Trends in smoking documentation rates in safety net clinics. (13th January 2020)

• Record Type: Journal Article
• Authors: Fortmann, Stephen P.; Bailey, Steffani R.; Brooks, Neon B.; Hitsman, Brian; Rittner, Sarah Stuart; Gillespie, Suzanne E.; Hill, Christian Nissen; Leo, Michael C.; Crawford, Phillip M.; Hu, Weiming; King, Dana S.; O'Cleirigh, Conall; Puro, Jon; Ann McBurnie, Mary
• Is Part Of: Health services research. Volume 55:Number 2(2020)
• Page Start: 170
• Page End: 177
• Publication Date: 2020-01-13
• Subjects: community health centers -- electronic health records -- meaningful use criteria -- tobacco use -- uniform data system standards; Medical care -- Periodicals; Medical care -- Evaluation -- Periodicals; Hospital care -- Periodicals; Health services administration -- Periodicals; 362
• DOI: 10.1111/1475-6773.13259
• Languages: English
• ISSNs: 0017-9124

Abstract

Abstract: Objective: To assess the impact of provider incentive policy on smoking status documentation. Data Sources: Primary data were extracted from structured electronic medical records (EMRs) from 15 community health centers (CHCs). Study Design: This was an observational study of data from 2006 to 2013, assessing changes in documentation of smoking status over time. Data Extraction Methods: We extracted structured EMR data for patients age 18 and older with at least one primary care visit. Principal Findings: Rates of documented smoking status rose from 30 percent in 2006 to 90 percent in 2013; the largest increase occurred from 2011 to 2012 following policy changes (21.3% [95% CI, 8.2%, 34.4%] from the overall trend). Rates varied by clinic and across patient subgroups. Conclusions: Documentation of smoking status improved markedly after introduction of new federal standards. Further improvement in documentation is still needed, especially for males, nonwhite patients, those using opioids, and HIV + patients. More research is needed to study whether changes in documentation lead to improvements in counseling, cessation, and patient outcomes.