Asthma Educator Sharing Day

October 17, 2011

Karen Meyerson, MSN, RN, FNP-C, AE-C

Update on Asthma Educator Certification and

Asthma Advocacy Efforts

Overview Role of Certification NAECB Update Advocacy Efforts on Capitol Hill

National Asthma Educator Certification Board (NAECB)

Mission Statement

– To promote optimal asthma management and quality of life among individuals with asthma, their families and communities, by advancing excellence in asthma education through the Certified Asthma Educator process.

National Asthma Educator Certification Board

Why is Certification Important? Role of the Asthma Educator has increased over the

past two decades as research demonstrated the importance of a well-educated, informed patient in the management of this chronic disease.

Needed to standardize the process to certify Asthma Educators/Coordinators/Counselors and to evaluate their effectiveness in disease management.

Certification assures that information obtained from a Certified Asthma Educator (AE-C) is based on scientifically sound concepts of disease management.

National Asthma Educator Certification Board (NAECB)

Voluntary health certifying board Created in 2001 – first exam offered in 2002 Purposes:

– To prepare examinations to test the qualifications of candidates for certification as asthma educators

– To conduct and evaluate these examinations

2011 NAECB Board of Directors

Stuart Abramson, MD, PhD, AE-C Traci Arney, MN, NP-C, FAANP, AE-C Suzanne Bollmeier, PharmD, BCPS, AE-C Mary Cataletto, MD, AE-C Clifton Dennis, RRT, AE-C Rose Dennis, MS, RN, RRT, CPFT, AE-C

Linda Ford, MD, FACAAI, FAAAAI, AE-C – Board Emeritus

Antoinette Gardner, RN, BSN, MEd, AE-C – Board Emeritus

Andrew Harver, PhD, AE-C Debi Holloway, BA, RRT, AE-C Carol Jones, RN, AE-C

Lisa Magary, DNP, APRN, CPNP, FNP-BC, AE-C

Capt. John Manning, MSN, RN, PNP, AE-C – U.S. Navy

Karen Meyerson, MSN, RN, FNP-C, AE-C

– Board Chair Gina Spinuzzi, RRT, AE-C Heather Steffens, RRT-NPS, AE-C Dennis Williams PharmD, BCPS, AE-C Dennis Wissing, PhD, RRT, CPFT, FAARC,

AE-C Romelia Rodriquez-Walters, AE-C

NAECB Exam Categories

11% IV. Organizational Issues

43% III. Asthma Management

26% II. Patient & Family Assessment

20% I. The Asthma Condition

% of TEST QUESTIONS

MAJOR CATEGORY

Derived from the Asthma Educator Job Tasks Survey

NAECB Exam 175 multiple choice questions

– 150 test items – 25 pretest items Not identified Performance on these items does not affect score

– Includes some “multiple multiples” – 3.5 hours allowed for exam

Multiple forms Sample questions and Review References are in the

Candidate Handbook on website: www.naecb.org Self Assessment Exam (SAE) available for $65 – 3

months on-line access with rationale/references for correct answers

Examination Eligibility Requirements

The following currently licensed or credentialed health care professional may be admitted to the examination:

Physicians (MD, DO) – Physician Assistants (PA-C) – Nurses (RN, LPN, NP) – Respiratory Therapists (RRT, CRT) – Pulmonary Function Technologists (CPFT, RPFT) – Pharmacists (RPh) – Social Workers (CSW) – Health Educators (CHES) – Physical Therapists (PT) – Occupational Therapists (OT)

Examination Eligibility Requirements cont.

OR – Individuals providing direct patient asthma

education, counseling, coordination services with a minimum of 1000 hours experience in above services.

NAECB Exam Fees $295 - New candidate

– If successful Certification designation of AE-C® Receipt of NAECB certificate Certification is valid for 7 years

$195 - Repeat candidate (fee per exam) – Must wait 90 days between attempts and no

more than 3 attempts allowed $245 – Recertification

– Renewal currently by re-examination only

NAECB Update

New Detailed Content Outline (DCO) Completely updated Candidate Handbook Exam is EPR-3 compliant SAE recently updated Board is discussing pathways to recertification –

no decision before the end of 2012 No new certificants’ names will be displayed on

current website due to malware issues and… Coming soon…newly redesigned website!

Advocacy Efforts

Asthma: A Preventable Disease… Out of Control

High business costs associated with asthma – Direct & indirect costs, lost productivity

Barriers to quality asthma care – Insufficient and inconsistent insurance benefits – High costs of medications – Lack of educational services and case

management – Challenges in reducing exposure to

environmental triggers

Controlling Asthma and Its Costs Best Practices for Asthma Management

(NAEPP Guidelines 2007): – Assessment and monitoring – Comprehensive pharmacologic therapy – Education for a partnership in asthma

care – Control of environmental triggers and co-

morbid conditions

Implementing Best Practices Asthma Education

– Based on cost-effectiveness of asthma education programs, the NAEPP Expert Panel recommended “that asthma self-management education delivered by trained health professionals be considered for policies and reimbursements as an integral part of effective asthma care.”

– “Abundant” scientific evidence that asthma self-management programs reduce urgent care visits and hospitalizations and improve overall health status.

What is the Evidence?

Asthma Regional Council of New England (ARC)

Investing in best practices - A

Business Case

Asthma: A Business Case for Employers

and Health Care Insurers

Insurance Coverage for Asthma- A Value

and Quality Checklist for

Purchasers of Health Care

Still emerging….

What is the Evidence?

Robust evidence shows widespread improvements in asthma patients’ health

when primary and specialist care is supplemented by in-depth asthma

education, home assessment and mitigation of home-based triggers provided by a team

of providers.

The Evidence: Published Studies

Bolton et al

• RCT • 3 one hour

group sessions to high risk adults by RN

• Cost $85/patient • 59% fewer ED

visits • Saved $22.50 in

health care costs for every $1 spent

Clark et al

• RCT • 6 one hours

individual session with high risk kids

• $1558/patient • 58% fewer

hospitalizations, 59% fewer ED visits

• Saved ~$11.22 in healthcare costs for every $1 spent on program

• RCT • Comprehensive

management services for high risk children, education delivered by Case Manager

• $190/patient • 57% fewer ED

visits; 75% fewer hospitalizations

• Saved ~$9 for every $1 spent on case manager

• Pre-post intervention

• Delivered by specialized nurse educator to high risk adults with asthma while in hospital

• $233/patient • Reduced

missed work days, physician visits, attacks

• Saved $3 in healthcare and lost work days for every $1 spent

Greineder et al

Trautner et al

Kattan et al

• RCT • Home-based

environmental interventions

• Delivered by environmental counselor to high risk children with asthma

• $1469/patient • 37.8 additional

symptom-free days

• Each symptom-free day gained costs $28

The Evidence Key Quote:

“By investing in good health, we can add

billions of dollars in economic growth in the coming decades.”

Ross DeVol, Director of Regional Economics and the Center for Health Economics, Milken Institute

The Congressional Allergy & Asthma Caucus gives asthma an official voice on Capitol Hill by combining

Congress members with legislative power and medical expertise and can help us reach our goals of

reducing health care costs and saving lives.

Asthma Awareness Day on Capitol Hill

Stressed to Congress the need for asthma and allergy care that is patient-centered and grounded in the NIH Asthma Guidelines and Food Allergy Guidelines.

Also discussed solutions with Congress for ensuring all patients with these conditions receive the care they need and, particularly with the nation’s current economic concerns and the need to cut wasteful spending, eliminate unnecessary healthcare expenditures associated with asthma and allergies.

Rep. Mazie Hirono (D-HI) visited the morning briefing to announce legislation she’d proposed just the night before: HR1692, a bill that would provide grants to

schools for developing asthma management plans and purchasing inhalers, nebulizers, valved holding

chambers and auto-injectable epinephrine in schools.

Asthma Awareness Day on Capitol Hill – May 2011

Congressional Briefing - October 2011

Congressional Allergy & Asthma Caucus co-Chair, Representative Bill Cassidy (R-TX) (above) supports AANMA's position that federal health care funds directed toward asthma should be distributed to ONLY those programs which utilize NIH Asthma Guidelines and access to specialty care.

Representative Nita Lowey (D-NY) (below), Congressional Allergy & Asthma Caucus co-Chair, warned if we are to be successful in our efforts to replace wasteful substandard care with quality services at a lower cost, we need to get many patients involved.

Congressional Briefing

Dr. James Kiley (left), Director, Division of Lung Diseases, National Heart, Lung, and Blood Institute (NHLBI) National Institutes of Health.presented how evidence-based clinical practice guidelines are developed and updated.

Dr. Paul Garbe (right), Chief of the Air Pollution and Respiratory Health Branch, National Center for Environmental Health at the Centers for Disease Control and Prevention. Dr. Garbe directs CDC’s National Asthma Control Program, which supports 36 state and territorial health departments for comprehensive asthma control activities.

Nancy Sander (above) Founder of Allergy & Asthma Network/Mothers of Asthmatics.

Allergy & Asthma Leadership Summit – Annapolis, MD

Purpose of the Leadership Summit is to create a new forum for meaningful dialogue among leaders of industry, health care professionals and patient advocates for potential collaboration on new programs, products and services that address the needs of allergy and asthma patients and their families.

Goal: Participate in the discussions; share knowledge, experiences, opinions and questions.

What can you do?

Get involved where you live: Contact Sandra Fusco-Walker, AANMA’s Director of Patient Advocacy, to help AANMA’s advocacy efforts: sfwalker@aanma.org. Volunteer in one of AANMA’s many

community outreach programs – contact Taurean Barber, Assistant Project Manager, at tbarber@aanma.org.

For more information: Karen Meyerson, MSN, RN, FNP-C, AE-C E-mail: meyersok@trinity-health.org Phone: 616-685-1432 Websites:

– www.asthmanetworkwm.org – www.GetAsthmaHelp.org – www.naecb.org