ECHO reducing impact of childhood asthma in Missouri

Deb Cook, RN, AE-C, and her team are serious about impacting asthma. To accomplish this goal, Cook who is the director of health services for the public school system in Kennett, Mo., regularly participates in Show-Me ECHO’s Impact Asthma ECHO. ECHOs (Extenstion for Community Healthcare Outcomes) are virtual learning networks where teams of specialists mentor primary care providers via videoconferencing technology.

“I don’t have to travel,” said Cook, “but I can connect with several experts is the area of asthma, including a pediatric pulmonologist, a pediatric allergist and other asthma experts to learn how to address barriers [children] may have.”

Cook said the case presentations and collaborative atmosphere have helped improve asthma treatment in her school district, where asthma prevalence is 18 percent, higher than the state average of 14 percent. Helping to improve treatment, both at school and at home, can have a lasting difference in children’s lives, said Cook.

“One of of my goals is to try to reduce absenteeism. And one of the ways I can do that is to help parents understand asthma, and better control their child’s asthma. If the child’s asthma is well-controlled then they’re going to be be in school, they’re going to be happier, they’re going to feel more normal and be able to participate like any other child can participate.”

To learn how to participate in an asthma ECHO, go to


Though improving the health of Missouri children is the chief aim of Impact Asthma ECHO, reducing health care costs also plays a major role. Using Medicaid claims records,
Missouri Telehealth Network’s Show-Me ECHO Evaluator Mirna Becevic, PhD, estimated that Impact Asthma ECHO saved more than $4 million in 2016. Counties with primary care providers who participated in Impact Asthma ECHO saw a 15 percent reduction in ED visits and a 42 percent drop for in-patient hospital days. With an average ED visit cost of $629 and daily in-patient hospital cost of $2439, the savings add up quickly. Becevic stressed that though promising, these numbers are preliminary and additional data is still being analyzed.

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