Grant aims to improve city’s asthma care



Asthma is responsible for 25 percent of school absences and is the most common chronic illness in children. With many patients suffering from asthma shuffling between care facilities, officials at the Yale School of Medicine hope a new project will improve communication between health care providers.

The University and a group of community partners have received a $1.2 million, three-year grant from the Electronic Records to Improve Care for Children with Asthma Project. According to Department of Pediatrics chair Dr. Margaret Hostetter, ERICCA will dramatically improve asthma care in the New Haven area.

The grant, awarded by the United States Agency for Healthcare Quality and Research, will implement an electronic health-record system linking asthma care providers all over the city to a common database.

“This type of electronic medical-care system will improve care by instantaneously linking the emergency room, the school nurse’s office, the pediatrician’s office and the community clinic,” Hostetter said.

Furthermore, specific clinical advice based on national guidelines will be provided to subgroups of clinicians to support their decision-making, according to Dr. Richard Shiffman, the grant’s principal investigator and professor of pediatrics and anesthesiology at the Yale School of Medicine.

Without an electronic linking system, lack of communication between health-care providers can lead to poor care for patients, Hostetter said.

“If a child has an asthma attack one night and goes to the emergency room, they can start him on steroids,” she said. “The nurse at the child’s school doesn’t know. The child’s doctor doesn’t know. Because of the fragmented nature of health care, the left hand may not know what the right hand is doing.”

More children are currently affected by asthma than in the past, and, while the reason is a mystery, Hostetter said it is certainly a combination of environmental and genetic factors.

She said one environmental factor is better home insulation and construction.

“Houses are more tightly sealed — we build them better than we used to,” Hostetter said. “So dust particles tend to stay in the house and not get blown out the window anymore.”

Community partners include the Yale-New Haven Hospital’s Pediatric Primary Care Center, the Organizational Development and Learning Center, the Hospital of St. Raphael and the New Haven Health Department.

“It was really Dr. Shiffman who recruited all these partners,” Hostetter said. “Not only do we need someone who is an expert with the electronic medical records, but we also need a person who believes in participatory health care — and that’s Dr. Shiffman.”

When Shiffman and his colleagues applied for the grant, their application was one of 800.

The project’s doctors said they are excited about the chances it will present to improve care in the community.

“This is really a wonderful partnership between the Yale University School of Medicine and the New Haven Children’s Hospital to provide care for children in the inner ring of New Haven for a health problem that is clearly at the top of our priority list,” Hostetter said.

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