House Community Budget Issue Requests - Tracking Id #304

Asthma Intervention Mangement

 

 

 

 

 

 

 

 

 

 

Requester:

Wil Trower

Organization:

North Broward Hospital District

 

 

 

 

 

 

 

 

 

 

Project Title:

Asthma Intervention Mangement

Date Submitted:

01/27/2000 12:54:57 PM

 

 

 

 

 

 

 

 

 

 

District Member:

Tracy Stafford

Service Area:

County

 

 

 

 

 

 

 

 

 

 

Counties Affected:

Broward

 

 

 

 

 

 

 

 

 

 

Recipient:

North Broward Hospital District

Contact:

Charlotte Mather

 

303 SE 17th St.

Contact Phone:

(954) 355-5180

 

 

Ft. Lauderdale 33316

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Project Description:

 

 

 

 

 

 

 

The Asthma Intervention Management (AIME) program was developed in response to an urgent community need for better asthma education and standardized clinical protocols to facilitate a continuum of care for asthma patients.  The four components of AIME include a standardized plan of care, an intervention program, patient education and outcome/evaluation procedures.  Resources available to asthma patients will be offered in multi-lingual format.

 

AIME is a collaborative effort between the North Broward Hospital District. American Lung Association, Broward County Health Department, Broward County School Board and the Broward County Emergency Services for Children.  Policies, procedures, educational materials, interactive activities, and related documentation were developed by a multidisciplinary team of physicians, pharmacists, respiratory therapists, case managers, nurse practitioners, quality managers, community, and health care educators. 

 

Enrollees in the program will receive valuable asthma educational information/ materials and be able to participate in a variety of interactive educational programs.  The following are key success factors included in the program for the asthma patient: Basic Facts about Asthma, Signs/Symptoms Triggers, Roles of Medications, and Self-Management Skills, pieces will be distributed to all patients enrolled in the program.  The resources made available to asthma patients will be offered in Spanish, English, and Creole when available.  All educational materials utilized by the program have been developed and/or approved by an asthma task force and participating community partners in conjunction with participating physicians.

 

Asthma affects more than 77,000 Broward County residents.  It is the sixth-ranking chronic condition in our nation and the leading serious chronic illness of children in the United States.  It is also the number one cause of school absences attributed to chronic conditions, resulting in an estimated average of 7.3 school days missed annually.  In the United States, there are approximately 15 million asthmatics; nearly one third of them are children under 18 years of age.  The alarming increase in asthma prevalence, morbidity, and mortality over the past decade has triggered serious concern among pulmonary-care physicians and other scientists.  Asthma continues to take, an enormous toll on our nation in terms of untimely death, disability, family dysfunction, and costs to society in both direct health care and loss in productivity. In 1998, asthma incurred an estimated annual economic cost to our nation, in direct health care alone, of $7.5 billion and indirect costs (lost productivity) of $3.8 billion, for a total of $11.3 billion.  Among the ten most prevalent conditions, asthma ranks third in the nation in causing limitations of activity.

 

 

 

 

 

 

 

 

 

 

 

 

Services Provided/Benefit to State:

 

 

 

 

 

1.  Health Status Improvement: AIME will provide increased education and support to asthma patients and their families which will assist them in accessing the appropriate level of care.  In addition, AIME will reach out to community providers to educate them on the national standards and to help them in enhancing the level of care they provide to their patients, through the availability of standardized treatment protocols.  The goal is for patients who suffer with Asthma to experience an improved quality of life and learn greater self-management skills, which in turn will keep their illlnes under better control.  Clinical case managers will work with patients when it is appropriate to seek care in an ambulatory setting, at home, or through telephonic communication, this approach will address patients clinical concerns before the patient reaches the point where they need a severe level of intervention, such as a visit to the Emergency room and/or hospitalization.  The result is the patient spending less time seeking medical attention and more time for them to enjoy and participate in the daily activites of life.

 

2.  Asthma Education:  The program will promote an increase in asthma self-management skills through a variety of interactive educational programs including community events, educational literature, seminars and workshops that are sensitive to the cultural diversity of the community.

 

3.  Health Tracking/Case Mangement: On-going clinical case management and consistent clinical pathways will be provided for each asthma patient.  A clinical case manager will continuously evaluate the medical status of the patient group by tracking inpatient admissions, emergency department visits and compliance to asthma standards of care.  AIME will prevent avoidable emergency department visits and inpatient admissions which can be measured in an improved health status for the patient and a decrease in the overall health care costs to the system.

 

4.  Savings to the system:  The combination of clinical case management and education will lead to a decrease in health care costs.  During Fiscal year 1998, there were a total of 430 emergency department visits related to asthma.  The total cost of these patients was $302,000.  In addition, there were 393 patients admitted to the hopsital due to asthma.  These patients had an average length of stay of 6 to 7 days in the hosptial.  The total cost for these inpatients was $6.4 million dollars.  One of AIME's goals is to reduce the need for emergency visits and the number of inpatient hospitalizations by implementing the clinical care plans developed by the provider in collaberation with the clinical case manager.  The interventions that support the care plan are all based on increasing patient and family support and learning improved self-managment skills.  The AIME clinical case manager follows the patient while they are hospitalized ensuring their transition from the inpaitent setting back to their home and to the outpatient setting where the case manager will continue to work closely with the asthma patient's physician provider.  The North Broward Hospital District currently cares for over 8,400 asthma patients who are uninsured in our outpatient clinics.

 

 

 

 

 

 

 

 

 

 

Measurable Outcome Anticipated:

 

 

 

 

 

1. AIME will improve the health status of the patient through the case management and education components.  The AIME clinical case manager will closely monitor and track patients, which will allow the physician to know first hand the health status of the asthma patient and address clinical concerns as they arise.  This will assist in curtailing unnecessary Emergency Department vists.  The teaching of asthma self-management skills through a variety of interactive, culturally sensitive educational programs will empower the patient to manage their own asthma, which leads to a more productive and active ife.  In addition, the provider education component will enhance the quality of services asthma patients receive.  Enrolles will spend less time in a hospital or physician's office receiving services and more time involved in daily life such as school attendance, school activities, work related activites and social and family gatherings. 

2.  AIME will reduce health care costs spent on asthma and will incorporate measurable outcomes that will demonstrate a reduction in lost school and work days, emergency room visits, inpatient statys, and untimely deaths.  AIME will provide significant opportunties to prevent the need for acute lebels of care such as emergency department vists and inpatient hospital admissions by utilizing case managers individually assigned to patients with asthma.  The focus of the clinical case manager is to incorporate these self-managment skills into the patient's life, by helping them to identify early signs and symptoms of their condition.  The clinical case manager utilizes a variety of culturally sensitive, interactive educational programs in order to achieve these outcomes.  The clinical case manager works also very closely with the patient's provider monitoring their clinical results and ensuring compliance to the provider's treatment plan.  By solidifying, reinforcing and/or creating a partnership between the provider, patient, family and clinical case manager, the patient becomes a more active participant in their care and treatment.

 

AIME will: reduce comorbidities, reduce mortality, increase community awaremess of asthma, its symptoms and treatment, create individualized, comprehensive, culturally sensitive plans of care, patient understanding of their illness and invovlement in their plan of care, improve quality of life of the asthma patient, create cooperative efforts between clinicians, patients, care providers, educators and social workers, promote the state initiatives for disease state management programs; stressing prevention and education, reduce the use of the emergency department for patient care, reduce unnecessary and costly medical intervention, and reduce health care costs.

 

 

 

 

 

 

 

 

 

 

Amount requested from the State for this project this year:

$500,000

 

 

 

 

 

 

 

 

 

 

Total cost of the project:

$725,040

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 

 

 

 

 

 

 

 

 

 

 

Request has been made to fund:

Operations

 

 

 

 

 

 

 

 

 

 

 

 

 

Is there Local Government or Private match for this request?

 

Yes

 

 

 

 

In-Kind Amount:

$225,040

 

 

 

 

 

 

 

 

 

 

 

Was this project previously funded by the State?

 

No

 

 

 

 

 

 

 

 

 

 

 

Is future-year funding likely to be requested?

 

Yes

 

 

Amount:

$500,000

 

 

 

 

 

 

Purpose for future year funding:

 

Recurring Operations

 

 

Will this be an annual request?

 

 

Yes

 

 

 

 

 

 

 

 

 

 

 

 

Was this project included in an Agency's Budget Request?

 

Unknown

 

Was this project included in the Governor's Recommended Budget?

Unknown

 

 

 

 

 

 

 

 

 

 

 

Is there a documented need for this project?

 

Yes

 

 

Documentation:

Asthma patient claims data, Emergency Department Asthma Reports

 

 

 

 

 

 

 

 

 

 

Was this project request heard before a publicly noticed meeting of a body of elected officials (municipal, county, or state)?

Yes

 

 

Hearing Body:

Broward Legislative Delegation

 

Meeting Date:

02/01/2000