Project Title:
Innovative Approaches to Better Detect and Treat Asthma and Chronic Obstructive Pulmonary Disease in Durham
Project Co-Leads:
Betty Masten, M.D., Lincoln Community Health Center
Monica Kraft, M.D., Duke Asthma, Allergy and Airway Center
Proposal Abstract:
Asthma and chronic obstructive pulmonary disease (COPD) are severe and under-recognized diseases in Durham County. COPD is the second leading cause of death in Durham, but the prevalence is recorded as only 2%! Asthma prevalence in Durham middle schools is 15.4% overall and 27.5% among African-American students, 2-3 times higher than national averages.
Durham County residents utilize the Duke Health System significantly: there were 61,933 visits from patients from Durham County to either Duke or Durham Regional Hospital for asthma or COPD between December 2006 and 2008. Of these patients, approximately 40% were uninsured or covered by Medicaid; 30% were covered by Medicare. Thus, the burden of respiratory disease is high in Durham County, with a large percentage of this population covered by federal programs or uninsured. In response to these astounding statistics, we are proposing an innovative model of care that builds upon programs existing in Durham county for patients with asthma and COPD, but adds two key components:
- a health care/quality improvement team that includes Lincoln Community Health Center (LCHC) and all primary care practices in Durham that will identify high risk patients with asthma and COPD and
- an asthma/COPD clinical decision support registry, the latter based on SEBASTIAN, developed at Duke. We propose a means to unite and coordinate the care of patients with chronic respiratory disease by allowing access to all electronic medical records of primary care practices in Durham and Duke using this model.
We also plan to integrate with other chronic care programs to create a comprehensive model that will change primary care practice and specialty referral in Durham County.
Asthma Final report [PDF]
