E-Referral Study Launches at Pilot Clinic


A primary-care outpatient clinic in Wisconsin has begun testing an innovative system that allows clinicians to electronically refer smokers to the Wisconsin Tobacco Quit Line. The Gundersen Health System Clinic in Whitehall, Wisconsin is the first to use the system, featuring a “closed loop” of communication between the Quit Line and clinic staff via electronic health records (EHR). It’s all done in a way that is compliant with HIPAA privacy standards.

Clinic staff are eager to explore the system’s ability to keep providers informed on patient progress throughout a quit attempt, and to prompt staff with reminders and updates.

“Gundersen is excited to participate in this research study with UW-CTRI,” said Epidemiologist Brenda Rooney, who has been involved in establishing the project at Gundersen. “We are so fortunate to have had a long-standing relationship with UW-CTRI for many years, utilizing their resources and expertise to help our patients in their quit attempts. This research will expand our use of the Wisconsin Tobacco Quit Line. Being on the ground floor of this new endeavor will certainly help us to better meet the needs of our patients.”

UW-CTRI Regional Outreach Specialist Kris Hayden trained the clinic staff, including clinicians, at the rural Whitehall clinic on how to use the eReferral system. Information-technology professionals from Gundersen Health System also attended, as well as UW-CTRI Associate Researcher Mark Zehner and Regional Outreach Specialist Amy Skora. Zehner thanked the clinic staff and noted that this system is a first of its kind.

The trial, known as the Quit Line Referral Methods Study, includes a total of 23 clinics from Wheaton Franciscan Healthcare and Gundersen Health System. In each system, half the clinics will test the HIPAA-compliant eReferral system while the others will continue using the current Fax to Quit program. Fax to Quit, designed by UW-CTRI to allow clinicians to refer patients to the Quit Line via a paper fax, has been implemented within hundreds of clinics across the state (669 registered; 225 active), and shown to increase referrals to the Quit Line fivefold.

UW-CTRI and Epic Systems staff collaborated to design the new EHR functionality to fit the structure and workflow of typical healthcare delivery and practice. UW-CTRI Outreach Director Rob Adsit, a member of the study team, has been key to building the EHR functionality with Epic. The project is made possible by a 7-year, $6.1 million R35 grant from the National Cancer Institute (NCI) called the Outstanding Investigator Award (OIA), given to UW-CTRI Director Dr. Michael Fiore. 

“This is a unique opportunity to reach out to patients who struggle to quit smoking and give them a boost to succeed,” Fiore said. “We are grateful to all of our partners for helping to make it a reality.”