We will carry out a systems change to enhance the integration of tobacco screening and treatment into electronic health record systems by including routine referral to our regionally tailored smartphone text and social messaging cessation services for more than 4,000 tobacco-using patients receiving services from UT Health San Antonio Primary Care Center (PCC) providers and oncologists at the Mays Cancer Center.

Following preparatory development, this systems change will add a tobacco counseling and cessation service protocol and record-keeping into all patients’ routine care, just as blood pressure and body weight are currently tracked and considered in patient encounter protocols. During p...

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We will carry out a systems change to enhance the integration of tobacco screening and treatment into electronic health record systems by including routine referral to our regionally tailored smartphone text and social messaging cessation services for more than 4,000 tobacco-using patients receiving services from UT Health San Antonio Primary Care Center (PCC) providers and oncologists at the Mays Cancer Center.

Following preparatory development, this systems change will add a tobacco counseling and cessation service protocol and record-keeping into all patients’ routine care, just as blood pressure and body weight are currently tracked and considered in patient encounter protocols. During patient visits, provider teams will prompt and guide patients who use tobacco to enroll via their smartphone in SMS text-messaging or social-media-messaging (Facebook Messenger) services designed specifically for the PCC and Mays Cancer Center patient populations. These cessation services—based on the research team’s effective Quitxt text-messaging quit-smoking service reported in a peer-reviewed publication last year—will provide messaging designed to increase readiness for patients who are not ready to quit promptly, and to assist cessation for those who are ready to quit.

Through CME, we will train primary care and cancer care team members to implement the new protocols to provide counseling and referral to the smartphone messaging cessation service, prescribe as-needed smoking cessation medication (nicotine replacement therapy, varenicline, etc., based on approval by clinical leadership), and conduct follow-up to provide tailored support according to data collected via the service in subsequent patient encounters. In addition to providing tobacco cessation services to more than 4,000 patients in the primary care (more than 2,700) and cancer center (more than 1,300) settings during the proposed grant interval, we will establish a model for innovation in tobacco service delivery that can be readily adopted by other provider systems across Texas.

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