Posted: 8/21/2017
Spirometry test provides more accurate diagnosis, treatment
In Texas, approximately 1.4 million adults and 617,000 children have asthma. According to the Texas Department of State Health Services, asthma is one of the most common long-term chronic diseases in childhood. Many of those patients seek treatment at Parkland Health & Hospital System’s Community Oriented Primary Care health centers (COPCs). In fiscal year 2016, Parkland treated 4,109 patients with asthma diagnoses; 2,830 were adult patients and 1,279 were pediatric.
Asthma symptoms vary from person to person. The most common include shortness of breath, chest tightness or pain, coughing or wheezing and episodes that worsen with respiratory viruses like the flu. These symptoms tend to appear when exposed to triggers like extreme weather changes, pollen, smoke, chemicals and exercise. Although determining if a child has asthma can be difficult, specific tests can pinpoint the diagnosis.
In 2016 assisted by funding from the Network Access Improvement Program (NAIP), Parkland physicians began administering spirometry tests on pediatric patients aimed at improving asthma diagnoses. NAIP was created by the 83rd Texas Legislature to increase the availability, quality and effectiveness of primary care for Medicaid clients by providing incentive payments administered by managed care organizations to participating health institutions and public hospitals.
Spirometry measures a patient’s overall lung function by measuring the amount of air they can breathe in and out of their lungs, and how hard and fast they can breathe. During the test patients breathe into a mouth piece attached to a tube connected to a spirometer.
“Without the test, you have to diagnose people with asthma based on their symptoms and their response to medication, which may not be the best way to do it,” said Barbara Durso, MD, Lead Pediatrician at Parkland’s Oak West Health Center. “Spirometry allows us to refine how we diagnose people and how we manage their medication.”
Dr. Durso says Parkland’s Oak West Health Center was an excellent location to pilot the use of the test because many asthma patients seek treatment there. “Oak West is a hot spot for asthma. The reasons are unclear, but asthma is often linked to areas of high population density, exposure to indoor allergens, and proximity to major highways, among other factors,” she said.
Due to its effectiveness, the procedure is now used in five of Parkland’s 12 COPCs. Improvements in the electronic health record (EHR) have also helped doctors better document every step in the treatment process.
“The information we receive from this test along with other data is incredibly helpful. Alert messages pop up when we open patient charts informing the provider that the person may be a high-risk patient. We then remind people they need to take their controller medication,” Dr. Durso said.
The EHR also allows doctors to see if prescriptions are filled and picked up by patients.
“In the past we just had to take their word for it. We had no way of knowing if they were taking their medicine or if it was working. All these pieces of information that we didn’t have access to in the past make a huge difference in the care we provide now,” Dr. Durso said.
“These types of tools help us improve our patients’ quality of life and in many cases save lives,” she stated.
For more information on services at Parkland, please visit www.parklandhospital.com.