Configure EHR

There are different levels of EHR integration for tobacco cessation. When working on integrating tobacco cessation in your EHR and developing a workflow that is appropriate for your organization, it is important to work with your entire team (e.g., providers, receptionists, and medical assistants). Walk through the process with staff so they can see what the process looks like and can understand what their role may be. To configure an EHR system to support Tobacco Cessation efforts, utilize these steps:

  • In your EHR, locate the pre-built templates or forms specifically designed for documenting tobacco use and tobacco cessation interventions. Enable and, if needed, customize these templates to capture relevant patient information, interventions, follow-up plans, and outcomes.
  • Update patient demographics, include tobacco use status as a standard field in the patient demographics section of the EHR. This allows easy identification of patients who are tobacco users and provides a quick overview of patients.
  • Develop specific documentation templates or forms for providers to record tobacco cessation interventions. This can include counseling sessions, prescription of nicotine replacement therapy or smoking cessation medications, referrals to specialized programs, and follow-up plans.
  • Implement Clinical Decision Support (CDS) tools within the EHR to help providers in delivering evidence-based tobacco cessation Interventions. This can include pop-up reminders or alerts when a tobacco use status indicates the need for intervention or when a provider is ordering medications that may interact with smoking cessation medications. See the next section for more details on utilizing CDS functionality.
  • Integrate links or references to reliable tobacco cessation resources within the EHR. This can include patient education materials, online support programs, local smoking cessation programs, and help/quit lines. Ensure these resources are accessible to providers and patients.
  • Configure the EHR system to generate reports that summarize tobacco cessation activities within your practice. These reports can include the number of patients screened for tobacco use, the percentage of smoker’s provided with counseling/interventions, and the quit rate achieved.
  • Provide training and education to providers on how to effectively use the EHR's tobacco cessation feature. This includes familiarizing them with templates, decision support tools, and reporting functions.
  • Encourage the Clinicians to get involved in the EHR modification process. Providers use the EHR daily and have firsthand knowledge and great suggestions for its use.

Obtain a Direct Address for your provider/practice. A Direct Address is used to exchange health information using direct secure messaging. It is a technical standard for exchanging protected health information (PHI) between healthcare entities (e.g., primary care physicians, specialists, hospitals, and clinical labs) through a trusted network.

To enable Point of Care (POC) Clinical Decision Support (CDS) tobacco user alerts, follow these general steps:

  • Identify the Clinical Decision Support System: Determine the specific CDS system being used within your Electronic Health Record (EHR). This should have the capability to support Point of Care CDS alerts.
  • Configure the Tobacco User Alert: Access the administrative settings or configuration options of the EHR or CDS system. Look for the section related to CDS alerts or notifications.
  • Define Alert Criteria: Specify the criteria that will trigger the tobacco user alert. This may include patient demographics, smoking history, recent encounters, or documented tobacco use.
  • Set Alert Triggers: Determine the events or actions that will trigger the tobacco user alert. For example, the alert can be triggered when a patient's chart is accessed, during the medication ordering process, or when relevant clinical data is entered.
  • Customize Alert Content: Customize the content of the tobacco user alert to provide relevant information to providers. This may include the patient’s smoking status, associated health risks, recommended interventions, and available resources for smoking cessation.
  • Determine Alert Delivery: Specify how the tobacco user alert will be delivered to the providers. This can be brought up as pop-up notifications, flagging the patient’s chart, or display the alert within the workflow of the EHR.
  • Define User Actions: Determine the recommended actions for providers when the tobacco user alert is triggered. This may include offering smoking cessation counseling, ordering appropriate diagnostic tests, prescribing smoking cessation medications, or referring the patient to a tobacco cessation program such as Michigan’s Quitline.
  • Test and Validate: Conduct thorough testing of the tobacco user alert functionality to ensure it is working as intended. Validate that the alert is triggered correctly based on the defined criteria and that it is delivered to the appropriate providers.
  • Train Providers: Provide training and education to providers on the purpose, significance, and proper response to the tobacco user alert. Ensure they understand the available resources and interventions for supporting tobacco cessation efforts.
  • Monitor and Evaluate: Continuously monitor the effectiveness of the tobacco user alert. Assess whether it is leading to improved identification and intervention for tobacco users and evaluate its impact on patient outcomes and smoking cessation rates. Adjust as needed.