Closing the Care Gap: Montefiore’s Tech Aims to Ease Asthma for NYC Kids

Bronx, NY – November 15, 2025 – For children with asthma, a school day can be fraught with anxiety – and potential medical crises. Ensuring these students have access to vital medication isn’t always simple. A new $4.1 million grant awarded to Montefiore Health System aims to change that, ushering in a tech-driven approach to asthma care coordination for schoolchildren in New York City. The initiative, dubbed “PRAGMATIC-S,” promises to streamline access to medication, improve health outcomes, and offer a potential model for other school districts grappling with similar challenges.

Asthma is a pervasive chronic illness impacting roughly 9.5% of children in NYC, a rate exceeding the national average. In the Bronx, that number jumps to 12.5%, disproportionately affecting low-income communities. The condition isn't just a health issue; it’s an educational one. Asthma-related absences contribute significantly to lost learning time, with affected students missing an average of 4.5 school days per year. Schools report over 1,200 asthma-related emergencies annually, highlighting the urgent need for better management.

“The current system is fragmented,” explains a physician involved in the project. “Getting the right medication to a child at the right time requires navigating multiple layers of paperwork and communication. It's a challenge for families, school nurses, and healthcare providers alike.”

The PRAGMATIC-S program addresses this head-on. The core of the initiative is an online portal designed to simplify the documentation process. Currently, parents and providers must complete multiple forms and physically deliver them to the school nurse. The new system allows for secure electronic completion and direct routing, significantly reducing administrative hurdles. This digital workflow is coupled with support from Asthma Outreach Workers who will provide personalized care coordination, bridging the gap between families, clinicians, and schools.

“It's about creating a seamless flow of information,” says a school nurse familiar with the program's design. “If a child’s asthma action plan changes, everyone – parents, teachers, and the nurse – is immediately updated. That’s a game-changer.”

The four-year study will enroll 400 children aged 4-12 with persistent or uncontrolled asthma from Montefiore Medical Group clinics. Half will receive the new technology-enabled care coordination, while the other half will receive standard care, allowing researchers to rigorously assess the intervention’s impact. Key metrics include asthma control, caregiver quality of life, school attendance, and emergency department visits.

Beyond Efficiency: A Shift Towards Community-Based Care

While the technology component is central, the PRAGMATIC-S program represents a broader shift towards integrated, community-based asthma care. “Traditionally, asthma management has been focused within the confines of the hospital or doctor’s office,” notes a public health official following the project’s development. “This initiative acknowledges that a child’s health is significantly influenced by their environment – their school, their home, and their community.”

This emphasis on community is crucial, particularly given the disparities in asthma prevalence. Lower-income communities often face higher levels of environmental triggers – such as air pollution and mold – and limited access to quality healthcare. The Asthma Outreach Workers will play a vital role in addressing these social determinants of health, connecting families with resources and providing education on asthma self-management.

A Model for Scaling Impact?

While the PRAGMATIC-S program is initially focused on a specific population in the Bronx, researchers hope the findings will be applicable to other school districts across the country. The potential for scaling is significant, but several challenges remain.

“Technology is only one piece of the puzzle,” cautions a school administrator involved in the program’s pilot phase. “Successful implementation requires buy-in from all stakeholders – school staff, healthcare providers, and most importantly, parents. Training and ongoing support are essential.”

Funding for sustaining the program beyond the initial four-year grant period is another key consideration. Sustainable funding models could involve partnerships with health insurance providers, philanthropic organizations, or government agencies.

Despite these challenges, the PRAGMATIC-S program offers a compelling vision for the future of school health. By leveraging technology, fostering collaboration, and addressing social determinants of health, Montefiore Health System is paving the way for a more equitable and effective approach to asthma management, ensuring that all children have the opportunity to breathe easier and reach their full potential. As one parent involved in the program put it, “This isn’t just about medication; it’s about giving my child a chance to thrive.”