The Association between the Electronic Health Record and Patient-Reported Receipt of Tobacco Cessation Care in Hospitalized Veterans

TY - JOUR

T1 - The Association between the Electronic Health Record and Patient-Reported Receipt of Tobacco Cessation Care in Hospitalized Veterans

AU - Kuperman, Ethan F.

AU - Chapin, Jennifer

AU - Grant, Kathleen M.

AU - Vander Weg, Mark W.

AU - Katz, David A.

N1 - Funding Information: There was poor agreement between EHR review and patient survey regarding receipt of tobacco cessation care during and after hospital admission. Regardless, delivery of cessation therapy was unacceptably low. In this study, differences in site-specific performance were driven by different ways of documenting within EHR templates. Given that patient refusal is taken into consideration by EHR review, measure compliance may not translate into tobacco cessation treatment. We suggest three strategies to improve tobacco cessation performance: 1. Inform staff of requirements, current performance, and institutional goals. Inpatient staff often addressed tobacco cessation within their notes with insufficient detail. We hypothesize that this is due to provider ignorance of the tobacco treatment measure requirements. 2. Construct EHR templates to facilitate rapid and accurate documentation of required elements. Staff rely on templates for documentation, and templates that incorporate required elements may remind providers to perform recommended interventions and improve performance. 3. Reevaluate patients initially refusing tobacco cessation care. Patients initially refusing care may have similar readiness to quit, and many succeed in quitting within 6 months. Approaching these patients after initial stabilization may further increase cessation. Funding and Disclaimer. The work reported in this article was funded by the U.S. Department of Veterans Affairs , Office of Research and Development and Health Services Research & Development ( IIR 07-113 ). The views expressed in this article are those of the authors and do not necessarily represent the views of the VA. Acknowledgments. The authors acknowledge the VA Quality Scholars (VAQS) program for providing training and support. Conflicts of Interest. All authors report no conflicts of interest. Ethan F. Kuperman, MD, MSc, is Clinical Assistant Professor of Internal Medicine, University of Iowa, and Investigator, Center for Comprehensive Access & Delivery Research and Evaluation (CADRE), US Department of Veterans Affairs (VA), Iowa City VA Health Care System. Jennifer Chapin, MSN, RN, is Clinical Analyst for Quality and Performance Improvement, Iowa City VA Health Care System. Kathleen M. Grant, MD, is Associate Professor, Department of Internal Medicine, University of Nebraska Medical Center, and Staff Physician, VA Nebraska-Western Iowa Health Care System (Omaha). Mark W. Vander Weg, PhD, is Core Investigator, CADRE, and Associate Professor of Internal Medicine and Psychological and Brain Sciences, University of Iowa, Iowa City. David A. Katz, MD, MSc, is Core Investigator, CADRE, and Associate Professor of Medicine and Epidemiology, University of Iowa.

PY - 2018/5

Y1 - 2018/5

UR - http://www.scopus.com/inward/record.url?scp=85046730551&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85046730551&partnerID=8YFLogxK

U2 - 10.1016/j.jcjq.2017.11.004

DO - 10.1016/j.jcjq.2017.11.004

M3 - Article

C2 - 29759264

AN - SCOPUS:85046730551

SN - 1553-7250

VL - 44

SP - 304

EP - 306

JO - Joint Commission Journal on Quality and Patient Safety

JF - Joint Commission Journal on Quality and Patient Safety

IS - 5

ER -