使用电子病例的反馈及促进计划使戒烟干涉措施增加－来自19个社区服务中心的数据，美国纽约，2010.10－2013.03
2014/12/22
摘要
戒烟可显著降低吸烟者与吸烟相关疾病的患病率和死亡率，并且可延长其预期寿命达10年。大部分吸烟者希望自己可以戒烟，每年至少一次去医疗服务站。卫生保障提供者可在帮助吸烟者戒烟的过程发挥重要作用，其措施包括记录吸烟者烟草使用情况，建议吸烟者戒烟，以及提供循征戒烟疗法或推荐戒烟方案。但是，很多卫生保障提供者和实践者并没有定期地采取这些措施。目前，存在一些可以帮助卫生保障提供者筛选并实施戒烟干预措施的系统。具体来讲，如电子病历（EHRs）可作为加强戒烟干预的强有力工具。本研究对纽约市（NYC）内19个社区服务中心（CHCs）采用电子病历改进措施进行报告，旨在提高对吸烟者情况的记录并加强戒烟干预措施。在电子病历投入使用后，社区服务中心记录的病人中吸烟者所占的比例由24%增加到27%，此外，吸烟者中接受戒烟干预治疗的比例由23%上升到54%。公共卫生方案及医疗体系应该考虑采取一些措施对卫生保障提供者进行相关培训和技能提高，使他们可以通过应用信息技术促进戒烟干预措施的实施。
（刘国梁 审校）
MMWR Morb Mortal Wkly Rep. 2014 Oct 17;63(41):921-4.
Increases in smoking cessation interventions after a feedback and improvement initiative using electronic health records - 19 community health centers, new york city, october 2010-march 2012.
Silfen SL, Farley SM, Shih SC, Duquaine DC, Ricci JM, Kansagra SM, Edwards SM, Babb S, McAfee T.
ABSTRACT
Quitting smoking substantially reduces smokers' risk for smoking-related morbidity and mortality and can increase life expectancy by up to a decade. Most smokers want to quit and make at least one medical provider visit annually. Health care providers can play an important role in helping smokers quit by documenting patients' tobacco use, advising smokers to quit, and providing evidence-based cessation treatments or referrals for treatment, but many providers and practices do not regularly take these actions. Systems to increase provider screening and delivery of cessation interventions are available; in particular, electronic health records (EHRs) can be powerful tools to facilitate increased cessation interventions. This analysis reports on an EHR-based pay-for-improvement initiative in 19 community health centers (CHCs) in New York City (NYC) that sought to increase smoking status documentation and cessation interventions. At the end of the initiative, the mean proportion of patients who were documented as smokers in CHCs had increased from 24% to 27%, whereas the mean proportion of documented smokers who received a cessation intervention had increased from 23% to 54%. Public health programs and health systems should consider implementing strategies to equip and train clinical providers to use information technology to increase delivery of cessation interventions.
MMWR Morb Mortal Wkly Rep. 2014 Oct 17;63(41):921-4.
