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The Asthma Kiosk: A Patient-centered Technology for Collaborative Decision Support in the Emergency Department

Affiliations of the authors: Department of Medicine (SCP, DAG, ISK) and Children's Hospital Informatics Program (SCP, ZC, ISK), Children's Hospital Boston, Boston, MA; Graduate Program in Human Factors and Information Design, Bentley College, Waltham, MA (SCP, WG).

Correspondence and reprints: Stephen C. Porter MD, MPH, Division of Emergency Medicine, MA-001, Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02115; e-mail: <stephen.porter{at}childrens.harvard.edu>.

Received for publication: 03/08/04; accepted for publication: 06/16/04.

The authors report on the development and evaluation of a novel patient-centered technology that promotes capture of critical information necessary to drive guideline-based care for pediatric asthma. The design of this application, the asthma kiosk, addresses five critical issues for patient-centered technology that promotes guideline-based care: (1) a front-end mechanism for patient-driven data capture, (2) neutrality regarding patients' medical expertise and technical backgrounds, (3) granular capture of medication data directly from the patient, (4) formal algorithms linking patient-level semantics and asthma guidelines, and (5) output to both patients and clinical providers regarding best practice. The formative evaluation of the asthma kiosk demonstrates its ability to capture patient-specific data during real-time care in the emergency department (ED) with a mean completion time of 11 minutes. The asthma kiosk successfully links parents' data to guideline recommendations and identifies data critical to health improvements for asthmatic children that otherwise remains undocumented during ED-based care.

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