite accepting of change.  The process of completing the encounter form was not as time consuming as anticipated.  Quantitative results have been motivational for the group.

16. Barriers and Successes Barriers Finding a registry to interface with our EMR was not as easy as anticipated. Successes Spirometry use rapidly increased. Use of asthma action plans dramatically increased.

17. Future Plans Dothan Pediatric Clinic is in the process of implementing Reach My Doctor’s Patient Registry to further improve patient care. This registry includes data tracking and reporting options that will offer providers easier and more efficient ways to monitor individual patient progress and assess how the clinic’s overall asthma patient population is improving.