Electronic Referral Gets Pennsylvania Smokers Help Quitting

Automatic referrals from UPMC to Pennsylvania Free Quitline

The University of Pittsburgh Medical Center (UPMC) has launched a pilot program giving its physicians the ability to refer hospitalized patients who use tobacco to the Pennsylvania Free Quitline directly through UPMC’s electronic health record (EHR). It is the first electronic tobacco cessation referral program in the nation that has been integrated into EHRs that are certified for Stage 2 Meaningful Use.

The eReferral system is bi-directional, which allows the PA Free Quitline, operated by National Jewish Health, to receive eReferrals and to send progress reports on patients’ treatment outcomes back to referring physicians and primary care teams. Once a patient referral is received, a quitline counselor reaches out to the patient and attempts to enroll him or her in the quitline program. 

The quitline includes telephone coaching, nicotine replacement therapy, an integrated website, text messaging, email support, and a mobile app, and is founded in behavioral change, motivational interviewing and Cognitive Behavioral Therapy.

The UPMC eReferral system is the result of collaboration among the Pennsylvania Department of Health, National Jewish Health and UPMC.

Dr. Karen Murphy, Pennsylvania Secretary of Health said, "One of the key roles of the Department of Health is to facilitate collaborations that improve health.  The successful launch of this initiative is an innovative approach to enhance tobacco cessation. We look forward to working with NJH and UPMC on this new approach.”

 “We are thrilled to be part of a project that uses cutting edge technology to improve public health and individuals’ chances at quitting tobacco,” said Robin Daigh, President of Health Initiatives at National Jewish Health.  “Currently, most referrals for tobacco cessation are faxed to the quitline and have to be manually entered.  We plan to work with hospital systems across the US to implement this new eReferral system, which saves time for doctors and nurses, and gives us better clinical information about patients referred to the quitline.” 

Physicians represent a great opportunity to generate referrals to the quitline because they have the opportunity to discuss tobacco use with their patients and provide counseling if the patient wishes to stop tobacco. Research shows that intervention by physicians and other clinicians can significantly increase cessation rates, and the quitline provides a quick, easy way for time-strapped physicians to offer an effective, free solution for these patients.

“Tobacco use is the single most preventable cause of disease, disability, and death in the United States and UPMC is dedicated to helping patients quit. This program has the opportunity to reach tobacco users across the UPMC system, which serves over 37,000 hospitalized tobacco users. The eReferral integrates the transition of care to the quitline seamlessly by providing proactive follow-up and treatment after the patient is discharged, all managed from the EHR,” said Esa Davis, M.D., M.P.H., Director of the UPMC Tobacco Treatment Service.

Physicians who are participating in financial incentives for meaningful use of a certified EHR can meet performance measures by referring patients electronically for tobacco cessation, and therefore the number of physician referrals to quitlines is expected to increase significantly over the next few years.

National Jewish Health operates the PA Free Quitline, as well as 13 other state quitlines, and is working with health systems in many of these states to develop eReferral programs giving physicians easy access to a referral process for an evidence-based tobacco cessation program. Dependent on the program protocol and population, the National Jewish Health quitline presents a 7-month, 30-day abstinence responder quit rate of between 28% and 42% with the most recent Pennsylvania quit rate at 36%. These data are consistent with or superior to national data, which show that 20 to 30% of smokers using a quitline have quit smoking, while only 3 to 5% of smokers are typically able to quit on their own. 

About UPMC
A world-renowned health care provider and insurer, Pittsburgh-based UPMC is inventing new models of accountable, cost-effective, patient-centered care. It provides more than $888 million a year in benefits to its communities, including more care to the region’s most vulnerable citizens than any other health care institution. The largest nongovernmental employer in Pennsylvania, UPMC integrates more than 60,000 employees, more than 20 hospitals, more than 500 doctors’ offices and outpatient sites, a more than 2.5-million-member health insurance division, and international and commercial operations. Affiliated with the University of Pittsburgh Schools of the Health Sciences, UPMC ranks No. 12 in the prestigious U.S. News & World Report annual Honor Roll of America’s Best Hospitals — and No. 1 in Pennsylvania. For more information, go to UPMC.com.