Spirometry 360 on-line training and feedback: Spring 2011 course results and future plans

Although office-based spirometry is increasingly gaining acceptance in general practice, wide variations in test quality impede its use. Spirometry 360 is a four-month interactive on-line training and feedback program currently delivered from the University of Washington to primary care practices around the U.S. It consists of: 1) Spirometry Fundamentals, a multi-media tutorial and reference tool; 2) interactive, case-based webinars led by clinical experts, and 3) an internet-based quality feedback reporting system that summarizes technique of de-identified spirograms automatically uploaded from the point of care. We delivered the training for the second time in 2010 to 23 general practices from 4 states around the U.S. Results included a doubling of the acceptable spirograms for children younger than eight years from 40% at baseline to 80% at the end of training, and an overall increase in the acceptable spirogram rate from 49% to 71%. Among course participants, 100% reported that they would recommend the training to a colleague. We are now delivering the course from February to June 2011 in two concurrent tracks to 70 pediatric and family practices, involving over 200 physicians and their support staffs from 35 states around the U.S. We will present a detailed analysis of over 4,000 tests from the Spring 2011 course, with a description of the reasons for variance from the ERS/ATS 2005 Spirometry Guideline, to further understand practitioners9 needs when performing office-based spirometry. We will also report on our plans for a “Train-the-Trainer” program with a goal of establishing independent training sites for ongoing delivery of the Spirometry 360 program.