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Electronic medical record tobacco use vital sign
John W Norris1, Smita Namboodiri, Syed Haque
1Division of Medical Informatics, Department of Medicine, New Jersey Medical School. norrisjw@umdnj.edu.
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.
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