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- Page navigation anchor for RE: Tobacco Cessation Champions: Recognizing Physicians Who Ask, Advise, and ReferRE: Tobacco Cessation Champions: Recognizing Physicians Who Ask, Advise, and Refer
Thank you for your eLetter.
Our project started with the development of a Clinical Decision Support (CDS) triggered by completion of the tobacco history in the Past History section of the EHR. The CDS was designed to be a two-way communication with the Maryland Tobacco Quitline, with the Quitline's outreach results populating patient’s medical charts for physician review. This was accompanied by multimedia tools to disseminate the innovation and to teach physicians and practitioners how to use and refer. We recognized major barriers to be time, comfort with tobacco cessation medications, billing, and other clinical competing priorities. Additionally, our e-referral system is opt-in. If a physician does not have time to complete the e-referral, it is not sent. To mitigate the barriers, our team provided training in tobacco treatment and billing and coding for tobacco cessation counseling. We saw some improvement, and with a new source of funding, the NCI Cancer Moonshot Cancer Center Cessation Initiative (C3I) grant, we were able to develop a new staff pathway in Epic for tobacco use assessment and treatment. This included the development of a fifth vital sign that staff was to complete to start the conversation on tobacco. Adjacent to the fifth vital sign was a hot link to the history section where tobacco history could be documented. Additionally, referrals to the Quitline and to the in-person Tobacco Health Practice (THP). was triggered. Lastly, we developed...
Show MoreCompeting Interests: None declared. - Page navigation anchor for RE: Tobacco Cessation Champions: Recognizing Physicians Who Ask, Advise, and ReferRE: Tobacco Cessation Champions: Recognizing Physicians Who Ask, Advise, and Refer
As three aspiring clinicians with a keen interest in primary care delivery and electronic health record (EHR) use, we found your article on "Tobacco Cessation Champions: Recognizing Physicians Who Ask, Advise, and Refer" very engaging. In reading your article, several findings stood out to us. First, we are curious to know if any barriers and/or challenges were faced by physicians and if so, how were they addressed? As we read on, we were intrigued to learn about the impact of the initiative. As such, we were left to ponder about the effectiveness of the e-referral initiative, particularly of the tobacco cessation success rates among referred patients. We are curious to know if you plan to conduct a longitudinal study to evaluate the long-term impact of the program, including impact of physician recognition? Third, we are also curious as to how years of clinical experience affected physicians’ adoption of the e-referral initiative. We are aware that primary care clinicians are experiencing high burnout rates. Thank you for considering our questions, we look forward to hearing from you.
Competing Interests: None declared.