Recently, 12 primary care sites affiliated with Harvard Vanguard Medical Associates (HMVA) changed their office systems, work-flow and electronic health records- to improve delivery and documentation of evidence based smoking cessation treatment. System changes at these sites were made as a result of HMVA’s clinical quality goal “to intervene” with patients who smoke.
Did the systems change in these real world settings make a difference? Yes, according to a study, “The Effect of Systematic Clinical Interventions with Cigarette Smokers on Quit Status and the Rates of Smoking-Related Primary Care Office Visits” . The study compared data from the 12 sites that made system wide changes with data from 5 HVMA sites that did not. The study covered the period between 1/5/2005 – 11/30/2010 and included data from 104,639 patients. Basically, the practices that made systems changes: identified the smoking status of their patients more frequently; intervened more; and realized greater patient outcomes; more patients quit and fewer patients came to the office with smoking caused disease diagnoses.
The Heart Network is providing technical assistance to North Country primary care practices to make similar changes in their office systems. With EHR capability to provide treatment and outcome data, we anticipate comparable results will be realized locally in time.