Jill Halterman, M.D., professor of Pediatrics at UR Medicine’s Golisano Children’s Hospital, has received a $3.6 million grant from the National Institutes of Health to research a preventive asthma intervention that could help patients better manage their condition while reducing acute emergency room visits.
The five-year study, which begins this month, will help connect pediatric asthma patients to primary care providers for follow-up after an emergency visit for asthma. The follow-ups would occur in the child’s school health office via telemedicine, ensuring easy access.
“Asthma is the most common reason for a pediatric emergency visit,” said Halterman. “But many of these patients don’t end up getting the preventive medication they need after being discharged, and they wind up back in the emergency department again a month later.”
Such recurring visits are nothing new. Direct health care costs for asthma top $50 billion annually in the United States, with hospital stays constituting the largest portion of these costs. But asthma, which affects 1 in 10 children, is a condition that can be effectively treated with appropriate preventive medications, meaning many of the hospital-related costs are avoidable.
Upon discharge, emergency departments have always encouraged patients to meet with their primary care physicians for long-term care. But many pediatric patients, particularly those experiencing disparity and barriers to appropriate care, may rely on emergency rooms for their health care and may have trouble attending a follow-up visit. These children are also much more likely to suffer from asthma.
“It can be very challenging for families,” said Halterman. “A caregiver will have just taken unplanned time off of work to bring their child to the emergency room, and now they are expected to find additional time to bring their child in for a follow-up appointment.”
Scheduling the follow-ups via telemedicine will help to solve this problem. Using a network that the Department of Pediatrics has established with the Rochester City School District, children who have been referred after an emergency room visit can be seen during the school day, in the school health office, by a pediatric provider working remotely. This allows their caregivers to return to work, if needed, with communication with the provider occurring via teleconference or telephone.
Should the research yield promising results, Halterman believes it can be adopted by health care networks throughout the country, which could help countless children prevent their asthma from reaching serious levels while reducing emergency room volumes.
The research builds on several of Halterman’s previous studies, which have attempted to improve the delivery of preventive asthma care, particularly for those from low-income families. She has also explored methods to promote the proper use of and adherence to asthma medications through partnerships with schools and school nurses.