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Health Informatics Journal, Vol. 12, No. 4, 259-273 (2006)
DOI: 10.1177/1460458206069761
© 2006 SAGE Publications

Computer-based decision support for pediatric asthma management: description and feasibility of the Stop Asthma Clinical System

Ross Shegog

Center for Health Promotion & Prevention Research, UT-School of Public Health, 7000 Fannin, Suite 2668, Houston, TX 77030, USA, Ross.Shegog{at}uth.tmc.edu

Leona K. Bartholomew

Center for Health Promotion & Prevention Research, UT-School of Public Health, 7000 Fannin, Suite 2572, Houston, TX 77030, USA, Leona.K.Bartholomew{at}uth.tmc.edu

Marianna M. Sockrider

Department of Pulmonology, Texas Children’s Hospital, 6621 Fannin, CC1040.01, Houston, TX 77030, USA, mmsockri{at}texaschildrenshospital.org

Danita I. Czyzewski

Department of Psychiatry and Psychology, Texas Children’s Hospital, 6621 Fannin, CC1740.01, Houston, TX 77030, USA, diczyzew{at}texaschildrenshospital.org

Susan Pilney

Clinical Information Systems, Senior Clinical Systems Services, Baylor College of Medicine, Mail Stop BCM430, Houston, TX 77030, USA, sapilney{at}bcm.tmc.edu

Patricia Dolan Mullen

Center for Health Promotion & Prevention Research, UT-School of Public Health, 7000 Fannin, Suite 2522, Houston, TX 77030, USA, Patricia.D.Mullen{at}uth.tmc.edu

Stuart L. Abramson

Department of Allergy and Immunology, Texas Children’s Hospital, 6621 Fannin, FC330.01, Houston, TX 77030, USA, slabrams{at}texaschildrenshospital.org

Clinical guidelines can assist in the management of asthma. Decision support systems (DSSs) can enhance adherence to clinical guidelines but tend not to provide clinicians with cues for behavioral change strategies to promote patient self-management. The Stop Asthma Clinical System (SACS) is a DSS designed for this purpose. To assess feasibility, seven clinicians used SACS to guide well visits with 26 predominantly persistent pediatric asthma patients. Data were collected via survey and in-depth semi-structured interviews. SACS improved assessment of asthma severity and control, classification of and intervention in medicine and environmental trigger management problems, and development of an action plan (all p < 0.05). Clinician-patient communication was enhanced. The primary challenge was that SACS increased clinic visit time. SACS can enhance clinician behavior to improve patient asthma self-management, but more studies are indicated to mitigate temporal constraints and evaluate impact on clinician and patient communication and behavior as well as clinical outcomes.

Key Words: asthma management • behavior • clinical guidelines • computer-based decision support


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