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 - Funding Information:
Joint Acknowledgment/Disclosure Statement : We acknowledge the significant contributions to this research effort of all our CHARN partners across the following organizations: AAPCHO, San Leandro, CA; Asian Health Services, Oakland, CA; Charles B. Wang Community Health Center, NY,; Waianae Coast Comprehensive Health Center, Waianae, HI; Waimānalo Health Center, Waimānalo, HI; University of California, Los Angeles, CA. Alliance of Chicago Community Health Services, Chicago, IL; Erie Family Health Center, Chicago, IL; Heartland Health Outreach, Chicago, IL; Howard Brown Health, Chicago, IL; Near North Health Service Corporation, Chicago, IL; North Country HealthCare, Flagstaff, AZ; PCC Community Wellness, Chicago, IL; Northwestern University, Chicago, IL. Fenway Health, Boston, MA; Chase Brexton Health Care, Baltimore, MD; Beaufort‐Jasper‐Hampton Comprehensive Health Services, Ridgeland, SC; University of Washington, Seattle, WA. OCHIN, Inc, Portland, OR; Open Door Community Health Centers, Arcata, CA; Virginia Garcia Memorial Health Centers, Hillsboro, OR; Multnomah County Health Department, Portland, OR; Oregon Health & Science University, Portland, OR; Richmond Family Medicine Clinic, Portland, OR. Kaiser Permanente, Center for Health Research, Portland, OR; Data Coordinating Center. This work was supported by the Health Resources and Services Administration, contract HHSH250201400001C and by grant UB3HA20236. The research presented in this paper is that of the authors and does not reflect official policy of Department of Health and Human Services.
Funding Information:
Joint Acknowledgment/Disclosure Statement: We acknowledge the significant contributions to this research effort of all our CHARN partners across the following organizations: AAPCHO, San Leandro, CA; Asian Health Services, Oakland, CA; Charles B. Wang Community Health Center, NY,; Waianae Coast Comprehensive Health Center, Waianae, HI; Waim?nalo Health Center, Waim?nalo, HI; University of California, Los Angeles, CA. Alliance of Chicago Community Health Services, Chicago, IL; Erie Family Health Center, Chicago, IL; Heartland Health Outreach, Chicago, IL; Howard Brown Health, Chicago, IL; Near North Health Service Corporation, Chicago, IL; North Country HealthCare, Flagstaff, AZ; PCC Community Wellness, Chicago, IL; Northwestern University, Chicago, IL. Fenway Health, Boston, MA; Chase Brexton Health Care, Baltimore, MD; Beaufort-Jasper-Hampton Comprehensive Health Services, Ridgeland, SC; University of Washington, Seattle, WA. OCHIN, Inc, Portland, OR; Open Door Community Health Centers, Arcata, CA; Virginia Garcia Memorial Health Centers, Hillsboro, OR; Multnomah County Health Department, Portland, OR; Oregon Health & Science University, Portland, OR; Richmond Family Medicine Clinic, Portland, OR. Kaiser Permanente, Center for Health Research, Portland, OR; Data Coordinating Center. This work was supported by the Health Resources and Services Administration, contract HHSH250201400001C and by grant UB3HA20236. The research presented in this paper is that of the authors and does not reflect official policy of Department of Health and Human Services.
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
UR - http://www.scopus.com/inward/record.url?scp=85078610999&partnerID=8YFLogxK
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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 -
