Dean Health System Provides Efficient Tobacco Treatment

Just as gunslingers from the Wild West had to be quick on the draw, physicians these days have to provide prompt, comprehensive care to a full slate of patients.

“A primary care provider has to cover a lot of ground in a routine office visit these days, often leaving very little time to address important healthcare issues such as tobacco abuse,” said Dr. Philip Bain, a practicing internist at Dean Health System. “In the past, smoking cessation often did not get the attention that it truly deserves.”

Not anymore. Dean has developed an effective tool to integrate tobacco treatment into a fast-paced primary-care practice.

At Dean, identifying tobacco use is not just a fifth vital sign, but rather the first step in a process to help smokers quit. The trick was to make the process quick and easy to use for front-line practitioners. The electronic medical record (EMR) team at Dean worked with clinicians to create a standardized workflow to quickly identify smokers who are ready to quit. Once identified, the EMR team created a one-stop tool that provides everything the clinician needs to help smokers quit–including medication orders, documentation and patient-information sheets.

From left: Training Manager Kelli Gradel, Dr. Philip Bain and Jill Hanson have worked hard to ensure Dean Health System has an efficient approach to helping patients quit. Cara Krinke, an outreach specialist from the UW Center for Tobacco Research, provides free training and technical assistance.

“The result is a quick, easy-to-use tool to address smoking cessation in the context of an often jam-packed office visit,” Bain said.


Patients like it because, even if they came for another reason, they can get help with quitting and still have time to address other health concerns. Providers like it because all of the tools they need are in one place. For example, instead of having to order varenicline (Chantix) each time, the EMR tool contains the order, a patient-information sheet on varenicline and the number for the Wisconsin Tobacco Quit Line, which offers free medication and coaching on how to quit at 1-800-QUIT-NOW.

“We’ve tested the tool extensively and have found that the entire brief intervention takes 60 seconds or less,” Bain said. “This makes selling the tool to providers easier, as they can see that they can easily address the smoking issue and still have time for the rest of the visit.”

“The EMR allows our practitioners to efficiently do what is right,” said Dr. Paul Reber, vice president for clinical excellence at Dean.

“The right thing to do is to identify and treat tobacco dependence. Since most patients don’t come in to quit smoking, this tool allows the tobacco issue to be addressed appropriately and still have time for the patient’s other concerns.”

Training Is Easy With EMR
Dean has created a Web page containing articles related to smoking cessation as well as a video tutorial showing how the tool works.

“Our providers can access the site any time on demand,” said Jill Hanson of the clinical and service-improvement department.

Bain added, “While the tutorial is helpful, our goal was to build the tool so that it is so intuitive that the practitioner can easily understand how to use it properly. We tried to structure the tool so that it could be used by someone on their first clinical day at Dean or if they are providing float coverage from a different department.”

“It’s fast, easy to use and it works,” said Reber.

Like the gunslingers of the Wild West, when it comes to tobacco treatment, Dean practitioners are quick on the draw.

Other Case Studies