By Megy Karydes
Troyanna’s asthma was so severe and uncontrolled that the 17-year-old Dunbar Vocational Career Academy student was making monthly visits to the hospital’s emergency room or being admitted to the intensive care unit. While her health needed immediate medical attention, her asthma caused her to miss school, which affected her grades and prevented her from participating in sports.
She wasn’t the only student suffering from asthma in the Bronzeville area high school. “Many students were leaving early due to medical reasons associated with asthma,” admits Karen Batty, nurse practitioner with Mercy Dunbar Clinic at Dunbar Vocational Career Academy. The school didn’t have the tools needed to proactively screen for asthma, and Batty knew that students’ medical problems would persist if their asthma went untreated.
Health Care Service Corporation (HCSC), the largest customer-owned health insurance company, has partnered with the American Lung Association (ALA) to launch the Enhancing Care for Children with Asthma Project in 2011, with the goal to reduce the impact of asthma and improve the health and quality of life for children across four states: Illinois, New Mexico, Oklahoma and Texas. Batty didn’t hesitate to join the program when it was offered to her school.
“With this program, we hoped to give our students a better quality of life by taking control of their asthma and providing the proper medication to treat it,” she says. “Prior to the HCSC and ALA partnership, many of our students were not using their medications properly, or they were receiving the wrong prescription.”
As part of the program, HCSC and ALA provided clinical trainings, including how to manage asthma, open airways and conduct and interpret spirometry. The program’s leaders developed several quality indicators, including severity rating, patient self-assessment about asthma control, use of controller medications, written asthma action plans, spirometry, patient education, absenteeism and healthcare utilization.
In a clinic visit as part of the Asthma 101 pilot by HCSC and ALA, which follows the nationally recognized asthma-care guidelines, the team used its new NIOX machine (from the ALA) to measure airway inflammation. They discovered that Troyanna needed an anti-inflammatory added to her medication regimen. Since altering her medication plan, she has not been hospitalized and has resumed school.
The Asthma 101 program implemented at Dunbar Vocational Career Academy has become a model for other schools, according to Marla Kushner, DO, a clinician who runs the Mercy Dunbar Clinic and served as the lead physician for this program. “Mercy Dunbar Clinic treats between 100 and 200 students with asthma, many of whom do not have primary care physicians and are on Medicaid,” Kushner says.
Batty worked closely with all her student patients to develop asthma action plans, which has proved enormously effective, she says. “Many students have [environmental and] social factors that impact their asthma, such as mold in their homes or other stressors,” she notes. “For example, Troyanna was living in an environment with smoke and mold, and did not realize this has an impact on her asthma. Through the program, we also work closely with social workers who help students like Troyanna move or reduce their environmental triggers for asthma.”
“We also did a huge asthma education push in our school, so our teachers are more equipped to identify and help students gain treatment for asthma,” she adds.
Across 69 clinics nationally, the Enhancing Care for Children with Asthma Project has improved asthma management for an estimated 480,000 children with asthma and their parents.
The numbers look great on paper, but the real benefit is for those battling this disease. There is no doubt that this program helped Troyanna. During the Asthma 101 class, Troyanna learned how to manage her asthma symptoms and medications; something she’d never been taught. She had been taking medications for years, not knowing what each medication was supposed to do for her.
“I now know how to properly use the NIOX machine, my inhaler and my preventive medication,” she adds. “Through this treatment and prevention, I have even been able to join the cheerleading squad and volleyball team. The first summer with treatment, I only had to go to the hospital once because of an allergic reaction. Before treatment, I would go four or more times in the summer.”
HCSC’s partnership with ALA shows how consumers can benefit from partnerships between nonprofits, health insurers and educational institutions. It’s a model that can be replicated on a wide scale to reduce absenteeism and improve the quality of life of asthma sufferers. In a partnership like this, training educators, providers and families is critical in enabling asthma patients to take control of their symptoms and lead a healthy, active life.