Resources

• Identify what EHR supports are needed for your chosen intervention and workflow. Refer to the C3I EHR Build Guides (Cerner and Epic versions) for examples of tobacco status documentation, flowsheets, best practice advisories (BPAs), and referral orders.
• Secure key IT staff buy-in and support and submit HIT requests as early as possible. 
• Ask your IT team whether standard or existing EHR functionality can meet program needs before requesting custom builds, which may be resource-intensive and time-consuming.

• Design your EHR build and tools to support the type and frequency of reports necessary to monitor and evaluate your programs. See the C3I Epic EHR Build Guide (pgs. 56-69) for examples.
• When externally referring to quitlines, SmokefreeTXT, or other community-based resources, close the loop and set up a way to receive referral outcome reports back. See the Pre-Implementation Module External Referral page for additional resources to build closed-loop eReferrals.
• Share outcomes regularly with cancer program and health system leaders and care teams to sustain engagement and improve performance. Refer to the Pre-Implementation Module Quality Improvement page for more information about assessment measures and reporting.

• Create handouts for providers that briefly explain the rationale for the tobacco treatment program (like this example from the Mayo clinic), provide key information about the program launch (like this example from Fox Chase Cancer Center), and offer guidance for advising patients to quit and offering treatment (like these quick guidance cards from the University of Kansas Cancer Center).
• Develop and deliver training modules in the new workflows that
  1. Empower the whole team, not just oncologists
  2. Emphasize the impact of tobacco treatment on patient outcomes
  3. Piggyback on existing meetings, when possible
  4. Include clear asks and IT screenshots
  5. Ask for feedback
  6. Provide incentives for attendance, such as free lunch
• Record trainings so that they can be conducted asynchronously and repeatedly to address staff turnover and sustain engagement.

• Invest in training for existing staff to become Certified Tobacco Treatment Specialists (CTTS). See the Council for Tobacco Treatment Training Programs website for accredited programs.
• Consider intensive workshops and communities of practice (such as the Memorial Sloan Kettering Assessment and Treatment of Tobacco Dependence in Cancer Care Training) to train clinical care teams to address tobacco use.

• Develop patient education materials to support tobacco treatment services, such as brochures, pamphlets, flyers, and infographics. These can be more exhaustive guides (like this booklet from the American Society of Clinical Oncology), brief one-pagers (like this NCI infographic), or detailed medication information lists (like this breakdown from the University of Maryland). 
• Tailor your education materials to your patient population. Refer to the National Center for Cultural Competence guide and the University of Wisconsin guide to enhance the linguistic and cultural competence and accessibility of your materials.

Engage your marketing department to help you develop additional branded collateral, including landing pages, newsletters, presentations, and digital and print communications that can enhance patient interest and trust in your program.

Programs that collaborate with internal teams and external partners are more likely to experience long-term success. Consider building partnerships with the following:

• Pharmacy
• Behavioral health and supportive care teams
• Patient navigation
• Cancer screening programs
• Community outreach and engagement programs
• Community oncology networks
• State quitlines
• Patient and caregiver advisory groups
• Health system leadership, C-suite, and board of directors

C3I example: See Case Studies P and R for examples of C3I programs that leveraged partnerships with pharmacy and nurse navigation.