Air Middlesex is a disease management asthma education program for children and adults in middlesex county. Our goals and objectives are to improve the quality of life for asthmatics in our community by reducing emergency department and inpatient hospitalizations. Our nursing based disease management programs work directly with primary care provider to enhance the care they provide. Our referral base is primary care provider, inpatient hospitalists, school nurses and self referrals. It is free of charge for patients and providers in the community. This in turn decreases the economic burden of people in our community. We also have patient specific goals so that they have symptom free days and nights again decreasing missed days of work and school. Every 6 months we measure outcomes that looks at emergency department and inpatient days as well as decrease in symptoms, use of peak flow meters/spacers, action plans for providers and quality of life indicators for patients.