@article{0c3d6965250a46e78d809af1ebe84365,
title = "Design and pilot implementation of an electronic health record-based system to automatically refer cancer patients to tobacco use treatment",
abstract = "Continued tobacco use after cancer diagnosis is detrimental to treatment and survivorship. The current reach of evidence-based tobacco treatments in cancer patients is low. As a part of the National Cancer Institute Cancer Center Cessation Initiative, the Mayo Clinic Cancer Center designed an electronic health record (EHR, Epic{\textcopyright})-based process to automatically refer ambulatory oncology patients to tobacco use treatment, regardless of intent to cease tobacco use(“opt out”). The referral and patient scheduling, accomplished through a best practice advisory (BPA) directed to staff who room patients, does not require a co-signature from clinicians. This process was piloted for a six-week period starting in July of 2019 at the Division of Medical Oncology, Mayo Clinic, Rochester, MN. All oncology patients who were tobacco users were referred for tobacco treatment by the rooming staff (n = 210). Of these, 150 (71%) had a tobacco treatment appointment scheduled, and 25 (17%) completed their appointment. We conclude that an EHR-based “opt-out” approach to refer patients to tobacco dependence treatment that does not require active involvement by clinicians is feasible within the oncology clinical practice. Further work is needed to increase the proportion of scheduled patients who attend their appointments.",
keywords = "Cancer, Electronic health record, Opt-out, Smoking, Tobacco",
author = "Thulasee Jose and Ohde, {Joshua W.} and {Taylor Hays}, J. and Burke, {Michael V.} and Warner, {David O.}",
note = "Funding Information: This research was funded by an administrative supplement to the Mayo Clinic Comprehensive Cancer Center from the NCI (P30CA015083-44S2). This publication was also supported by CTSA Grant Number TL1 TR002380 from the National Center for Advancing Translational Science (NCATS). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. Funding Information: Author Contributions: Conceptualization, T.J. and D.O.W; methodology, D.O.W.; software, T.J.; validation, T.J., J.W.O. and D.O.W.; formal analysis, T.J., J.W.O., J.T.H., M.V.B., and D.O.W.; investigation, T.J., J.W.O., J.T.H, M.V.B. and D.O.W.; resources, J.W.O., J.T.H., M.V.B.; data curation, T.J.; writing—original draft preparation, T.J and D.O.W.; writing—review and editing, T.J., J.W.O., J.T.H., M.V.B. and D.O.W.; visualization, T.J.; Supervision, D.O.W.; project administration, T.J.; funding acquisition, D.O.W. All authors have read and agreed to the published version of the manuscript Funding: This research was funded by an administrative supplement to the Mayo Clinic Comprehensive Cancer Center from the NCI (P30CA015083-44S2). This publication was also supported by CTSA Grant Number TL1 TR002380 from the National Center for Advancing Translational Science (NCATS). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. Funding Information: Setting: The MCCC is a NCI-designated comprehensive cancer center with primary campuses in Minnesota, Florida, and Arizona, as well as a network of 12 community oncology practices across Minnesota, Wisconsin, and Iowa. The clinical practice has been supported by EHR vendor Epic{\textcopyright} Systems Corporations since 2018. Approximately 157,000 oncology patients receive care annually. The design and pilot implementation work described in this report was performed in the Division of Medical Oncology practice at Mayo Clinic in Rochester, MN, as a precursor to later implementation of the system across the MCCC. Publisher Copyright: {\textcopyright} 2020 by the authors. Licensee MDPI, Basel, Switzerland.",
year = "2020",
month = jun,
day = "1",
doi = "10.3390/ijerph17114054",
language = "English (US)",
volume = "17",
pages = "1--11",
journal = "International Journal of Environmental Research and Public Health",
issn = "1661-7827",
publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",
number = "11",
}