title: TLC-Asthma: an integrated information system for patient-centered monitoring, case management, and point-of-care decision support.
abstract: A great deal of successful work has been done in the area of EMR development, implementation, and evaluation. Less work has been done in the area of automated systems for patients. Efforts to link data at multiple levels - the patient, the case manager, and the clinician have been rudimentary to-date. In this paper we present a model information system that integrates patient health information across multiple domains to support the monitoring and care of children with persistent asthma. The system has been developed for use in a multi-specialty group practice and includes three primary components: 1) a patient-centered telephone-linked communication system; 2) a web-based alert reporting and nurse case-management system; and 3) EMR-based provider communication to support clinical decision making at the point-of-care. The system offers a model for a new level of connectivity for health information that supports customized monitoring, IT-enabled nurse case-managers, and the delivery of longitudinal data to clinicians to support the care of children with persistent asthma. Systems like the one described are well-suited, perhaps essential, technologies for the care of children and adults with chronic conditions such as asthma.
authors.affiliation: Boston University School of Medicine/Boston Medical Center, MA, USA.
authors.forename: William G
authors.initials: WG
authors.lastname: Adams
authors.forename: Anne L
authors.initials: AL
authors.lastname: Fuhlbrigge
authors.forename: Charles W
authors.initials: CW
authors.lastname: Miller
authors.forename: Celeste G
authors.initials: CG
authors.lastname: Panek
authors.forename: Yangsoon
authors.initials: Y
authors.lastname: Gi
authors.forename: Kathleen C
authors.initials: KC
authors.lastname: Loane
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Madden
authors.forename: Anne M
authors.initials: AM
authors.lastname: Plunkett
authors.forename: Robert H
authors.initials: RH
authors.lastname: Friedman
mesh_terms: D000293:Adolescent; D000555:Ambulatory Care Information Systems; D001249:Asthma / Q000451:nursing / Q000628:therapy*; D019090:Case Management; D002648:Child; D002675:Child, Preschool; D003199:Computer Systems; D020000:Decision Support Systems, Clinical; D006801:Humans; D020407:Internet; D008404:Massachusetts; D016347:Medical Records Systems, Computerized; D024802:Nurse's Role; D010353:Patient Education as Topic; D018802:Patient-Centered Care; D019095:Point-of-Care Systems; D011320:Primary Health Care / Q000458:organization & administration*; D012648:Self Care / Q000379:methods; D018511:Systems Integration; D013689:Telephone