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. 2023 Mar;11(3):855-862.e4.
doi: 10.1016/j.jaip.2022.11.032. Epub 2022 Dec 12.

Leveraging Electronic Health Records for Guideline-Based Asthma Documentation

Jeremy Landeo-Gutierrez  1 , Andrew Defante  2 , Matejka Cernelc-Kohan  1 , Kathryn Akong  1 , Aparna Rao  1 , Daniel Lesser  1 , Thu Elizabeth Duong  1 , Eulalia R Y Cheng  1 , Julie Ryu  1 , Kelan Tantisira  3
Affiliations

Leveraging Electronic Health Records for Guideline-Based Asthma Documentation

Jeremy Landeo-Gutierrez et al. J Allergy Clin Immunol Pract. 2023 Mar.

Erratum in

  • Correction.
    [No authors listed] [No authors listed] J Allergy Clin Immunol Pract. 2023 Dec;11(12):3823. doi: 10.1016/j.jaip.2023.10.033. J Allergy Clin Immunol Pract. 2023. PMID: 38065652 No abstract available.

Abstract

Background: Asthma is the most common pediatric chronic disease; thus, clinical guidelines have been developed for its assessment and management, which rely on systematic symptom documentation. Electronic health records (EHR) have the potential to record clinical data systematically; however, variability in documentation persists.

Objective: To identify if the use of a structured asthma template is associated with increased guideline-based asthma documentation and clinical outcomes when compared with the use of nonstructured ones.

Methods: We performed a retrospective case-control study comparing the use of nonstructured templates (NSTs) and asthma-structured templates (ASTs) in new patient and first follow-up encounters, evaluated by pediatric pulmonologists between March 2016 and December 2021. Asthma history items were selected following clinical guidelines, summarized in 29 items for new and 22 items for follow-up encounters. Associations with demographic, spirometry, and health care utilization were explored.

Results: A total of 546 initial encounters were included; 450 used structured templates. The use of an AST was associated with higher documentation of asthma items in initial and follow-up encounters. Linear regression analysis showed that the use of ASTs was associated with a 28.2% and 39.65% increase in asthma history completeness (in initial and follow-up encounters, respectively), compared with the use of NSTs. AST use was associated with higher rates of systemic steroid prescriptions within 12 months. No other differences were observed after adjusting for asthma severity.

Conclusions: Using asthma-specific structured templates was associated with increased guideline-based asthma documentation. Leveraging the EHR as a clinical and research tool has the potential to improve clinical practice.

Keywords: Asthma; Children; Documentation; Electronic health records; Guideline-based documentation; Pediatric pulmonology; Structured data entry systems; Structured templates.

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Conflict of interest statement

Conflicts of interest: The authors declare that they have no relevant conflicts of interest.

Figures

FIGURE 1.
FIGURE 1.
Boxplots of structured template use and asthma history completeness in initial and follow-up encounters.
See this image and copyright information in PMC

References

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