Implementation, Maintenance, and Outcomes of an Electronic Referral to a Tobacco Quitline Across Fiv

Tong EK, Zhu SH, Anderson CM, Avdalovic MV, Amin AN, Diamant AL, Fong TW, Clay B, El-Kareh R, Sankaran S, Bonniot C, Kirby CA, Mayoral A, Sarna L.
Implementation, Maintenance, and Outcomes of an Electronic Referral to a Tobacco Quitline Across Five Health Systems
Nicotine Tob Res. 2023 Mar 29:ntad008. doi: 10.1093/ntr/ntad008. Epub ahead of print. PMID: 36977494.

Electronic referral (e-referral) to quitlines helps connect tobacco-using patients to free, evidence-based cessation counseling. Little has been published about the real-world implementation of e-referrals across US health systems, their maintenance over time, and the outcomes of e-referred patients. Beginning in 2014, the University of California (UC)-wide project called UC Quits scaled up quitline e-referrals and related modifications to clinical workflows from one to five UC health systems. Implementation strategies were used to increase site readiness, and maintenance was supported through ongoing monitoring and quality improvement programs.

With a whole-systems approach, quitline e-referrals can be established and sustained across inpatient and outpatient settings with diverse patient populations. Cessation outcomes were similar to those of general quitline callers. Modifying electronic health records systems and clinical workflows to enable and encourage e-referrals, if implemented and maintained appropriately, can be expected to improve patient care, make it easier for clinicians to support patients in quitting, increase the proportion of patients using evidence-based treatment, provide data to assess progress on quality goals, and help meet reporting requirements for tobacco screening and prevention.