title: Integrating tobacco dependence counseling into electronic dental records: a multi-method approach.
abstract: Dentistry has historically seen tobacco dependence as a medical problem. As a consequence, dentistry has not adopted or developed effective interventions to deal with tobacco dependence. With the expanded use of electronic dental records, the authors identified an opportunity to incorporate standardized expert support for tobacco dependence counseling during the dental visit. Using qualitative results from observations and focus groups, a decision support system was designed that suggested discussion topics based on the patient's desire to quit and his or her level of nicotine addiction. Because dental providers are always pressed for time, the goal was a three-minute average intervention interval. To fulfill the provider's need for an easy way to track ongoing interventions, script usage was recorded. This process helped the provider track what he or she had said to the patient about tobacco dependence during previous encounters and to vary the messages. While the individual elements of the design process were not new, the combination of them proved to be very effective in designing a usable and accepted intervention. The heavy involvement of stakeholders in all components of the design gave providers and administrators ownership of the final product, which was ultimately adopted for use in all the clinics of a large dental group practice in Minnesota.
authors.affiliation: HealthPartners Institute for Education and Research, 8170 33rd Ave. S., Mail Stop 21111R, Minneapolis, MN 55425;. william.a.rush@healthpartners.com.
authors.forename: William A
authors.initials: WA
authors.lastname: Rush
authors.forename: Titus K L
authors.initials: TK
authors.lastname: Schleyer
authors.forename: Michael
authors.initials: M
authors.lastname: Kirshner
authors.forename: Raymond
authors.initials: R
authors.lastname: Boyle
authors.forename: Merry Jo
authors.initials: MJ
authors.lastname: Thoele
authors.forename: P A
authors.initials: PA
authors.lastname: Lenton
authors.forename: Steve
authors.initials: S
authors.lastname: Asche
authors.forename: Thankam
authors.initials: T
authors.lastname: Thyvalikakath
authors.forename: Heiko
authors.initials: H
authors.lastname: Spallek
authors.forename: Emily C
authors.initials: EC
authors.lastname: Durand
authors.forename: Chris J
authors.initials: CJ
authors.lastname: Enstad
authors.forename: Charles L
authors.initials: CL
authors.lastname: Huntley
authors.forename: D Brad
authors.initials: DB
authors.lastname: Rindal
mesh_terms: D003376:Counseling / Q000193:education*; D003792:Dental Records / Q000592:standards; D004497:Education, Dental / Q000379:methods*; D057286:Electronic Health Records / Q000592:standards; D005069:Evaluation Studies as Topic; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008910:Minnesota; D009910:Oral Hygiene / Q000193:education; D064424:Tobacco Use; D020340:Tobacco Use Cessation / Q000379:methods* / Q000523:psychology
keywords: dental care; dental hygienists; dental records; dentists; electronic dental records; electronic health records; tobacco; tobacco dependence