How Can Providers Implement Meaningful Use and Tobacco Cessation
Q: What is Meaningful Use?
A: Meaningful Use is an incentive plan that eligible health care professionals and hospitals can qualify for through Medicare and/or Medicaid when they adopt certified Electronic Health Record (EHR) technology and use it to achieve specified objectives. The Recovery and Reinvestment Act of 2009 (ARRA) established the Health Information Technology for Economic and Clinical Health (HITECH) Act. Meaningful Use came out of regulations from the HITECH Act.
Meaningful use is using certified electronic health record (EHR) technology to:
- Improve quality, safety, efficiency, and reduce health disparities
- Engage patients and family
- Improve care coordination
- Improve population and public health
- Maintain privacy and security of patient health information
Ultimately, it is hoped that the meaningful use compliance will result in: Long-term outcomes from Meaningful Use compliance:
- Better clinical outcomes
- Improved population health outcomes
- Increased treatment transparency and efficiency
- Empowered individuals Empowered patients and patient families
- Robust tobacco treatment data collection within health systems
More details about Meaningful Use core and clinical quality measures (CQM) can be found here: http://www.healthit.gov/policy-researchers-implementers/meaningful-use
Q: What is the impact on quitlines when implementing Tobacco Treatment with Meaningful Use?
A: There are 3 Stages to the CMS Medicaid and Medicare EHR Incentive Programs:
Stage 1 Data Capture and Sharing – 2011-2012
Stage 2 Advanced Clinical Processes – 2014
Stage 3 Improved Outcomes – 2016
In each Stage tobacco dependence should be routinely screened for and consistently treated with referrals to quitlines plus medication. Documenting this process will be fully integrated in the health system’s EHR. By using the EHR meaningfully, tobacco screening and treatment may be delivered consistently and follow best practice recommendations (per the Public Health Service Guidelines).
While having an effective tobacco dependence screening and treatment template is critical to a comprehensive tobacco treatment system, it is not sufficient. Comprehensive tobacco treatment systems depend on the delivery of effective brief cessation interventions (e.g., 5A or 2AR) and the availability and utilization of community-based and statewide cessation resources. Meaningful Use is an opportunity to implement health systems change and can maximize tobacco cessation efforts.
Content adapted from University of Wisconsin Center for Tobacco Research and Intervention, Partnership for Prevention, Multi-State Collaborative for Health Systems Change, and Action to Quit. 2012
Families First Health and Support Center of the Greater Seacoast receives TREATING TOBACCO USE & DEPENDENCE INNOVATION AWARD
The aim of this clinical quality improvement project was to increase the capacity of Families First Health and Support Center to effectively provide a brief tobacco use and dependence intervention with clients who use tobacco. Interventions were incorporated by making modifications to their electronic health/medical records and clinical workflow using evidence-based US Public Health Service Taskforce recommendations for providing clinical brief interventions for Treating Tobacco Use and Dependence.
The result of this clinical quality improvement project was a unique, paperless communication loop between Families First clinicians, and the NH Tobacco Helpline, the proactive tobacco cessation counseling service offered via the clinician portal QuitWorks-NH. Today, clients who are seen at Families First that use tobacco and want to quit are referred by clinicians to a Certified Tobacco Treatment Specialist with the touch of a button. The Specialist will call the patient and offer up to five no cost counseling sessions over the phone. The referring clinician then receives a confidential report from the Specialist about what treatment services were accepted by the patient, referred to as the patient status report. The patient status report is then downloaded into the patient’s electronic medical record.
This project fulfills activities for Meaningful Use and Medical Home requirements.
This project is the first of its kind in the State to complete all the steps mentioned above and is one of the first being achieved in the Nation.
To implement this paperless referal and feedback loop into your practice, contact Teresa Brown at the NH Tobacco Prevention & Control Program at 603.271.8949 or firstname.lastname@example.org.
Why 2As and 1R?
The alternative protocol to the gold standard 5As (Ask, Advise, Assess, Assist, Arrange).
The U.S. Public Health Service Clinical Practice Guideline, Treating Tobacco Use and Dependence 2008 Update calls for systems level tobacco intervention efforts using the 5As. However, working the 5As into the practice’s current workflow may be overwhelming, particularly if providers are not connected to state quitline resources. As Meaningful Use rolls out, QuitWorks-NH via the NH Tobacco Prevention and Control Program (TPCP), can provide training and technical assistance (TA) for practices integrating tobacco treatment into electronic medical records (EMR) using the 2A (Ask and Assist) and R (Refer to QW-NH) so that providers have a resource to refer patients that want to quit.
|QuitWorks-NH TA Protocol:
To begin implementing 2As and 1R into your practice, contact Teresa Brown at the NH Tobacco Prevention & Control Program at 603.271.8949 or email@example.com
2010 Surgeon General’s report Clinician Sheet
A new report from the Surgeon General contains important new information on how tobacco smoke causes disease and explains why it is crucial to stop smoking and avoid secondhand smoke.
This one-page fact sheet summarizes the findings from How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. This fact sheet features smoking-attributable chronic disease information as well as “how to quit” information from the Clinical Practice Guidelines (published by the U.S. Agency for Healthcare Research and Quality). The fact sheet provides simple talking points and key information to help medical providers talk to their patients about quitting tobacco use.
What happens when a patient calls the NH Tobacco Helpline?
Multi-State Collaborative for Health Systems Change
For providers interested in what/how other states are implementing the PHSG, the Multistate Collaborative for Health Systems Change is a collaborative of tobacco control programs working in states to facilitate sustainable changes in health care systems within the states and nationally in order to reduce tobacco use and prevalence.
|Visit multistatecessationcollaborative.org for more information|
Text4baby is a free mobile information service designed to promote maternal and child health. An educational program of the National Healthy Mothers, Healthy Babies Coalition (HMHB), text4baby provides pregnant women and new moms with information they need to take care of their health and give their babies the best possible start in life. Women who sign up for the service by texting BABY (or BEBE for Spanish) to 511411 will receive free SMS text messages each week, timed to their due date or baby’s date of birth.
|Visit Text4baby.org for more information|
Law Banning Flavored Tobacco Goes Into Effect
The FDA has released a notice regarding Tobacco products stating that effective September 22, 2009, cigarettes that contain certain characterizing flavors are considered adulterated under the Federal Food, Drug, and Cosmetic Act, as amended by the Family Smoking Prevention and Tobacco Control Act (FSPTCA). Menthol is not prohibited but rather flavors such as vanilla, mint and clove would be.
|Learn more about Health Risks Specific to Flavored Cigarettes|
Treating Tobacco Use and Dependence: 2008 Update - Clinical Practice Guideline
This Guideline is an updated version of the 2000 Treating Tobacco Use and Dependence Guideline. It is the product of a private-sector panel of experts, consortium representatives, and staff. The update was written to include new, effective clinical treatments for tobacco dependence that have become available since the 2000 Guideline was published. The 275-page Guideline contains strategies and recommendations designed to assist clinicians; tobacco dependence treatment specialists; and health care administrators, insurers, and purchasers in delivering and supporting effective treatments for tobacco use and dependence.
NH Indoor Smoking Law Amended
New Hampshire lawmakers passed an amendment to the NH Indoor Smoking Act in June 2007. The amended statute protects the workforce and the public by reducing exposure to secondhand smoke.
Effective September 17, 2007, restaurants and bars in New Hampshire became smoke-free. New Hampshire joins the rest of New England by implementing such a law.
|Download the Indoor Smoking Act Factsheet (PDF, 92 KB)|