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Parents who arrive at the emergency department (ED) seeking care for a child with asthma who is gasping for breath clearly need help controlling their child's asthma. An asthma kiosk in the ED may be useful, according to a study supported in part by the Agency for Healthcare Research and Quality (K08 HS11660).
The kiosk developed and tested in this study includes an interactive computer program that queries parents about the child's asthma symptoms and current medications and links parents to recommended guidelines for controlling asthma. Parents can complete the kiosk task in 11 minutes while waiting in the ED, and they can use its printed child-specific care recommendations to discuss their child's asthma with the ED health care provider.
The kiosk output module presents a health message to the parent organized in four sections: about your child, what your child needs, how the doctors and nurses can help, and how you can help your child. A printed copy of the patient-specific action plan is both a targeted summary and a "to do" list. For example, the written asthma plan includes use of a peak flow meter to monitor asthma and the child's response to medication. The action plan also serves as a template for ED providers to review important and clinically relevant data with the parent, according to lead investigator Stephen C. Porter, M.D., M.P.H., of Children's Hospital, Boston.
Dr. Porter and his colleagues tested three prototypes of the asthma kiosk over 8 months. They recruited 66 parents of children with asthma who brought their child to the pediatric ED of an urban hospital. The parents used the asthma kiosk while in the ED and completed a questionnaire about their demographics and feelings about kiosk use. Overall, 95 percent of parents agreed that entering data at the kiosk was a good use of their time. Also, 88 percent agreed that a parent could enter information using the kiosk "as well as a doctor or nurse could," with most finding it as easy to use as a bank ATM.
See "The asthma kiosk: A patient-centered technology for collaborative decision support in the emergency department," by Dr. Porter, Zhaohui Cai, M.D., Ph.D., William Gribbons, Ph.D., and others, in the November 2004 Journal of the American Medical Informatics Association 11, pp. 458-467.
Editor's Note: Another study, coauthored by AHRQ researcher David Lanier, M.D., found that parents and children with asthma associate missed school days and work days with more severe asthma, which are different measures of asthma severity than those used by physicians and researchers. The researchers conclude that more widely understood asthma measures may be needed. See Yawn, B.P., Fryer, G.E., and Lanier, D. (2004). "Asthma severity: The patient's perspective." Journal of Asthma 41(6), pp. 623-630. Reprints (AHRQ Publication No. 05-R047) are available from the AHRQ Publications Clearinghouse.
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