Transforming The Treatment of Tobacco Use in Health Care: Seizing The Potential of the Electronic Health Record to Deliver Comprehensive Chronic Care Treatment for Smoking

改变医疗保健中烟草使用的治疗：抓住电子健康记录的潜力，提供全面的吸烟慢性病护理治疗

• 批准号: 10005034
• 负责人: MICHAEL C FIORE
• 金额: $ 81.4万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-01 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10005034
• 关键词: Address; American; Award; Cessation Research; Cessation of life; Chronic Care; Clinic Visits; Economics; Electronic Health Record; Engineering; Failure; Fostering; Goals; Health; Health Care Visit; Health system; Healthcare; Intervention; Laboratories; Malignant Neoplasms; Methodology; Patient Care; Physicians; Policies; Preventable cancer cause; Preventive; Primary Health Care; Principal Investigator; Research Methodology; Research Personnel; Science; Scientist; Smoker; Smoking; Support System; System; Technology; Testing; Tobacco; Tobacco Use Cessation; Tobacco use; Translating; Translational Research; Translations; Treatment Effectiveness; Vendor; Visit; Wisconsin; base; design; effective therapy; experience; grasp; health care delivery; health information technology; novel; prevent; primary care setting; public health relevance; reduce tobacco use; tobacco cessation intervention; tobacco control; treatment research

 DESCRIPTION (provided by applicant): Smoking maintains its grip on over 40 million Americans, resulting in devastating illness, grievous economic loss, and tragic death for over 480,000 Americans each year. Tobacco use is the leading preventable cause of cancer, directly responsible for 1/3 of cancer deaths. This profound toll would be dramatically reduced if we substantially boosted rates of cessation among the 70% of smokers making healthcare visits each year. Despite multiple effective smoking treatments, and despite powerful health information technologies such as the electronic health record (EHR), far too few smokers get effective treatment during their healthcare visits. This is largely due to a failure of translatioal science; much translation of treatment research occurs by guesswork and hunch. This R35 Outstanding Investigator proposal will address the great need for translation of tobacco science via a unique set of real-world partners: a Wisconsin health system that will serve as a "primary care laboratory," the world's leading EHR vendor, and a nationally renowned tobacco cessation research team led by the PI, Michael Fiore. These partners propose to: 1) develop and apply highly efficient and novel research methods to advance methodologically principled intervention translation, 2) design and test a highly efficient EHR-based treatment support system that organizes tobacco cessation treatment and fosters its dissemination, and 3) increase treatment effectiveness by delivering truly comprehensive chronic care smoking treatment to primary care patients. Thus, EHR changes and groundbreaking research methods will be used to re-engineer healthcare delivery systems to efficiently and seamlessly organize and deliver state-of-the-art treatment to the great majority of the nearly 30 million smokers visiting primary care settings each year. The smoking treatment and its support system will be designed for ready dissemination across health systems and diverse EHR platforms. The translational research methods should benefit any attempt to translate preventive health interventions. The proposed Principal Investigator has a 26-year track record of reducing tobacco use and its resulting harms. His experiences as a practicing physician, tobacco control scientist, and designer of national smoking policies, reflect enormous potential to fulfill the goals of the R35 mechanism - to revolutionize the delivery of tobacco use treatment so as to prevent literally millions of cance deaths.

 描述（由申请人提供）：吸烟困扰着超过 4000 万美国人，每年导致超过 480,000 名美国人罹患毁灭性疾病、严重经济损失和悲剧性死亡。烟草使用是可预防的癌症的主要原因，直接导致 1。 /3 的癌症死亡人数。如果我们大幅提高每年就诊的 70% 吸烟者的戒烟率，那么尽管多次有效吸烟，这一数字仍将大幅降低。尽管电子健康记录 (EHR) 等强大的健康信息技术，但很少有吸烟者在就诊期间获得有效治疗，这主要是由于转化科学的失败；许多治疗研究的转化都是通过猜测和进行的。预感 R35 杰出研究者提案将通过一组独特的现实世界合作伙伴满足烟草科学转化的巨大需求：将充当“初级保健实验室”的威斯康星州卫生系统、世界领先的 EHR 供应商和全国知名由 PI Michael Fiore 领导的戒烟研究团队建议：1）开发并应用高度新颖的研究方法来推进方法论原则的干预转化，2）设计和测试一个高效的基于 EHR 的治疗支持系统。戒烟治疗并促进其传播，3) 通过向初级保健患者提供真正全面的慢性护理吸烟治疗来提高治疗效果。因此，电子病历的变化和突破性的研究方法将用于重新设计医疗保健提供系统，以有效地实现这一目标。每年访问初级保健机构的近 3000 万吸烟者中的绝大多数将无缝组织和提供最先进的治疗。吸烟治疗及其支持系统的设计将便于在卫生系统和不同的 EHR 平台上传播。转化研究方法应该有利于任何转化预防性健康干预措施的尝试。拟议的首席研究员拥有 26 年减少烟草使用及其造成的危害的经验。政策，体现巨大潜力实现 R35 机制的目标——彻底改变烟草使用治疗的提供方式，从而预防数以百万计的癌症死亡。