TY - JOUR
KW - Adult
KW - Aged
KW - Algorithms
KW - Boston/epidemiology
KW - Counseling/methods/statistics & numerical data
KW - Family Practice/standards/statistics & numerical data
KW - Female
KW - Guideline Adherence/statistics & numerical data
KW - Humans
KW - Logistic Models
KW - Male
KW - Managed Care Programs/standards
KW - Medical Records Systems, Computerized/statistics & numerical data
KW - Middle Aged
KW - Outcome Assessment (Health Care)/statistics & numerical data
KW - Patient Education as Topic/statistics & numerical data
KW - Patient Satisfaction/statistics & numerical data
KW - Physician-Patient Relations
KW - Practice Guidelines as Topic
KW - Primary Health Care/statistics & numerical data
KW - Smoking Cessation/methods
KW - Smoking/epidemiology/prevention & control
AU - M. B. Conroy
AU - N. E. Majchrzak
AU - C. B. Silverman
AU - Y. Chang
AU - S. Regan
AU - L. I. Schneider
AU - N. A. Rigotti
A1 - 
AB - An accurate method of measuring primary care providers' tobacco counseling actions is needed for monitoring adherence to clinical practice guidelines. We compared three methods of measuring providers' tobacco counseling practices: electronic medical record (EMR) review, patient survey, and provider survey. We mailed a survey to 1,613 smokers seen by 114 Boston-area primary care providers during a 2-month period to assess what tobacco counseling actions had occurred at the visit (N = 766; 47% response rate). Smokers' reports were compared with the EMR and with their providers' self-reported usual tobacco counseling practices, derived from a provider survey (N = 110; 96% response rate). Patients reported receiving each counseling action more frequently than providers documented it in the EMR. Agreement between the patient survey and the EMR was poor for all 5A steps (kappa statistic = 0.01-0.22). Providers reported that they often or always performed each 5A action at a higher rate than indicated by EMR or patient report. However, providers who said they often or always performed individual 5A steps did not have consistently higher mean rates of EMR documentation or patient report than those who said they performed the 5A's less frequently. Little agreement was found among the three methods of measuring primary care providers' tobacco counseling actions. Implementing an EMR does not necessarily improve providers' documentation of tobacco interventions, but EMR adaptations that would standardize provider documentation of tobacco counseling might make the EMR a more reliable tool for monitoring providers' delivery of tobacco treatment services.
BT - Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
C5 - HIT & Telehealth
CY - England
DO - 10.1080/14622200500078089
JF - Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
N2 - An accurate method of measuring primary care providers' tobacco counseling actions is needed for monitoring adherence to clinical practice guidelines. We compared three methods of measuring providers' tobacco counseling practices: electronic medical record (EMR) review, patient survey, and provider survey. We mailed a survey to 1,613 smokers seen by 114 Boston-area primary care providers during a 2-month period to assess what tobacco counseling actions had occurred at the visit (N = 766; 47% response rate). Smokers' reports were compared with the EMR and with their providers' self-reported usual tobacco counseling practices, derived from a provider survey (N = 110; 96% response rate). Patients reported receiving each counseling action more frequently than providers documented it in the EMR. Agreement between the patient survey and the EMR was poor for all 5A steps (kappa statistic = 0.01-0.22). Providers reported that they often or always performed each 5A action at a higher rate than indicated by EMR or patient report. However, providers who said they often or always performed individual 5A steps did not have consistently higher mean rates of EMR documentation or patient report than those who said they performed the 5A's less frequently. Little agreement was found among the three methods of measuring primary care providers' tobacco counseling actions. Implementing an EMR does not necessarily improve providers' documentation of tobacco interventions, but EMR adaptations that would standardize provider documentation of tobacco counseling might make the EMR a more reliable tool for monitoring providers' delivery of tobacco treatment services.
PP - England
PY - 2005
SN - 1462-2203; 1462-2203
EP - 43
EP - S35+
T1 - Measuring provider adherence to tobacco treatment guidelines: a comparison of electronic medical record review, patient survey, and provider survey
T2 - Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
TI - Measuring provider adherence to tobacco treatment guidelines: a comparison of electronic medical record review, patient survey, and provider survey
U1 - HIT & Telehealth
U2 - 16036268
U3 - 10.1080/14622200500078089
VL - 7 Suppl 1
VO - 1462-2203; 1462-2203
Y1 - 2005
ER -