Utilizing clinical support staff and electronic health records to increase tobacco use documentation and referrals to a state quitline
Utilizing clinical support staff and electronic health records to increase tobacco use documentation and referrals to a state quitline
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DOI：
10.1016/j.jvn.2012.04.001
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发表时间：
2012-12-01
影响因子：
1
通讯作者：
Buss, Kimberly A.
中科院分区：
文献类型：
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作者：
Greenwood, Deborah A.;Parise, Carol A.;Buss, Kimberly A.
这项研究的目的是确定在电子健康记录(EHR)中纳入工作流程，使医疗助理(MA)成为戒烟促进者，是否会增加烟草文件和戒烟咨询的转介。三个初级保健中心的MA接受了培训，在每次就诊时询问每位患者有关烟草使用的情况，然后将这一情况记录在EHR中。准备戒烟的患者被电子转介到戒烟咨询热线进行戒烟咨询。对干预前后的烟草状况记录、持续的烟草使用核实和主要投诉记录进行比较。Logistic回归分析显示，在调整了不同护理中心之间的差异后，与2009年相比，2010年初始文件(OR=1.52；95%CI=1.42-1.62)和正在进行的验证(OR=2.86；95%CI=1.42-1.62)的优势增加。在当前吸烟者中，戒烟记录作为主要抱怨增加了91%(OR=1.91；95%CI=1.56-2.34)。在使用电子健康记录的组织中，可以通过授权MA促进戒烟并提供电子转介选项来增加戒烟文件和转介。
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.