An Innovative, Community-based Approach to Smoking Cessation

One of the criteria set forth in Stage One Meaningful Use guidelines pertains to capturing information at the point of care about patients’ smoking status, and as relevant, offering counseling to help patients quit smoking. While attending the Rhode Island Statewide Patient Centered Medical Home Learning Collaborative Exit Disclaimer on February 5, we learned about the kinds of innovations that this aspect of meaningful use may inspire and make more widespread in the future.

Terri Mrozak of Quality Partners of Rhode Island Exit Disclaimer introduced us to a comprehensive smoking cessation strategy that makes the best available use of health information technology (health IT) to support patients seeking to quit smoking across three states. She explained that quitting smoking is often the single most important thing one can do to improve their health, and that it takes most smokers as many as eight quit attempts before they are able to quit permanently.1

Terri then told us about QuitWorks – RI Exit Disclaimer, a free stop-smoking service sponsored by the Rhode Island Department of Health Exit Disclaimer and based on a program created by the Massachusetts Tobacco Control Program in 2002. Since its inception, providers in three states (Massachusetts, New Hampshire, and Rhode Island) have referred more than 30,000 patients to QuitWorks, and nearly one in every five patients contacted has quit smoking within six months after enrolling in the program.2 More than a telephonic quit line, which are widely available across the country, QuitWorks combines traditional telephonic care management with a health IT-enabled referral management system.

According to Donna Warner, QuitWorks founder in Massachusetts, patients interested in smoking cessation resources can be electronically referred to the QuitWorks program through their physicians’ electronic health records (EHRs) with the patient’s medical ID attached. This automatically triggers a follow-up telephonic referral to a trained quitline counselor who will reach out to the patients and offer targeted education and coaching. Importantly, status reports can be provided back to physicians directly into their EHR system, which allows physicians to follow up with patients and monitor their progress as they seek to quit. As part of the program, Quality Partners of Rhode Island Exit Disclaimer also helps physician practices develop the workflow changes needed in their office to support approaches to tobacco-dependence treatment. While QuitWorks itself pre-dates the meaningful use rule, the combination of well-established tobacco counseling approaches with health IT linking patients’ data back into referring physicians’ EHRs represents the kind of innovation that meaningful use may support more broadly.


1 Massachusetts Office of Health and Human Services

2 Dr. Thomas Land, Massachusetts Tobacco Control Program, Director of Surveillance and Evaluation

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