Epic EHR Optimization Helps Cancer Patients Quit Smoking
Cancer patients had a better reach of smoking cessation treatments and greater quit rates following an Epic EHR optimization.
An Epic EHR optimization, featuring an electronic health record-enabled smoking module and decision support tools, helped cancer patients successfully quit smoking, driving healthy behavior change, researchers wrote in the Journal of the National Comprehensive Cancer Network.
Smoking after a cancer diagnosis can lead to lower survival rates, a higher risk of additional cancers, and more severe side effects from cancer treatments. Abstaining from smoking can positively impact cancer patients, decreasing the number, severity, and frequency of adverse effects experienced.
Yet, not enough patients are receiving adequate counseling and support according to evidence-based smoking cessation guidelines, the press release stated.
Even though multiple effective cessation treatments currently exist, barriers have limited the access leading to treatment underutilization.
“ELEVATE seems to be emerging as a relatively rare example of a program that enables access to high-quality smoking cessation care while minimizing costs and burden,” lead researcher Alex T. Ramsey, PhD, a Washington University researcher at Siteman Cancer Center, said in a public statement.
“ELEVATE features an easy-to-use smoking module built into the electronic health record that cues actions by multiple members of the oncology care team to assess smoking status, provide cessation advice, prescribe cessation medications, and offer a variety of cessation counseling options to patients who smoke,” Ramsey explained.
The study, including 3,238 medical oncology patients, examined how ELEVATE can affect the reach and effectiveness of evidence-based cessation treatment.
The electronic alerts and decision support tools provided a broader reach of effective interventions to patients. The smoking cessation tool elevated reach by eliminating time-consuming barriers related to scheduling, traveling, and attending separate in-person appointments.
The implementation of ELEVATE increased smoking cessation treatment reach from 12 percent to nearly 28 percent within usual care clinics.
Patients with access to smoking cessation treatment are three times more likely to stop smoking, the researchers pointed out.
“We must make sure oncology providers are fully supported by the entire healthcare team and have access to efficient EHR decision support,” Li-Shiun Chen, MD, MPH, ScD, senior researcher at Siteman and Washington University, said.
“We were pleasantly surprised to see how eager oncology providers are to transform their practice in order to offer tobacco treatment as part of routine care, as long as this evidence-based care is baked into their workflow and EHR. ELEVATE offers an innovative, low-burden paradigm shift so tobacco cessation strategies can be fully embedded into point-of-care for every oncology visit.”
The researchers at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine found that only 12 percent of patients treated had quit smoking prior to implementing ELEVATE.
Following the implementation, slightly over 17 percent of patients achieved smoking cessation.
“Abstinence from smoking is a critical component of cancer care,” Christine E. Sheffer, PhD, Roswell Park Comprehensive Cancer Center, commented. “The findings from this pre-post quasi-experimental study, conducted from 2018 to 2019, demonstrates the utility of using an EHR-enabled cessation tool to reach cancer patients with a moderate intervention for smoking cessation.”
Even though the study showed increases in reach and smoking cessation compared with usual care, further research is needed to understand the long-term impact, the researchers stated.
“Although the proportion of patients for whom a period of abstinence was reported during the six months after the intervention increased significantly, it still falls short of an obligation to provide long-term effective smoking cessation treatment as a critical component of care,” continued Sheffer, who is also a member of NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) Panel for Smoking Cessation.
“Combining an EHR-enabled cessation tool with NCCN-recommended counseling and pharmacotherapy has the potential to further increase the proportion of patients who achieve, and maintain, abstinence from smoking.”
Ultimately, enhancing efficient workflow for clinicians has been a key strategy for improving cancer care in 2022.
Earlier this year, Epic Systems announced that it would integrate Guardant Health tests within its EHR to expedite the test ordering process for clinicians and improve patient access to cancer screenings.
The EHR integration will allow clinicians to order Guardant Health Center tests electronically within Epic, which the companies said will improve cancer care. More than 250 million patients with a record in Epic will now have access to cancer screenings through this new partnership.