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Researchers and data experts at the Dell Medical School at the University of Texas at Austin say a new database will help doctors treat children with asthma, while helping parents better understand how to reduce the frequency of attacks.
With funding from the Michael & Susan Dell Foundation, a team at the Dell Medical School at UT Austin is trying to help patients and doctors track and mitigate environmental conditions that trigger asthma attacks. Factors like pollution, housing conditions and allergens not only cause asthma attacks, but are also linked to health disparities. Currently, uninsured, lower-income and black communities are more affected by asthma.
Dr. Louis Appel, a pediatrician People’s Community Clinic, will be among the first doctors to have access to this database.
During a recent visit at a PCC clinic in Austin, Appel spoke to Katrina Robinson about her 10-year-old son, Darren, who has had asthma since he was a baby. He asks about Darren’s medication, about his allergies – particularly, to his two cats.
Towards the end of their conversation, Appel asked Robinson if there are any other factors she thinks could be affecting Darren’s asthma.
Robinson says a construction crew has been doing work around their home. They’ve mostly been cutting trees and that dust has gotten in her house, which has aggravated Darren’s asthma.
It’s those kind of environmental factors, doctors say, that have a big effect on someone with asthma.
Dr. Anjum Khurshid says his research team at Dell Medical hopes the database they’re designing will enumerate those factors – for doctors and patients.
“The main impetus of the project that we are doing is to being able to build a platform that allows us capture data from different sources,” he said.
The database will collect information from organizations like the City of Austin, nonprofits and even the EPA. They’re also collecting data about neighborhoods – considering factors like access to food, transportation and parks – as well as information about area-specific allergy threats.
Khurshid said they are also working on a way to include this data on a child’s electronic medical record, so doctors treating children with asthma would have information right in front of them.
“Right now, you know honestly, we spend a lot of time working on the medication management, for better or worse,” said Appel.
Appel says it will be useful to have a more helpful conversation with families about things other than medication that they can look out for.
“I think the environmental stuff is a definitely a big issue,” he said. “The more information we have about that – and the more we can really get down to figuring out what does trigger somebody and work to prevent the asthma exacerbation in the first place – the better we are.”
Robinson said any help is welcome, because having kid with asthma is scary.
“It’s because you feel so helpless,” she said. “You can’t do anything. You are just hoping the medication is going to work – or that you can get to the hospital in time.”
She said there are times an asthma attack will wake Darren up in the middle of the night. If the medicine is ineffective, they’ll often end up going to the hospital – and Darren often ends up missing school.
“When you go into the E.R. for asthma you are going to be there a long time,” Robinson said. “And sometimes it takes a long time to resolve the asthmatic issue because sometimes you don’t even know what’s causing it.”
Khurshid and his team want to arm doctors with data to help families prepare for, and maybe even prevent, situations that could cause severe asthma attacks.
“What we do in clinical practice only affects 20 percent of the outcomes,” he said. The other 80 percent, Khurshid says, are affected by where and how people live. That’s why, he says, it’s important to make managing a chronic condition a team project, and that patients should be armed with information, too. That way, when they aren’t with their doctor, they know what to avoid, or what to do to prevent, an asthma attack.
“As we think of a more holistic way of managing a condition and managing a patient, rather than just a provider of services, we start thinking of other factors or what other information that will help us make that care plan be more patient-centric,” he said.
For example, a doctor could eventually refer someone to the city to improve their housing conditions or email them a warning that the pollen count is going to be especially high that day, so they could avoid going outside.
Khurshid said all this could make a doctor’s treatment plan more effective, ideally leading to better patient health.
He says his team plans to have the database up and running by early next year.
It will launch in the Central Texas area with People’s Community Clinic, but he hopes it can eventually expand to other areas, as well as used for other chronic conditions.
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