United States Health Information Knowledgebase

 
National Learning Consortium Logo

The Importance of EHR Quality Measures & Smoking Cessation


Donna is approaching her 50th birthday. She has been a 1 pack per day smoker for the past 35 years. She has discussed tobacco cessation options with her primary care physician, but has not been ready in the past. Donna meets with her primary care physician to discuss her path of living smoke-free. Her provider prescribes Chantix tablets and refers her to telephone quit-line counseling.

Which Smoking Cessation Quality Measures Count for Stage 1 2013 Meaningful Use?

  • Measure Pair: a) Tobacco Use Assessment (NQF# 0028a) b) Tobacco Cessation Intervention (NQF# 0028b)
  • Smoking and Tobacco Cessation, Medical Assistance: a) Advising Smokers and Tobacco Users to Quit b) Discussing Tobacco Use Cessation Medication c) Discussing Tobacco Use Cessation Strategies (NQF# 0027)

Which Smoking Cessation Quality Measures Count for Stage 1 & 2 2014 Meaningful Use?

  • Measure Pair: a) Tobacco Use Assessment b) Tobacco Cessation Intervention (NQF# 0028; CMS138v7)

Measuring & Improving Ischemic Vascular Disease Care: A Real Impact on Your Patients

  • Tobacco is the single greatest cause of disease and premature death in America today and is responsible for:1
    • More than 435,000 deaths annually;
    • $96 billion annually in medical expenses; and
    • $97 billion annually in lost productivity.
  • When compared with non-smokers, smoking is estimated to increase the risk of:2
    • coronary heart disease by 2 to 4 times;
    • stroke by 2 to 4 times;
    • men developing lung cancer by 23 times;
    • women developing lung cancer by 13 times; and
    • Death from chronic obstructive lung diseases by 12 to 13 times.
  • According to the National Cancer Institute, there immediate and substantial health benefits to quitting smoking:3
    • Heart rate and blood pressure begin to return to normal immediately;
    • Carbon monoxide levels in the blood begin to decline within a few hours;
    • Circulation improves, and phlegm production, coughing, and wheezing decrease within a few weeks;
    • Lung function improves substantially within several months;4 and
    • Sense of smell taste will improve.
  • People who quit smoking, regardless of their age, are less likely to die from smoking-related illness than those who continue to smoke:5
    • Quitting at age 30 reduce reduces the risk of dying prematurely by more than 90 percent.
    • Quitting at age 50 reduces the risk of dying prematurely by 50 percent;
    • Quitting at age 60 or older will extend life when compared with those who continue to smoke.

Conclusion

Helping Donna quit smoking will improve her quality of life both in the short and long term. She was will be able to breathe more easily on only months, and will significantly decrease her chances of developing a chronic illness. Donna will likely even add many healthy years to her life.

Clinical Quality Measure Information

Smoking and Tobacco Cessation, Medical Assistance: a) Advising Smokers and Tobacco Users to Quit b) Discussing Tobacco Use Cessation Medication c) Discussing Tobacco Use Cessation Strategies

NQF# Description Numerator Denominator Exclusions
0027a Percentage of patients who received advice to quit smoking All patients who:
  • Responded to survey and indicated they have received advice to quit smoking
All patients with:
  • Age > 18 years, &
  • Current smoking status
  • > 1 visit during the measurement year
All patients with:
  • < 1 visit during the measurement year
  • Smoking status "not at all"
0027b Percentage of patient whose practitioner recommended or discussed smoking cessation medication. All patients who:
  • Responded to survey and indicated there provider recommended or discussed smoking cessation medication
0027c Percentage of patient whose practitioner recommended or discussed smoking cessation strategies All patients who:
  • Responded to survey and indicated there provider recommended or discussed smoking cessation strategies

Measure Pair: a) Tobacco Use Assessment b) Tobacco Cessation Intervention

NQF# Description Numerator Denominator Exclusions
0028a Percentage of patients who were queried about tobacco use one or more times during the measurement year All patients who:
  • Were queried about tobacco use > 1 time
Patients with:
  • Age > 18 years
  • None
0028b Percentage of patients identified as tobacco users who received cessation intervention during the two-year measurement period All patients who:
  • Are tobacco users, and
  • Received cessation intervention
Patients with:
  • Age > 18 years &
  • Currently active tobacco use status

About National Quality Forum (NQF) Endorsement

Each of the Clinical Quality Measures has an NQF number, indicating that it has received endorsement from the National Quality Forum (NQF) , a nonprofit organization with the mission to improve the quality of American healthcare. NQF uses a formal Consensus Development Process (CDP) to evaluate and endorse consensus standards, including performance measures. This process includes gathering input on performance measures from a wide variety of stakeholders including consumer organizations and health care providers.6

  1. Fiore MC, Jaén CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Quick Reference Guide for Clinicians. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. April 2009.
  2. U.S. Department of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2004 [accessed 2012 Jan 10].
  3. http://www.cancer.gov/cancertopics/factsheet/Tobacco/cessation#r19
  4. U.S. Department of Health and Human Services. The Health Benefits of Smoking Cessation. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1990.
  5. Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years' observations on male British doctors. British Medical Journal 2004; 328(7455):1519-1527. [PubMed Abstract]
  6. http://www.qualityforum.org Exit Disclaimer [www.qualityforum.org]. Accessed January 31, 2012

Produced by Meaningful Use Quality Workgroup - February 14, 2013

Scroll To Top