Arrowhead Regional Medical Center and the County of San Bernardino in association with the Asthma and Allergy Foundation of America have implemented a new approach to pediatric asthma management by establishing a program that provides care via an “asthma clinic on wheels”. The Breathmobile® provides coordinated case identification, structured mobile office visits, diagnostic testing, physical exam, pharmacological therapy and patient/family education in asthma management. The Breathmobile® staff consists of a physician who is a pediatric allergist, a licensed vocational nurse, a clinic assistant and a respiratory therapist, specially trained in asthma case management. The Breathmobile® team in collaboration with school nurses and health aides facilitates initial identification of patients. Ongoing communication with the school nurses and health aides helps the patients remain compliant with their asthma management program. During the school hours the Breathmobile® staff sees patients that attend the school site as well as any child referred from the surrounding area. A complete evaluation, examination, care plan and extensive patient family education are completed at the time of the visit. The Breathmobile® healthcare model has proven to be very successful in overcoming the complex social and economic barriers that can prevent successful chronic disease management in children in lower socio-economic areas.

The goal of the Breathmobile® program is to help children control their asthma by providing accessible care at local school sites.

Fifty-nine patients entered the program during 2007 and received on-going care for > 1 year. Emergency Room visits decreased by 63% and Hospitalizations decreased by 83%. Of the 51 patients that were included in the absenteeism portion, the percentage of patients that missed > 5 days of school decreased from 45.1% to 2.0%. Seventy-five percent of children participating in the program have their asthma symptoms under control by the third follow-up visit, regardless of the severity of their illness. The Breathmobile® program has referred 118 children to the Coordinated Asthma Referral and Education (CARE) Program for continued asthma management.