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Implementing point of care "e-referrals" in 137 clinics to increase access to a quit smoking internet system: the Quit-Primo and National Dental PBRN HI-QUIT Studies
University of Massachusetts Medical School Faculty Publications
  • Rajani S. Sadasivam, University of Massachusetts Medical School
  • Timothy P. Hogan, University of Massachusetts Medical School
  • Julie E. Volkman, University of Massachusetts Medical School
  • Bridget M. Smith, Loyola University Chicago
  • Heather L. Coley, University of Alabama at Birmingham
  • Jessica H. Williams, University of Alabama at Birmingham
  • Kathryn Delaughter, University of Massachusetts Medical School
  • Midge N. Ray, University of Alabama at Birmingham
  • Gregg H. Gilbert, University of Alabama at Birmingham
  • Daniel E. Ford, Johns Hopkins University
  • Jeroan J. Allison, University of Massachusetts Medical School
  • Thomas K. Houston, University of Massachusetts Medical School
  • National Dental PBRN and QUITPRIMO Collaborative Groups, National Dental PBRN and QUITPRIMO Collaborative Groups
UMMS Affiliation
Department of Quantitative Health Sciences
Publication Date
12-1-2013
Document Type
Article
Abstract
Integrating electronic referral systems into clinical practices may increase use of web-accessible tobacco interventions. We report on our feasibility evaluation of using theory-driven implementation science techniques to translate an e-referral system (ReferASmoker.org) into the workflow of 137 community-based medical and dental practices, including system use, patient registration, implementation costs, and lessons learned. After 6 months, 2,376 smokers were e-referred (medical, 1,625; dental, 751). Eighty-six percent of the medical practices [75/87, mean referral = 18.7 (SD = 17.9), range 0-105] and dental practices [43/50, mean referral = 15.0 (SD = 10.5), range 0-38] had e-referred. Of those smokers e-referred, 25.3 registered [mean smoker registration rate-medical 4.9 (SD = 7.6, range 0-59), dental 3.6 (SD = 3.0, range 0-10)]. Estimated mean implementation costs are medical practices, US$429.00 (SD = 85.3); and dental practices, US$238.75 (SD = 13.6). High performing practices reported specific strategies to integrate ReferASmoker.org; low performers reported lack of smokers and patient disinterest in the study. Thus, a majority of practices e-referred and 25.3 % of referred smokers registered demonstrating e-referral feasibility. However, further examination of the identified implementation barriers is important as of the estimated 90,000 to 140,000 smokers seen in the 87 medical practices in 6 months, only 1,625 were e-referred.
Keywords
  • UMCCTS funding
DOI of Published Version
10.1007/s13142-013-0230-3
Source
Sadasivam RS, Hogan TP, Volkman JE, Smith BM, Coley HL, Williams JH, Delaughter K, Ray MN, Gilbert GH, Ford DE, Allison JJ, Houston TK; National Dental PBRN and QUITPRIMO Collaborative Groups. Implementing point of care "e-referrals" in 137 clinics to increase access to a quit smoking internet system: the Quit-Primo and National Dental PBRN HI-QUIT Studies. Transl Behav Med. 2013 Dec;3(4):370-8. doi: 10.1007/s13142-013-0230-3. Link to article on publisher's site
Related Resources
Link to Article in PubMed
PubMed ID
24294325
Citation Information
Rajani S. Sadasivam, Timothy P. Hogan, Julie E. Volkman, Bridget M. Smith, et al.. "Implementing point of care "e-referrals" in 137 clinics to increase access to a quit smoking internet system: the Quit-Primo and National Dental PBRN HI-QUIT Studies" Vol. 3 Iss. 4 (2013) ISSN: 1869-6716 (Print)
Available at: http://works.bepress.com/rajani_sadasivam/27/