Utilizing clinical support staff and electronic health records to increase tobacco use documentation and referrals to a state quitline

• Published in: Journal of vascular nursing Vol. 30; no. 4; pp. 107 - 111
• Main Authors: Greenwood, Deborah A., Parise, Carol A., MacAller, Tami A., Hankins, Andrea I., Harms, Kristin R., Pratt, Leslie S., Olveda, Joan E., Buss, Kimberly A.
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.12.2012
• Subjects: Adult; California; Cessation; Complaints; Computerized medical records; Data Collection - methods; Electronic Health Records; Female; Health Promotion - methods; Humans; Logistic Models; Male; Nurse's Role; Nursing; Recording; Referral and Consultation; Referrals; Smoking; Smoking Cessation - methods; Smoking Cessation - statistics & numerical data; Smoking Prevention; Tobacco Use Disorder - diagnosis; Tobacco Use Disorder - nursing
• ISSN: 1062-0303; 1532-6578
• DOI: 10.1016/j.jvn.2012.04.001

The purpose of this study was to determine if incorporation of a workflow in the electronic health record (EHR) that empowered medical assistants (MA) to become tobacco-cessation promoters, would increase tobacco documentation and referral for cessation counseling. MAs in three primary care centers were trained to ask every patient, at every visit, about tobacco use then document this status in the EHR. Patients ready to quit were electronically referred to the quitline for tobacco cessation counseling. Documentation of tobacco status, ongoing verification of tobacco use, and chief complaint recording was compared before and after the intervention. Logistic regression analysis indicated that after adjusting for differences between care centers, there were increased odds in initial documentation (OR = 1.52; 95% CI = 1.42 – 1.62) and ongoing verification (OR = 2.86; 95% CI = 1.42 – 1.62) in 2010 in comparison with 2009. Recording of tobacco cessation as the chief complaint in current smokers increased 91% (OR = 1.91; 95% CI = 1.56 – 2.34). Documentation and referrals for smoking cessation can be increased in organizations using EHR by empowering MAs to promote tobacco cessation and providing electronic referral options.