TY - JOUR AU - Hood-Medland, Eve Angeline; Stewart, Susan L.; Nguyen, Hien; Avdalovic, Mark; MacDonald, Scott; Zhu, Shu-Hong; Mayoral, Antonio; Tong, Elisa K. TI - Health System Implementation of a Tobacco Quitline eReferral SN - 1869-0327 PY - 2019 JO - Appl Clin Inform JF - Applied Clinical Informatics LA - EN VL - 10 IS - 04 SP - 735 EP - 742 DA - 2019/10/02 KW - specific condition: tobacco use cessation KW - electronic health record KW - implementation science KW - preventive medicine KW - adoption AB - Background Proactive referrals through electronic orders (eReferrals) can increase patient connection with tobacco quitlines. More information is needed on “real-world” implementation of electronic health record tools to promote tobacco cessation while minimizing provider burden.Objectives This paper examines the health system implementation of an eReferral to a tobacco quitline without best practice alerts in primary care, specialty, and hospital settings in an academic health system.Methods This is a prospective implementation study of a health system tobacco eReferral to a state quitline that was completed with an approach to minimize provider cognitive burden. Data are drawn from electronic health record data at University of California, Davis Health Systems (March 2013–February 2016).Results Over 3 years, 16,083 encounters with smokers resulted in 1,137 eReferral orders (7.1%). Treatment reach was 1.6% for quitline services and 2.3% for outpatient group classes. While the group classes were offered to outpatient smokers, the eReferral order was included in an outpatient order set and eventually an automated inpatient discharge order set; no provider alerts were implemented. Referrals were sustained and doubled after inpatient order set implementation. Among all first time eReferral patients, 12.2% had a 6 to 12 month follow-up visit at which they were documented as nonsmoking.Conclusion This study demonstrates a quitline eReferral order can be successfully implemented and sustained with minimal promotion, without provider alerts and in conjunction with group classes. Reach and effectiveness were similar to previously described literature. PB - Georg Thieme Verlag KG DO - 10.1055/s-0039-1697593 UR - http://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0039-1697593 ER -