6 | SBH Caring
FOR YOUR
Health
SBH Caring
FOR YOUR
Health | 7
ASTHMA ALLEY
As a member of Bronx Partners for Healthy Communities,
whose mission is to transform the healthcare of people
who live in the Bronx, the state’s least healthy county,
a.i.r. bronx’s mission is to keep asthmatic children and
adults healthy, active and out of the hospital.
“We reach the patient at a point where the clinician
visit ends,” says Shoshanah Brown, the organization’s
executive director. “This includes making sure patients
take the proper medication, understand the different
medication options and usage, and adjust those
environmental issues (including pets, mold, roaches,
etc.) where housing conditions are substandard and
people are living in unhealthy conditions and need
extra help.”
a.i.r. bronx also links patients to housing and
legal services and coordinates with doctors’
offices to address all issues which make asthma
hard to manage.
Community health workers focus on education, conduct
home assessments to identify triggers, and design plans
to bring the individual’s asthma under control. What
makes a.i.r. bronx unique is its strategic use of data as
a core element of its model. Community health workers
employ 4G-equipped smartphones and tablets in the
field to record data in real time and build a sophisticated
patient management system with rich analytic capacity.
Meanwhile, community health workers speak the language
of the community. They both have an intimate knowledge
of the community and are fluent in English, Spanish, French,
Mandingo, Mandarin, and other languages spoken here.
Bronx Partners for Health Communities, led by SBH
Health System (St. Barnabas Hospital), is a partnership
of over 200 Bronx-based organizations with a new
vision for healthcare in the Bronx. Members work
together to make high-quality, coordinated health
services accessible for every Bronx resident.
It’s the perfect storm:
heavy
traffic, construction, overcrowded
living conditions, a high rate of
smokers, poor compliance.
As a result, it’s no surprise that the Bronx
has the highest incidence of asthma in
America – and it’s not even close. The
hospitalization rate is 21 percent higher
than the national average and the death
rate from asthma is 43 deaths per million
residents (compared to 13 deaths per
million throughout New York State).
“Our Emergency Department sees
about 400 patients with asthma
every month,” says Dr. Mihai Smina, a
pulmonary specialist with the Center for
Comprehensive Care at SBH Health
System (St. Barnabas Hospital). “Our
physicians and physician assistant
speak to repeat patients in the ER and
make appointments with them, yet only
about 10 percent follow up.
We’re working hard to better educate
patients and improve compliance.”
The Center for Comprehensive Care
treats asthma patients who are 16
years of age and over (in addition to
younger patients who are seen at the
center’s pediatric allergy clinic). Initially,
specialists evaluate and diagnose
patients – an important need, says Dr.
Smina, as 40 percent of these patients
are actually found to have COPD,
congestive heart failure, sleep apnea,
or some other condition. They check
patients’ medications and adjust them
if necessary. A pharmacist dedicated
to the center answers questions
regarding the use of inhalers, nebulizers
and bronchodilators. Patients undergo
a pulmonary lung function test and
those who smoke are encouraged to
participate in the smoking cessation
program. For those with more severe
asthma, the use of advanced therapy,
such as injectable medications, may be
explored. A referral may be warranted
to a.i.r. bronx (Asthma, Intervention and
Relief), an organization that brings care
into the patient’s home by checking for
and remediating such risk factors as
dust, mold, and vermin.
“Most importantly, we put together an
action plan that examines the triggers
that cause the patient’s asthma attacks
and offers solutions,” says Dr. Smina.
“With these patients, we’ve had very
good results in getting them the help
they need to avoid trips to the ER
and hospitalization.”
for asthma patients
In search of
FRESH AIR
SBH Health System is partnering with a.i.r. bronx
to provide
FREE
, home-based services to children
and adults in the Bronx with poorly controlled asthma.
by Steven Clark
Treating Asthma in the Bronx
“We put together an action
plan that examines the
triggers that cause the
patient’s asthma attacks
and offers solutions.”
