TY - JOUR
T1 - Trends in smoking documentation rates in safety net clinics
AU - Fortmann, Stephen P.
AU - Bailey, Steffani R.
AU - Brooks, Neon B.
AU - Hitsman, Brian
AU - Rittner, Sarah Stuart
AU - Gillespie, Suzanne E.
AU - Hill, Christian Nissen
AU - Leo, Michael C.
AU - Crawford, Phillip M.
AU - Hu, Weiming
AU - King, Dana S.
AU - O'Cleirigh, Conall
AU - Puro, Jon
AU - Ann McBurnie, Mary
N1 - Publisher Copyright:
© Health Research and Educational Trust
PY - 2020/4/1
Y1 - 2020/4/1
N2 - 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.
AB - 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.
KW - community health centers
KW - electronic health records
KW - meaningful use criteria
KW - tobacco use
KW - uniform data system standards
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U2 - 10.1111/1475-6773.13259
DO - 10.1111/1475-6773.13259
M3 - Article
C2 - 31930738
AN - SCOPUS:85078610999
SN - 0017-9124
VL - 55
SP - 170
EP - 177
JO - Health Services Research
JF - Health Services Research
IS - 2
ER -