Szpunar Susan M, Williams Patricia D, Dagroso Deborah, Enberg Robert N, Chesney James D
Henry Ford Health System, Detroit, MI, USA.
Am J Manag Care. 2007 Jun;13(6 Part 1):313-5.
To describe user acceptance of and satisfaction with the Tobacco Use Cessation (TUC) Automated Clinical Practice Guideline (ACPG) at the Henry Ford Health System.
A previous investigation assessed compliance with the 5 As (ask, advise, assess, assist, and arrange) of the TUC ACPG across 3 study arms. This article describes user satisfaction with the TUC ACPG after implementation.
In all study arms, providers completed a survey before participating in a focus group.
All providers in the TUC arm indicated that they "almost always" asked their patients about tobacco use. Providers in the TUC arm were generally satisfied with the features of the TUC ACPG, particularly the ease of electronically referring a patient to the Smoking Intervention Program. Barriers to use included time constraints, lack of staff, and the desire to "opt out" of the program for patients in specific situations (eg, patients with terminal illnesses).
Because ACPGs are incorporated into electronic medical records, it is important to obtain provider input before implementation, to supply technology that is user friendly and fits into the work flow of the clinic, and to afford physicians the autonomy to opt out of the guideline in specific clinical circumstances.