Measure:

More than 50 percent of all unique patients 13 years old or older seen by the eligible professional have smoking status recorded as structured data.

Clinical Importance

Tobacco use and tobacco-related illness represents the single greatest health risk to patients in the United States. With clear and compelling evidence that provider interest in a patient’s tobacco use can be an important first step in durable cessation, the simple act of asking and recording a patient’s use of tobacco can have a profound benefit.

Lessons from the Field

Implementers in the field identified an efficient process for recording smoking status while ensuring provider to patient discussions were pursued when necessary. During the patient workup, a nurse documents the patient’s vitals and chief complaint as well as their tobacco status and body mass index (BMI). All tobacco and BMI data is then flagged in the EHR by applying blue font. The diagnosis of “Tobacco Use Disorder” or “Overweight” is also added to the problem list in blue font if that tobacco status is positive or if BMI is elevated. The blue font highlights these issues for the physician, alerting them to review the data and pursue tobacco or obesity counseling conversations during the patient appointment if necessary.

Ensuring that the smoking status data is entered appropriately into an EHR is a key component to successfully meeting this meaningful use measure. Each practice must work with their vendor to guarantee that all six (6) of the required smoking status options  are available for physicians to select. However, they should also confirm that there are no duplicative options that might cause inconsistent data entry or limited use of the required status options. Properly utilizing these six (6) required options allows for physicians to compare their care to others across their community, their state, and the nation as these options are also utilized with the Center for Disease Control’s Behavioral Risk Factor Surveillance System.