Project Summary

PCORI implementation projects promote the use of findings from PCORI-funded studies in real-world healthcare and other settings. These projects build toward broad use of evidence to inform healthcare decisions.

This PCORI-funded implementation project is expanding use of an electronic asthma tracker, or e-AT, which improved asthma control in children.

Asthma is a common chronic illness in children that can make it hard to breathe. Asthma attacks can cause children to miss school and their parents to miss work. Being aware of asthma symptoms and changing treatments early before asthma symptoms get worse can help prevent severe asthma attacks. 

What is the goal of this implementation project?

Being aware of asthma symptoms and changing treatments when asthma gets worse can help children and their families prevent severe attacks. A PCORI-funded study found that children who used the e-AT had improved asthma control and quality of life than those who didn’t use it. In addition, children had fewer missed school days, asthma attacks, emergency room, or ER, visits, and hospital admissions. Parents also missed work less often.

This project will expand use of the e-AT for children with asthma and their families to improve asthma control and quality of life and reduce hospital and ER visits due to asthma attacks.

What will this project do?

The project team is rolling out the e-AT at 61 clinics and community health centers. The sites serve patients in Utah and three surrounding states. To use the e-AT, children or their families enter their asthma symptoms in English or Spanish on a website through a computer or smart phone once a week. The e-AT then calculates an asthma control score. The e-AT tracks changes in asthma control over time and sends suggestions for follow-up care. If symptoms get worse, the e-AT sends alerts to parents and to the children’s clinics.

The project team is training care managers and clinic staff, including nurses, assistants, and doctors, on

  • The benefits of the e-AT
  • How to identify families who could benefit from the e-AT and how to enroll patients
  • How to use a web-based dashboard at each site to help care managers and clinic staff track family use of the e-AT
  • How to monitor changes in children’s asthma control and respond to alerts in a timely fashion when children’s symptoms start to get worse

Throughout the project, the project team is providing ongoing support to care managers and clinic staff. Support includes monthly virtual meetings and calls, site visits, in-person meetings, and monthly patient user reports.

What is the expected impact of this project?

This project will show what’s required to put the e-AT in place through a health insurer and at clinics and community health centers, including those that mainly serve Spanish-speaking and Native American children.

Through this project, sites will use the e-AT with more than 6,000 children with asthma. The project evaluation will confirm if the e-AT is working as intended to improve asthma control.

More about this implementation project:

Stakeholders Involved in This Project

  • Utah Pediatric Partnership to Improve Healthcare Quality (UPIQ)
  • Utah Department of Health Asthma Program
  • Utah Medicaid
  • University of Utah Health Plans
  • Intermountain Healthcare

Implementation Strategies

  • Use an electronic system, e-AT, that includes clinical decision support -- real-time results interpretation and recommendations.
  • Adapt the e-AT program to work with sites’ existing resources and workflows.
  • Provide sites with IT tools to support implementation, including alerts, reminders, and dashboards to support use by families and clinic staff.
  • Provide educational materials to patients, as written materials and videos.
  • Train care managers and clinic staff to use the program in-person, as well as through written materials and videos.
  • Use a phased implementation approach, launching the program in three waves.
  • Identify and prepare physician champions and systems leaders at sites.
  • Conduct site visits.
  • Provide technical assistance to sites, including practice facilitation and consultation.
  • Offer primary care physicians maintenance of certification credits from the American Academy of Pediatrics.

Evaluation Outcomes

To document implementation:

  • Number of care managers and clinic staff trained and using e-AT
  • Number of patients using e-AT
  • Additional measures of acceptability, fidelity of program delivery and use, maintenance
  • Implementation barriers and facilitators

To assess healthcare and health outcomes:

  • Number of ED visits and hospital admissions
  • Oral corticosteroid use
  • Asthma medication ratio
  • Asthma control
  • Number of interrupted/missed school days
  • Number of interrupted/missed workdays
  • Patient self-management skills

Project Information

Flory Nkoy, MD, MS, MPH
University of Utah

Key Dates

November 2019
August 2023

Study Registration Information

Initial PCORI-Funded Research Study

This implementation project focuses on putting findings into practice from this completed PCORI-funded research study: Does an Advanced Electronic Tracker Help Families Manage Children's Asthma Symptoms Better Than a Standard Electronic Tracker?


Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
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Last updated: September 26, 2023