RESEARCH PAPER
Electronic Medical Record Tobacco Use Vital Sign
John W. NorrisIII 1, 2  
,   Smita Namboodiri 1, 2,   Syed Haque 1, 2,   David J. Murphy 1, 2,   Frank Sonneberg 3, 2
 
More details
Hide details
1
Division of Medical Informatics, Department of Medicine, New Jersey Medical School, USA
2
University of Medicine and Dentistry of New Jersey, Newark, USA
3
Department of Medicine, Robert Wood Johnson Medical School, USA
CORRESPONDING AUTHOR
John W. NorrisIII   

185 South Orange Avenue, I506, Newark, New Jersey 07103
Publication date: 2004-06-15
 
Tobacco Induced Diseases 2004;2(June):109
 
KEYWORDS
ABSTRACT
Objective:
Determination of the prevalence of tobacco use and impact of tobacco prevention/treatment efforts in an electronic medical record enabled practice utilizing a defined tobacco vital sign variable.

Design and Measurements:
Retrospective cohort study utilizing patient data recorded in an electronic medical record database between July 15, 2001, and May 31, 2003. Patient-reported tobacco use status was obtained for each of 6,771 patients during the pre-provider period of their 24,824 visits during the study period with the recorder blinded to past tobacco use status entries.

Results:
An overall current tobacco use prevalence of 27.1% was found during the study period. Tobacco use status was recorded in 96% of visits. Comparison of initial to final visit tobacco use status demonstrates a consistency rate of 75.0% declaring no change in tobacco status in the 4,522 patients with two or more visits. An 8.6% net tobacco use decline was seen for the practice (p value < 0.001)

Conclusion:
Self reported tobacco use status as a vital sign embedded within the workflow of an electronic medical record enabled practice was a quantitative tool for determination of tobacco use prevalence and a measuring stick of risk prevention/intervention impact.

 
REFERENCES (22)
1.
Treating Tobacco Use and Dependence. Summary, June 2000. U.S. Public Health Service, [http://www.surgeongeneral.gov/...].
 
2.
Robinson MD, Laurent SL, Little JM: Including smoking status as a new vital sign: it works!. Journal of Family Practice. 1995, 40 (6): 556-561.
 
3.
Ahluwalia JS, Gibson CA, Kenney RE, Wallace DD, Resnicow K: Smoking Status as a Vital Sign. Journal of General Internal Medicine. 1999, 14 (7): 402-408. 10.1046/j.1525-1497.1999.09078.x.
 
4.
Bentz CJ, Davis N, Bayley B: The feasibility of paper-based Tracking Codes and electronic medical record systems to monitor tobacco-use assessment and intervention in an Individual Practice Association (IPA) Model health maintenance organization (HMO). Nicotine & Tobacco Research. 2002, 4 (Suppl 1): 9-17. 10.1080/14622200210128036.
 
5.
Bates DW, Cohen M, Leape LL, Overhage JM, Shabot MM, Sheridan T: Reducing the frequency of errors in medicine using information technology. Journal of the American Medical Informatics Association. 2001, 8 (4): 299-308.
 
6.
Wang SJ, Middleton B, Prosser LA, Bardon CG, Spurr CD, Carchidi PJ, Kittler AF, Goldszer RC, Fairchild DG, Sussman AJ, Kuperman GJ, Bates DW: A cost-benefit analysis of electronic medical records in primary care. American Journal of Medicine. 2003, 114 (5): 397-403. 10.1016/S0002-9343(03)00057-3.
 
7.
Fiore MC, Jorenby DE, Schensky AE, Smith SS, Bauer RR, Baker TB: Smoking status as the new vital sign: effect on assessment and intervention in patients who smoke. Mayo Clinic Proceedings. 1995, 70 (3): 209-213. 10.4065/70.3.209.
 
8.
Norman LA, Hardin PA, Lester E, Stinton S, Vincent EC: Computer-assisted quality improvement in an ambulatory care setting: a follow-up report. Joint Commission Journal on Quality Improvement. 1995, 21 (3): 116-131.
 
9.
Lawthers AG: Validity review of performance measures. International Journal for Quality in Health Care. 1996, 8 (3): 299-306. 10.1093/intqhc/8.3.299.
 
10.
Hippisley-Cox J, Pringle M, Cater R, Wynn A, Hammersley V, Coupland C, Hapgood R, Horsfield P, Teasdale S, Johnson C: The electronic patient record in primary care – regression or progression? A cross sectional study. British Medical Journal. 2003, 327 (7413): 2003-483.
 
11.
Briggs B: Electronic medical records: a "work-flow" in progress. Health Data Management. 2002, 10 (6): 64-9.
 
12.
Thorndike AN, Rigotti NA, Stafford RS, Singer DE: National patterns in the treatment of smokers by physicians. Journal of the American Medical Association. 1998, 279 (8): 604-608. 10.1001/jama.279.8.604.
 
13.
Centers for Disease Control and Prevention (CDC): Behavioral Risk Factor Surveillance System Survey Data. 2000, Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.
 
14.
Hecht SS: Tobacco carcinogens, their biomarkers and tobacco-induced cancer. Nature Reviews. Cancer. 2003, 3 (10): 733-744.
 
15.
McAfee T, Grossman R, Dacey S, McClure J: Capturing tobacco status using an automated billing system: steps toward a tobacco registry. Nicotine & Tobacco Research. 2002, 4 (Suppl 1): S31-7. 10.1080/14622200210128009.
 
16.
Ornstein SM, Jenkins RG, MacFarlane L, Glaser A, Snyder K, Gundrum T: Electronic medical records as tools for quality improvement in ambulatory practice: theory and a case study. Topics in Health Information Management. 1998, 19 (2): 35-43.
 
17.
Cooley KA, Frame PS, Eberly SW: After the grant runs out. Long-term provider health maintenance compliance using a computer-based tracking system. Archives of Family Medicine. 1999, 8 (1): 13-17. 10.1001/archfami.8.1.13.
 
18.
Piper ME, Fiore MC, Smith SS, Jorenby DE, Wilson JR, Zehner ME, Baker TB: Use of the vital sign stamp as a systematic screening tool to promote smoking cessation. Mayo Clinic Proceedings. 2003, 78 (6): 716-722. 10.4065/78.6.716.
 
19.
Steinberg MB, Delnevo CD, Hrywna M: Update in New Jersey tobacco-dependence treatment. New Jersey Medicine. 2002, 99 (11): 21-26.
 
20.
Foulds J, Burke M, Richardson D, Kazimir E: Tobacco dependence treatment services in New Jersey. New Jersey Medicine. 2002, 99 (3): 23-28.
 
21.
Lindsay EA, Ockene JK, Hymowitz N, Giffen C, Berger L, Pomrehn P: Physicians and smoking cessation. A survey of office procedures and practices in the Community Intervention Trial for Smoking Cessation. Archives of Family Medicine. 1994, 3 (4): 341-348. 10.1001/archfami.3.4.341.
 
22.
Hosler AS, Godley K, Rowland DH: An initiative to improve diabetes care standards in healthcare organizations serving minorities. Diabetes Educator. 2002, 28 (4): 581-589. 10.1177/014572170202800412.
 
 
CITATIONS (5):
1.
Cochrane Database of Systematic Reviews
Raymond Boyle, Leif Solberg, Michael Fiore, Raymond Boyle
 
2.
Changes in Veteran Tobacco Use Identified in Electronic Medical Records
Paul G. Barnett, Adam Chow, Nicole E. Flores, Scott E. Sherman, Sonia A. Duffy
American Journal of Preventive Medicine
 
3.
Call to Action on Making Physical Activity Assessment and Prescription a Medical Standard of Care
Robert E. Sallis, Jason M. Matuszak, Aaron L. Baggish, Barry A. Franklin, Wojtek Chodzko-Zajko, Barbara J. Fletcher, Andrew Gregory, Elizabeth Joy, Gordon Matheson, Patrick McBride, James C. Puffer, Jennifer Trilk, Janet Williams
Current Sports Medicine Reports
 
4.
Exercise Is Medicine
Walter Thompson, Robert Sallis, Elizabeth Joy, Carrie Jaworski, Robyn Stuhr, Jennifer Trilk
American Journal of Lifestyle Medicine
 
5.
Tracking Dental Patient Tobacco Use and Intervention in the Academic Clinical Setting
Susan Morgan, William Dumire, Carol Caudill, Amy Lewis
Journal of Dental Education
 
eISSN:1617-9625