Washington Asthma Initiative

1
Washington Asthma Initiative

• The Asthma Plan for Washington
• Presentation for All-Plan Medical Directors
  meeting June 10

2
Washington Asthma Initiative

• "To mobilize individuals, organizations, and
  communities throughout the state to improve the
  prevention, diagnosis, and management of asthma
  in order to decrease its individual and societal
  burdens."

3
WAI Background

• Phase I 1997 to 2001 (Len Hudson, MD)
• Washington State Asthma Project Accomplishments
• Distributed 15,000 pocket sized NAEPP asthma
  guidelines
• Community awareness campaign - Chad Brown
• Organized statewide data on asthma alaw.org
• Prevalence, hospitalization, mortality by county
• Supported development of local and regional
  resource guides
• Mobilized community coalitions
• Delivered gt 5 CME/CE programs on asthma
  management
• Initiated the annual Washington State Asthma
  Summit

4
(No Transcript)
5
Washington Asthma Coalitions

• Map here

6
Washington Asthma Coalitions

• Structure and variation
• Successes and Barriers
• Sustainability

7
WAI Background

• Phase II 2001 to -
• Washington Asthma Initiative
• Steering Committee (15 members)
• Four Work Groups
• Provider Education Nancy Anderson, Peggy
  Odegard.
• Data and Resources Randy Legg, Penny Nelson
• Advocacy Laird Harris, Art Sprenkle, Nick
  Federici, Jim Kreiger
• Community Activities Leslie Benoit, Barbara
  Baker

8
2002-2004 Outcomes

• Standardize Tools
• Common state guidelines for diagnosis, clinical
  assessment and treatment of asthma
• WSMA, DoH, ALAW (WAI), Health Plans
• Common asthma action plans
• WSMA, DoH, ALAW (WAI), KCAF, Medicaid, Health
  Plans
• Dissemination of these efforts
• Professional Education
• Professional education programs (Asthma Educator
  Institute)
• Advanced practitioner education programs
• Medical assistant training program
• Supporting ongoing QI and clinic-based efforts in
  asthma disease management
• CHPW, McKesson and Medicaid, etc.

9
Next Steps to Improve Asthma Care in Washington
State

• Improve provider adherence to guidelines
• Empower patients to take control of and
  responsibility for their disease
• Improve the ability of clinics to engage in
  chronic disease management, to include
• Guideline centered practice
• Severity assessment
• Patient tracking
• Patient education
• Adherence to therapy
• Develop a statewide asthma plan for addressing
  asthma

10
System Assessment

• Asthmatic Population

11
System Assessment

• Medical Home
• 99 WA asthmatics under primary care
• 25 (150K) under specialty care

12
System Assessment

• Insurance
• 12 (72K) do not receive services
• 20 (120K) do not receive medications
• 12 (72K) do not receive durable medical
  equipment (DME)

what do the commercials cover??
13
System Assessment

• Elements of optimal care
• 75 (360,000) should have an action plan
• 80 (288K) of these do not
• 75 population should be on controller medication
• 50 (225K)of these do not

14
What improves asthma outcomes?

• Action Plan
• Adherence to Controller Therapy
• Registries ?
• Patient Education /-
• Provider Education /-
• Severity Assessment ?
• Spirometry Measurement ?

15
WAI Asthma Plan Logic Model


Enhance Infrastructure
Risk Reduction
Decreased Incidence
Individual Behavior Change
Mobilize Support
Earlier Detection
Decreased Morbidity
Assess Address Asthma Burden
Build Partnerships
Guideline centered care
Decreased Mortality
System Environmental Change
Utilize Data Research
Improved adherence
Improved Quality of Life
Conduct Evaluation
Reduced Disparities
Effective Management
16
Five Essential Components of an Integrated Asthma
Plan
17
WAI Organizational Chart
18
Developing the Plan

• Basic steps at the work group level
• Defining the scope
• Recruiting participants
• Gathering evidence
• Assessing evidence
• Making evidence-based decisions to develop goals,
  objectives, and strategies

19
Purpose of Plan

• Framework and guide for coordinated and
  integrated statewide efforts
• Highlight priority asthma issues in WA
• Set goals and objectives for improvement
• Propose evidence-based or theory-based strategies
• Catalyst / focal point for ongoing WAI

20

• When You Cant Breathe
• Nothing Else Matters!

21
Washington Asthma Initiative

• "To mobilize individuals, organizations, and
  communities throughout the state to improve the
  prevention, diagnosis, and management of asthma
  in order to decrease its individual and societal
  burdens."