Grant Number:	3R35CA197573-06S1 Interpret this number
Primary Investigator:	Fiore, Michael
Organization:	University Of Wisconsin-Madison
Project Title:	Transforming the Treatment of Tobacco Use in Health Care: Seizing the Potential of the Electronic Health Record to Deliver Comprehensive Chronic Care Treatment for Smoking
Fiscal Year:	2020

Parent Project Summary Combustible cigarette smoking carries an enormous toll in terms of mortality, chronic illness, and economic costs for the approximately 34 million Americans who continue to smoke regularly1. An R35 Outstanding Investigator Award to Michael Fiore (PI) serves as the parent project to this application. This parent grant supports innovative approaches to increase the rate of smoking cessation among the estimated 75% of smokers who make healthcare visits each year2. A key aspect of the parent project is to increase the rates at which evidence-based smoking cessation treatment is offered in primary care, as fewer than half of primary care patients who smoke report being offered assistance quitting smoking in a given year3. Through the parent R35 award, Wisconsin health systems, the world’s leading EHR vendor, and the tobacco cessation research team, led by Michael Fiore, are working to: 1) develop and apply novel research methods to advance methodologically principled intervention translation; 2) design and test an efficient EHR-based treatment support system to organize tobacco cessation treatment and foster its dissemination; and 3) increase treatment effectiveness by delivering comprehensive chronic care smoking treatment to primary care patients. These partners implemented EHR changes and innovative healthcare delivery systems to efficiently and seamlessly deliver state-of-the art treatment to offer smoking cessation treatment to every patient identified as a smoker in a healthcare system. This innovative intervention model involving in-clinic, phone, and mailed/electronic direct outreach to patients has tremendous potential to enhance the reach of evidence-based smoking cessation interventions if adopted by healthcare systems. The R35 parent project to this supplement is evaluating the reach, effectiveness, and cost-effectiveness of the Comprehensive Chronic Care Smoking Treatment System (CCCSTS) Implementation Project at Group Health Cooperative of South Central Wisconsin (GHC). The key components of the CCCSTS are: systematic identification of patients who smoke at all visits, assessing patient willingness to set a quit date in the next 30 days at all primary care visits, offering all patients ready to quit within 30 days evidence-based smoking cessation treatment (referral to counseling services delivered by the WTQL, SmokefreeTXT, and/or GHC Tobacco Cessation Outreach Specialists [TCOS], and provision of FDA-approved smoking cessation pharmacotherapies). In addition, the CCCSTS leverages the EHR to facilitate telephone proactive outreach to patients who smoke who have not been seen in primary care or who were not offered or declined support in clinic. The overarching goal of this parent R35-funded project is to evaluate the EHR-enabled CCCSTS to enhance tobacco dependence treatment in a sustainable, efficient, cost-effective manner. A secondary aim of the parent project is to assess staff engagement in delivering CCCSTS through aggregate patient-engagement data and through assessment of workflow. The proposed supplement research directly supports these aims.





None. See parent grant details.