Design:  AAP documentation was noted for all in-person, asthma-related visits prior to the pandemic over a 3 week period from 1/13 to 1/31/20. The same data was collected for 3 weeks of telemedicine visits from 4/27 to 5/15/20. The first Plan-Do-Study-Act (PDSA) cycle involved sending twice-weekly reminders to all allergy-immunology faculty requesting that they “favorite” the AAP CPT code in the EMR to allow for more visible access when completing asthma visit billing.

Main Findings:  Provider AAP documentation was similar in the pre- and post-telemedicine audits (48% and 45%, respectively). The first 2-week PDSA cycle improved provider AAP generation to 73% for all asthma-related visits, exceeding our goal of 70%.

Impact on Practice:  Straightforward process changes can lead to increased provider and parent use of AAPs as demonstrated by the PDSA cycle interventions. To limit manual chart review, the Children’s Healthcare of Atlanta’s performance analytics team assisted in developing a report that automatically generates information regarding AAPs and ACT scores for all asthma-related visits. This report is accessible to multiple divisions via a secure, online reporting portal and will be used to streamline data collection for future asthma-related QI projects.


Submitted by Katherine Tison, MD  from Emory University and Children's Healthcare of Atlanta