Addressing Asthma Disparities

Easy Breathing Asthma Program Goes Digital

By: Jessica Hollenbach, PhD and Christine Langton, MSW, MPH

The COVID-19 pandemic placed new pressure on healthcare providers to adapt to the rapidly changing healthcare landscape. Innovative solutions are more welcome and necessary than ever. Our Easy Breathing asthma management program, which is a program of Connecticut Children’s Office for Community Child Health, is now more accessible than ever through digital technology, which makes it easier for healthcare providers to diagnose asthma in pediatric patients and ensure they are following recommended treatment protocols.

Modernizing Easy Breathing

Prior to the spread of COVID-19, we received funding from the Cigna Foundation in late 2018 to develop a digital version of our nationally recognized Easy Breathing program. Our intent was to modernize the formerly paper-based program to keep it simple and user-friendly for providers.

Easy Breathing translates complex national asthma guidelines into a usable format for pediatricians, primary care practitioners, and family medicine practitioners. The evidence-based asthma management program helps providers improve diagnosis rates of asthma in pediatric patients and also helps create a standardized approach for them to help keep asthma under control.

In going digital, Easy Breathing is now accessible to child health providers through the Tonic iPad-based platform. Previously, patients and providers filled out paper surveys. We launched a pilot test of the digital program at Community Health Services (CHS) in Hartford in May 2019. Through Tonic, patients with asthma complete all Easy Breathing forms on a tablet. Providers then create severity-appropriate treatment plans on the tablet, which are easily shareable with school nurses.

In January and February of 2020, before COVID-19, the utilization of digital Easy Breathing by CHS providers reached a clinic average of 82 surveys per month.

Digital Easy Breathing and COVID-19

Like many healthcare practices adjusting to COVID-19, CHS limited in-person visits and quickly shifted to providing telehealth visits for routine care during the pandemic. Recognizing the opportunity, we worked with CHS to fold digital Easy Breathing into their telehealth visits, ensuring that patients with asthma would continue to receive the same quality and frequency of care they enjoyed prior to the shift.

In addition to utilizing Easy Breathing in telehealth visits, CHS is prioritizing patients with asthma to assess asthma control and make sure asthma treatment plans are up-to-date. Before the pandemic, the CHS Asthma Outreach Coordinator ran a report identifying nearly 1,000 patients in the past year who have asthma, but had not been scheduled for an asthma follow-up visit. When the pandemic hit, CHS used this list to prioritize these patients for telehealth follow-up visits based on provider, age, asthma severity, and the length of time since the patient’s last appointment.

Often, parents wait until symptoms are bad before they seek care, so these routine calls facilitated by the digital Easy Breathing platform seem to be making a difference in managing children’s asthma symptoms before they get worse. Through this process, CHS providers were able to determine that several patients experiencing allergy symptoms needed refills on their asthma medications. CHS providers also determined that another patient’s medications were not properly controlling their asthma symptoms, so the patient received a referral to a pulmonologist.

In April and May of 2020, the utilization of Easy Breathing by CHS providers increased to a clinic average of 103 surveys per month on the digital platform.

Continuing to Advance Digital Easy Breathing

In June 2020, we worked with CHS to incorporate new technology that integrates the clinic’s daily schedule into the Tonic platform. We hope that time saved from this integration will promote further adoption of the platform and lead to even higher use of digital Easy Breathing in the months ahead.

Amid the COVID-19 pandemic, CHS demonstrated a remarkable commitment to asthma healthcare in Connecticut through their use of digital Easy Breathing and telehealth. As we continue to adjust to conditions under COVID-19, we plan to continue evolving digital Easy Breathing to respond to any additional needed changes with practical, forward-thinking innovation.

Read additional blog posts related to how programs of Connecticut Children’s Office of Community Child Health are addressing pandemic needs.

Jessica Hollenbach, PhD, is co-director of the Asthma Center at Connecticut Children’s.

Christine Langton, MSW, MPH is senior program evaluator and research associate at the Asthma Center.

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