EHR Tobacco

In the EHR Dashboard, click Edit smoking status.

Alternatively, double-click in the Patient Info Medical area of the Chart Module, then click the Tobacco Use tab. Or double-click the Tobacco Use row in the Chart Module, Patient Info Medical area. To add this row to the Patient Info area, in Display Fields, add Tobacco Use to ChartPatientInformation.

Note: In any case EHR must be enabled.

Smoking status, tobacco use, and documented interventions affect EHR Clinical Quality Measures in EHR Modified Stage 2.

A history of the patient's smoking status, tobacco use, and interventions show on the right.

Current smoking status

This status affects the percentage calculation for EHR Smoking Status. Click the dropdown to select the patient's current smoking status. The available options are based on SNOMED CT codes (see Importing Code Systems to obtain all required code systems for EHR). If none is the selection, the status will not be counted in the numerator. Only one status selection per day will be added to the Assessment History.

Tobacco Use Screening and Cessation Intervention (CQM)

Document information for CQM #138 (Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention). This CQM calculates how many patients 18 years and older are assessed as 'tobacco user' and also receive a cessation counseling intervention. See EHR Clinical Quality Measure Descriptions.

Tobacco Use Assessment: Assess the patient's tobacco use. The date defaults to today's date.

  1. Select the Assessment Type option that best describes the question asked to the patient. There are three options:
    • History of tobacco use Narrative.
    • Have you used tobacco in the last 30 days SAMH.
    • Have you used smokeless tobacco product in the last 30 days SAMH.
  2. (optional) Select a Filter Statuses By option to filter the Tobacco Status list.
    • All = all statuses
    • User = status options for tobacco users
    • Non-User = status options for non-tobacco users
    • Frequent = status options used most often
  3. Click the Tobacco Status dropdown to select the patient's current tobacco status. The available options are based on SNOMED CT codes. To select a different code, select Choose from all SNOMED CT codes. If you use a code that is not recommended CQMs percentages may be affected.
  4. Click Add Assessment. A log entry for today's date will be added to the Assessment History. Multiple entries can be added for the same day.

To edit an assessment date, enter notes, document tobacco use start date, or rate desire to quit, double click an Assessment History log entry.

The following items can be changed:

Cessation Intervention: If patient is assessed as a tobacco user, document an Intervention. The date defaults to today's date.

  1. (optional) Select a Filter Codes by option to filter the Intervention Code list.
    • All = all interventions
    • User = interventions for tobacco users
    • Non-User = interventions for non-tobacco users
    • Frequent = interventions used most often
  2. Click the Intervention Code dropdown to select the intervention.
  3. Patient Declined: Check to indicate a patient is declining the intervention (optional). This is informational only. Declined interventions still count in CQMs.
  4. Click Add Intervention to add a log entry to Intervention History. If you select a medication, the Medication for Patient window will open so you can enter instructions and start date. The medication will be added to the Medications list.

To edit an intervention's date or patient declined status, enter notes, or delete an intervention, double click the intervention under Intervention History. The documented intervention will be highlighted in the list.