EHR-based program reduces tobacco use
Gayle Sisbarro, DO | 06.28.13
According to Healthy People 2020, tobacco use is the single most preventable cause of disease, disability, and death in the United States.
As a result of widespread tobacco use, approximately 443,000 Americans die from tobacco-related illnesses, such as cancer and heart disease, each year. An estimated 49,000 of these deaths are the result of secondhand smoke exposure.
"For every person who dies from tobacco use, another 20 suffer from at least one serious tobacco-related illness."
In 2009, an estimated 20.6% of all American adults age 18 and older—46.6 million people—smoked, and every day another 850 young people age 12 to 17 began smoking on a daily basis.
Lancaster County appears to have a lower rate of smoking than the State and the Nation, however we recognize to maintain this status we have to continue to launch evidenced based programs to reduce the burden of tobacco use.
Research indicates physician recommendation as a best practice for assisting people with quitting tobacco use. Lancaster General Health Physicians launched a tobacco refer pilot through our electronic health record (EHR). As lead physician on the project I gathered a multidisplinary team including information technology, community health and quality to address tobacco use and referral to treatment across our system.
The project is based on the tobacco clinical practice guidelines model, 5A’s (Ask, Assess, Advise, Assist and Arrange). LGHP ask patients about their tobacco use at every visit, assess readiness to quit, advise on the health benefits of a tobacco free life, assist patients with access medications to support them through the quit process and arrange an electronic referral to the Community Health and Wellness (CHW) department for tobacco dependence treatment. CHW runs referral reports from the EHR and contacts the patients to arrange for group, individual, telephonic or web based treatment programs. The programs are funded through the Health Promotion Council and the PA Department of Health and provide free treatment and access to nicotine replacement therapy.
Once the patients complete treatment CHW reports patient outcomes back to the provider so the practice can congratulate their patient or continue to provide support for those continuing the quit process. We view tobacco use as a chronic disease and expect patients may cycle though periods of abstinence and relapse.
We believe with repeated intervention and a supportive treatment environment we can help our patients obtain and maintain a tobacco free life.
I am proud to say our pilot is now hard wired through out the LGHP system. Reports from our last quarter show that 98% of LGHP patients were screened for tobacco use and 83% were counseled. CHW team reports that 38% of patients enrolled in their program are tobacco free by the end of treatment. I am proud of the accomplishments our team has made and look forward to future collaborations across our system.
For More information on the tobacco EHR pilot contact Dr. Gayle Sisbarro 717-569-2678
For More information on the tobacco dependence treatment programs contact Mary LeVasseur – 544-3269