A formalized approach to remedy tobacco addiction: e-referrals and the ability of documentation to influence opportunities through motivational interviewing
Hoffman, Matthew Douglas
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It is an understatement to report that there is an inconsistent approach for tobacco cessation therapy (TCT) techniques, and this is negatively affecting those with the desire to pursue cessation. Therefore, it is long overdue to better address and incentivize a more consistent quality improvement process to remedy the multifaceted dynamic of tobacco cessation (TC). According to the World Health Organization (WHO) tobacco globally affects 1.2 billion people, and annually imposes an economic damage of $500 billion worldwide (Caponnetto et al., 2019; Epku & Brown, 2015; Gonzales et al., 2020). With attention to detail in the foreground of billing, coding, and documentation, it is anticipated that increased opportunities for a more formalized approach to remedy tobacco addictions through motivational interviewing (MI) have been encouraged. Ultimately, this project guided a synergistic effect between the financial integrity of the medical clinic and the health of the rural Montana population that it serves. In a small rural family medicine clinic and over a six-week timeframe, a provider instituted basic MI techniques to enroll patients interested in TCT via an electronic (e-Referral) to the Montana Tobacco Quit Line (MTQL) to remedy tobacco addiction. Data collection was facilitated and contained within the EPIC EHR system, monitoring the number of known tobacco users, ready to quit statuses, and those both currently and newly enrolled for counseling with an e-Referral to the MTQL. Prior to the project's implementation, a total 23 patients were known as tobacco users at this clinic, two of which were being counseled; three new e-Referrals submitted increase the total to five. Nonetheless, there are now 51 patients that are newly known tobacco users after this project's screening and documentation. The thematic underpinnings that surfaced include a lack of healthcare engagement with documenting tobacco users and the need for continued pursuit of TCT. The generalization that this data infers is that the rural population at this clinic is asking for help, but the health system is not responding adequately.