title: Systematically Improving Tobacco Cessation Patient Services Through Electronic Medical Record Integration.
abstract: The Health Information Act of 2010 has presented an opportunity to discuss, establish, and promote innovative ways to incorporate tobacco cessation assistance to patients in the health care setting. This article provides an overview of the development and implementation of an electronic tobacco cessation protocol (the eTobacco protocol), into an electronic medical record (EMR) system, while evaluating the barriers and benefits encountered. The protocol was developed to facilitate the process of electronically referring patients to a state-funded quitline service by establishing a one-click connect for providers to use within the EMR system. While evaluating the implementation of the protocol, findings indicate that several barriers were encountered including disruption of clinic workflow, EMR limitations, and training complications. In spite of the barriers, the protocol shows promising results by increasing referrals to the quitline from 7 patients the year prior to implementation to 1,254 patients after the implementation of the electronic solution. Health care systems that have the ability to modify their EMR system can help lower tobacco use rates among their patients while meeting Meaningful Use requirements. Future research should examine if referrals through the eTobacco protocol are directly associated with patients' tobacco cessation rates.
authors.affiliation: The University of Texas at Austin, Austin, TX, USA Shelleykarn@austin.utexas.edu.
authors.forename: Shelley
authors.initials: S
authors.lastname: Karn
authors.affiliation: The University of Texas at Austin, Austin, TX, USA.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Fernandez
authors.affiliation: The University of Texas at Austin, Austin, TX, USA.
authors.forename: Lou Ann
authors.initials: LA
authors.lastname: Grossberg
authors.affiliation: The University of Texas at Austin, Austin, TX, USA.
authors.forename: Trina
authors.initials: T
authors.lastname: Robertson
authors.affiliation: The Texas Department of State Health Services, Austin, TX, USA.
authors.forename: Barry
authors.initials: B
authors.lastname: Sharp
authors.affiliation: Austin/Travis County Health and Human Services Department, Austin, TX, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Huang
authors.affiliation: The University of Texas at Austin, Austin, TX, USA.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Loukas
mesh_terms: D057286:Electronic Health Records / Q000458:organization & administration*; D006293:Health Promotion; D015277:Hotlines; D006801:Humans; D010865:Pilot Projects; D015397:Program Evaluation; D012017:Referral and Consultation / Q000458:organization & administration*; D016540:Smoking Cessation / Q000379:methods*
keywords: access to health care; behavior change; cessation; community intervention; community-based participatory research; health research; quality assurance/quality improvement; tobacco prevention and control; training