Last updated: May 2020
Author: Asthma Program, Vermont Department of Health
The MAPLE plan is a project designed to increase the delivery of asthma education and patient self-management after hospital discharge. Initially, the MAPLE plan was being implemented in Rutland at the Rutland Regional Medical Center (RRMC). This program became the model for the Springfield Health Center Systems (SMCS), who started their 2017 and reaching 9 surrounding clinics. Patients with a recent Emergency Department visit or hospitalization due to asthma, are flagged for outreach and scheduled for telephone call backs to check on the patient's asthma, ensure medication adherence, and to provide reinforcing self-management education and coaching. Originally, the patient call-backs occurred through RRMC’s Pulmonary Rehab Department, but has since been integrated into the central hospital call-back center. This has caused a decrease in those attributed to the RRMC's Maple Plan data records. Furthermore, both medical systems are undergoing significant transitions in staffing, structure, and funding, which we anticipate will lead to reductions in call backs in the future. The Vermont Asthma Program is working with partners to further enhance capacity and use of electronic health records to help flag patients for follow-up, including monitoring asthma control at each point of contact.