Online Program

Impact of clinical practice EMR capabilities on the pharmacotherapy and behavioral intervention activities in patient smoking cessation

Monday, November 4, 2013

Thomas English, PhD, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
Rebecca Kinney, MPH, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
Ariana Kamberi, MBA, Department of Quantitative Health Sciences, Univeristy of Massachusetts Medical School, Worcester, MA
Thomas K. Houston, MD, MPH, Department of Quantitative Health Sciences, Health Informatics and Implementation Science Division, University of Massachusetts Medical School, Worcester, MA
Smoking is the number one preventable cause of premature death in the United States. The majority of smokers (70%) see a healthcare provider at least once, annually, resulting in the encounter being the ideal time in which to address cessation. The Electronic Medical Record (EMR) may offer an effective intervention in which to improve smoking cessation at the point of care. This study investigates the relationship between Electronic Medical Record (EMR) capabilities and smoking cessation activities. The primary outcome, smoking cessation activities, was measured utilizing a Likert scale format. The study survey also solicited feedback from these clinics on their practice technology. For analyses, the clinics were separated into three groups based on EMR capabilities: Full EMR Group with decision support and drug reference database; Partial EMR Group with some of the capabilities to achieve the definition of meaningful use; and the No EMR Group or clinic without electronic capabilities. Kendall's Tau-b statistic was used to assess the ordinal differences in the variables based on EMR type allowing us to see a trend in relation to EMR capability. 174 Internal and Family Medicine practices participated in this study. Most of the clinics initiated smoking cessation counseling, but the majority of practices did not establish follow-up cessation visits for their patients who smoke. Rate of follow-up appointments varied by the EMR capability of the clinic, with those practices reporting “No EMR capabilities” being significantly (p=0.028) more likely to schedule follow-up appointments than their “partial or full” EMR counterparts. Conversely, nicotine replacement therapy was significantly more likely to be prescribed by clinics with “partial or full” EMR capabilities than those practices that did not have an EMR. (p=0.016). EMR capabilities were positively associated with NRT and negatively related to arranging follow up visits for smoking cessation.

Learning Areas:

Implementation of health education strategies, interventions and programs

Learning Objectives:
Describe the impact of the Electronic Medical Record (EMR) on primary care practice smoking cessation activities.

Keyword(s): Smoking Cessation, Health Information Systems

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I work closely with the medical management office that oversees quality impovement and pay for performance initiatives for the outpatient providers. I have successfully implemented Electronic medical records into 6 clinics and have also worked to upgrade and maintain those systems. My experience implementing informatics, quality improvement projects, and my prior research provides me with the expertise needed to present at APHA.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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