• Lindsay Kuhn, Kelly Reeves, Yhenneko Taylor, Hazel Tapp, Andrew McWilliams, Andrew Gunter, Jeffrey Cleveland, and Michael Dulin.
• From the Department of Family Medicine (LK, KR, HT, AM, MD), Dickson Advanced Analytics (YT, MD), and Department of Pediatrics (AG, JC), Carolinas HealthCare System, Charlotte, NC. lindsay.kuhn@carolinashealthcare.org.
• J Am Board Fam Med. 2015 May 1; 28 (3): 382-93.

IntroductionAsthma is a chronic airway disease that can be difficult to manage, resulting in poor outcomes and high costs. Asthma action plans assist patients with self-management, but provider compliance with this recommendation is limited in part because of guideline complexity. This project aimed to embed an electronic asthma action plan decision support tool (eAAP) into the medical record to streamline evidence-based guidelines for providers at the point of care, create individualized patient handouts, and evaluate effects on disease outcomes.MethodseAAP development occurred in 4 phases: web-based prototype creation, multidisciplinary team engagement, pilot, and system-wide dissemination. Medical record and hospital billing data compared frequencies of asthma exacerbations before and after eAAP receipt with matched controls.ResultsBetween December 2012 and September 2014, 5174 patients with asthma (∼10%) received eAAPs. Results showed an association between eAAP receipt and significant reductions in pediatric asthma exacerbations, including 33% lower odds of requiring oral steroids (P < .001), compared with controls. Equivalent adult measures were not statistically significant.ConclusionsThis study supports existing evidence that patient self-management plays an important role in reducing asthma exacerbations. We show the feasibility of leveraging technology to provide guideline-based decision support through an eAAP, addressing known challenges of implementation into routine practice.© Copyright 2015 by the American Board of Family Medicine.

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