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eReferral Between Hospitals and Quitlines

An Emerging Tobacco Control Strategy
      More than two thirds of adult U.S. smokers, or about 30 million people, see a healthcare provider every year
      • Fiore M.C.
      • Jaen C.R.
      • Baker T.B.
      • et al.
      Treating Tobacco Use and Dependence: 2008 Update.
      and more than half try to quit smoking. Yet most are not successful because they do not use recommended treatments of counseling and medication,
      • Shiffman S.
      • Brockwell S.E.
      • Pillitteri J.L.
      • Gitchell J.G.
      Use of smoking-cessation treatments in the United States.
      even when seen by a health professional.
      Centers for Disease Control and Prevention
      Tobacco use screening and counseling during physician office visits among adults—National Ambulatory Medical Care Survey and National Health Interview Survey, United States, 2005–2009.
      Although healthcare encounters offer an opportunity to treat smoking, most healthcare systems do not have the resources to deliver full evidence-based treatments to their smokers. To address this problem, healthcare systems, including hospitals, are partnering with the nationwide network of state tobacco-cessation quitlines to implement a new, technologically advanced bidirectional electronic referral (eReferral) designed under the auspices of the North American Quitline Consortium (NAQC), the organization tasked with maximizing access, use, and effectiveness of quitlines in the U.S. and Canada. Built to federal health information technology (IT) standards, eReferral has tremendous potential to deliver high-value treatment to millions of smokers who are hospitalized or otherwise engaged in the healthcare system by connecting them with state quitlines. The purpose of this article is to introduce and illustrate eReferral and to discuss the promises and challenges associated with its widespread implementation.
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      References

        • Fiore M.C.
        • Jaen C.R.
        • Baker T.B.
        • et al.
        Treating Tobacco Use and Dependence: 2008 Update.
        Public Health Service, Rockville, MD2008
        • Shiffman S.
        • Brockwell S.E.
        • Pillitteri J.L.
        • Gitchell J.G.
        Use of smoking-cessation treatments in the United States.
        Am J Prev Med. 2008; 34: 102-111https://doi.org/10.1016/j.amepre.2007.09.033
        • Centers for Disease Control and Prevention
        Tobacco use screening and counseling during physician office visits among adults—National Ambulatory Medical Care Survey and National Health Interview Survey, United States, 2005–2009.
        MMWR Morb Mortal Wkly Rep. 2012; 61: 38-45
      1. Rudie M, Bailey L. Results from the 2013 NAQC Annual Survey of Quitlines. www.naquitline.org/?page=survey (slides 29, 30, 64). Published 2015. Accessed December 17, 2015.

        • North American Quitine Consortium
        Results from the 2015 NAQC Annual Survey of Quitlines.
        NAQC, Phoenix, AZ2015
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      2. Health Level 7 International. About HL7. www.hl7.org/about/index.cfm?ref=footer. Accessed April 18, 2016.

        • North American Quitline Consortium
        Guide for Implementing eReferral Using Certified EHRs.
        NAQC, Phoenix, AZ2015
        • Boyle R.
        • Solberg L.
        • Fiore M.
        Use of electronic health records to support smoking cessation.
        Cochrane Database Syst Rev. 2011; 12: CD008743https://doi.org/10.1002/14651858.cd008743.pub2