A computerized surveillance system for asthma

Purpose: Asthma is a chronic inflammatory airways disease characterized by acute exacerbations interspaced by symptom-free periods. Its management imposes a substantial burden on healthcare services, as well as personal suffering and significant financial tolls. The aim of this paper is to demonstrate links between routinely used computerized databases and to establish an automatic mechanism for monitoring asthma patients. Design/methodology/approach: The study population was all adult subscribers to a major health maintenance organization (HMO) in Southern Israel (230,000 adults, age 20-65 years). Relevant data for this retrospective analysis (2000 to 2004) were extracted from several computerized databases routinely used in the service: pharmacy; administrative; and each person's personal computerized medical file in the primary care clinic. Findings: Based on data from 72 regional primary care clinics, during the study period, 11,054 adults were treated simultaneously by β₂ agonists and steroids - assumed to be asthmatics. In contrast, asthma diagnosis was recorded in only 4,061 personal files. The intersection between two databases yielded 2,569 persons recorded in both. These findings attest to the feasibility of developing computerized automatic surveillance systems for monitoring asthma patients with certain algorithms to assure service quality. Research limitations/implications: Data extracted from the various databases were unequal quality, a factor that imposed data management difficulties. Practical implications: Similar surveillance systems can be developed relatively easily by using comparable algorithms for monitoring different chronic diseases or introducing management indices to secure quality of services. Originality/value: The paper focuses on developing an automatic asthma monitoring model, using information from routinely used computerized HMO DBs.