scholarly journals Design and Pilot Implementation of an Electronic Health Record-Based System to Automatically Refer Cancer Patients to Tobacco Use Treatment

2020 ◽  
Vol 17 (11) ◽  
pp. 4054 ◽  
Author(s):  
Thulasee Jose ◽  
Joshua W. Ohde ◽  
J. Taylor Hays ◽  
Michael V. Burke ◽  
David O. Warner
Keyword(s):  
Electronic Health Record ◽  
Cancer Patients ◽  
Tobacco Use ◽  
Mayo Clinic ◽  
Cancer Center ◽  
Health Record ◽  
Oncology Patients ◽  
Tobacco Treatment ◽  
Opt Out ◽  
Electronic Health

Continued tobacco use after cancer diagnosis is detrimental to treatment and survivorship. The current reach of evidence-based tobacco treatments in cancer patients is low. As a part of the National Cancer Institute Cancer Center Cessation Initiative, the Mayo Clinic Cancer Center designed an electronic health record (EHR, Epic©)-based process to automatically refer ambulatory oncology patients to tobacco use treatment, regardless of intent to cease tobacco use(“opt out”). The referral and patient scheduling, accomplished through a best practice advisory (BPA) directed to staff who room patients, does not require a co-signature from clinicians. This process was piloted for a six-week period starting in July of 2019 at the Division of Medical Oncology, Mayo Clinic, Rochester, MN. All oncology patients who were tobacco users were referred for tobacco treatment by the rooming staff (n = 210). Of these, 150 (71%) had a tobacco treatment appointment scheduled, and 25 (17%) completed their appointment. We conclude that an EHR-based “opt-out” approach to refer patients to tobacco dependence treatment that does not require active involvement by clinicians is feasible within the oncology clinical practice. Further work is needed to increase the proportion of scheduled patients who attend their appointments.

scholarly journals External Validity of Electronic Health Record Studies of Cancer Patients

2017 ◽  
Vol 4 (3) ◽  
pp. 150
Author(s):  
Anqi Jin ◽  
Scarlett Gomez ◽  
Harold Luft ◽  
Daphne Lichtensztajn ◽  
Caroline Thompson
Keyword(s):  
Electronic Health Record ◽  
Cancer Patients ◽  
External Validity ◽  
Health Record ◽  
Electronic Health

scholarly journals Caregivers' role in using a personal electronic health record: a qualitative study of cancer patients and caregivers in Germany

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Aline Weis ◽  
Sabrina Pohlmann ◽  
Regina Poss-Doering ◽  
Beate Strauss ◽  
Charlotte Ullrich ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Electronic Health Record ◽  
Cancer Patients ◽  
Health Record ◽  
Electronic Health

scholarly journals Care-paradigm shift promoting smoking cessation treatment among cancer center patients via a low-burden strategy, Electronic Health Record-Enabled Evidence-Based Smoking Cessation Treatment

2019 ◽  
Author(s):  
Alex T Ramsey ◽  
Ami Chiu ◽  
Timothy Baker ◽  
Nina Smock ◽  
Jingling Chen ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Electronic Health Record ◽  
Paradigm Shift ◽  
Point Of Care ◽  
Cancer Center ◽  
Evidence Based ◽  
Health Record ◽  
Smoking Cessation Treatment ◽  
Cessation Treatment ◽  
Electronic Health

Abstract Tobacco smoking is an important risk factor for cancer incidence, an effect modifier for cancer treatment, and a negative prognostic factor for disease outcomes. Inadequate implementation of evidence-based smoking cessation treatment in cancer centers, a consequence of numerous patient-, provider-, and system-level barriers, contributes to tobacco-related morbidity and mortality. This study provides data for a paradigm shift from a frequently used specialist referral model to a point-of-care treatment model for tobacco use assessment and cessation treatment for outpatients at a large cancer center. The point-of-care model is enabled by a low-burden strategy, the Electronic Health Record-Enabled Evidence-Based Smoking Cessation Treatment program, which was implemented in the cancer center clinics on June 2, 2018. Five-month pre- and post-implementation data from the electronic health record (EHR) were analyzed. The percentage of cancer patients assessed for tobacco use significantly increased from 48% to 90% (z = 126.57, p < .001), the percentage of smokers referred for cessation counseling increased from 0.72% to 1.91% (z = 3.81, p < .001), and the percentage of smokers with cessation medication significantly increased from 3% to 17% (z = 17.20, p < .001). EHR functionalities may significantly address barriers to point-of-care treatment delivery, improving its consistent implementation and thereby increasing access to and quality of smoking cessation care for cancer center patients.

The role of electronic records in reporting adverse drug reactions.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 309-309
Author(s):  
Alanna M. Poirier ◽  
Paul Nachowicz ◽  
Subhasis Misra
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Electronic Health Record ◽  
Adverse Drug Reactions ◽  
Improve Patient Safety ◽  
Cancer Center ◽  
Health Record ◽  
Drug Reactions ◽  
History Of ◽  
Electronic Health

309 Background: The Pharmacy and Therapeutics committee at a regional cancer center is responsible to report and trend existing adverse drug reactions. The electronic health record did not have an option to document the history of an event or have an alert function if a medication was re-ordered. The frequency of documented adverse drug reactions did not correlate to what was being observed on the units with the use of a paper document. Methods: InAugust 2010 a Lean Six Sigma project was initiated to improve adverse drug reaction reporting. An adverse drug reaction document along with standard work instructions was completed by March 2011. A report was built in the electronic health record and a computer based learning module was created and rolled out to clinical staff by October 2011. Results: The turn-around time in days to document an adverse drug reaction in the patients chart decreased from 6.8 days to 0.7 days. The documented adverse drug reactions increased by 37%; verified by the use of supportive medications. Conclusions: The root cause for under-reporting was attributed to lack of knowledge, process, and automation. The history of an adverse drug reaction can now be viewed and an automatic alert is produced requiring physician acknowledgement decreasing the chance of repeated discomfort or harm to the patient. Adverse drug reaction documentation can be retrieved within 24 hours, analyzed, trended, and used for educational purposes to improve patient safety. [Table: see text]

Electronic health record use among cancer patients: Insights from the Health Information National Trends Survey

2017 ◽  
Vol 25 (1) ◽  
pp. 83-90 ◽  
Author(s):  
Yulia A Strekalova
Keyword(s):  
Electronic Health Records ◽  
Electronic Health Record ◽  
Cancer Patients ◽  
Health Information ◽  
Information Seeking ◽  
Health Record ◽  
Online Information ◽  
Health Records ◽  
Electronic Health ◽  
National Trends

Over 90% of US hospitals provide patients with access to e-copy of their health records, but the utilization of electronic health records by the US consumers remains low. Guided by the comprehensive information-seeking model, this study used data from the National Cancer Institute’s Health Information National Trends Survey 4 (Cycle 4) and examined the factors that explain the level of electronic health record use by cancer patients. Consistent with the model, individual information-seeking factors and perceptions of security and utility were associated with the frequency of electronic health record access. Specifically, higher income, prior online information seeking, interest in accessing health information online, and normative beliefs were predictive of electronic health record access. Conversely, poorer general health status and lack of health care provider encouragement to use electronic health records were associated with lower utilization rates. The current findings provide theory-based evidence that contributes to the understanding of the explanatory factors of electronic health record use and suggest future directions for research and practice.

scholarly journals Implementation of an Electronic Health Record-Based Care Management System to Improve Tobacco Treatment

2012 ◽  
Vol 27 (12) ◽  
pp. 1690-1696 ◽  
Author(s):  
Gina R. Kruse ◽  
Jennifer H. K. Kelley ◽  
Jeffrey A. Linder ◽  
Elyse R. Park ◽  
Nancy A. Rigotti
Keyword(s):  
Electronic Health Record ◽  
Management System ◽  
Care Management ◽  
Health Record ◽  
Tobacco Treatment ◽  
Electronic Health

Incorporating systematic financial screening into the electronic health record.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 184-184
Author(s):  
Melissa Parsons Beauchemin ◽  
Elena B. Elkin ◽  
Jason Dennis Wright ◽  
Rita Kukafka ◽  
Dawn L. Hershman ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Qualitative Interviews ◽  
Gynecologic Oncology ◽  
Financial Hardship ◽  
Cancer Center ◽  
Health Record ◽  
Patient Portal ◽  
Financial Toxicity ◽  
Collect Paper ◽  
Electronic Health

184 Background: Routine screening for financial hardship may identify patients at risk of financial crisis (bankruptcy or inability to afford food or medication). Identifying financial hardship risk is a critical step toward mitigating financial toxicity, associated with earlier mortality and poorer quality of life. We are studying the implementation of systematic financial hardship screening using the electronic health record (EHR) in a large, urban, outpatient cancer center. Methods: Guided by the Consolidated Framework for Implementation Research, we met with key stakeholders, including providers, medical assistants (MA’s), administrative staff, and patient advocates to develop a process to systematically screen all cancer patients for financial hardship risk using 2 items (Q1 and Q3) from the Comprehensive Score for Financial Toxicity (COST). We initiated the process in the breast oncology clinic and partnered with EPIC to integrate the items in the EHR and patient portal. In March 2021, we implemented systematic screening, with automatic prompts to reassess monthly. Results: The workflow includes two mechanisms for patients to complete the 2 items: through the online patient portal during appointment check-in; or through a paper form in English or Spanish, distributed to patients during check-in. An EHR flag was created to notify staff if the patient is due to complete the questions during check-in. During vital signs assessment, the MA collects the form and enters the responses into the EHR. Two important factors were identified to improve the implementation: 1) Patient support to facilitate EHR portal use to reduce clinic workflow congestion; and 2) printed resources for patients who express financial concern. Ongoing discussions reveal that certain clinic days are busier, during which staff find it difficult to review EHR flag, provide and collect paper forms. To date, of 1,358 patients seen in the breast oncology clinic, 526 (39%) have responded to the question, “I know that I have enough money in savings, retirement, or assets to cover the costs of my treatment,” and of those, 278 (53%) responded “not at all” or “a little bit.” Of the 532 patients (39%) who responded to the question, “I worry about the financial problems I will have in the future as a result of my illness or treatment,” 215 (40%) responded “quite a bit” or “very much.” Conclusions: Preliminary analysis highlights the complexities of initiating systematic financial screening in oncology clinics. However, interim results suggest financial hardship is prevalent. Next steps include: expanding to pediatric and gynecologic oncology; building a dashboard to inform financial referrals; comparison of the 2-item screener to the COST survey in a subset of patients; qualitative interviews and focus groups with patients and staff to improve current procedures and optimize the use of dashboards and alerts to focus interventions and referrals on patients most in need.

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