A Proactive Population Health Strategy to Offer Tobacco Dependence Treatment to Smokers in a Primary Care Practice Network

This project will implement and evaluate a novel population health strategy to increase the delivery of tobacco dependence treatment to smokers who receive health care in adult primary care practices affiliated with Massachusetts General Hospital, a member of Partners HealthCare System, Eastern Massachusetts’ largest integrated health-care delivery system.  Unlike most health-care system-based strategies, which are triggered by a smoker’s office visit, this project uses the electronic health record to identify all smokers in the target practices.  It proactively reaches out to engage them in tobacco cessation treatment independent of office visits, thereby supplementing but not replacing PCPs’ practice-based efforts.  Automated telephone calls using interactive voice response (IVR) technology, supplemented by email messages, do the outreach.  When a smoker responds, the project compares two strategies to link the smoker to evidence-based tobacco cessation treatments.  (1) A Chronic Disease Management model has an internal Tobacco Care Coordinator to help the smoker address tobacco dependence using resources available in the community or health care system.  (2) A technology-facilitated health care system-to-community linkage transfers the smoker seamlessly in real time from the IVR call to the Massachusetts Smokers Helpline, a community-based resource.  A pragmatic randomized controlled trial will determine whether the population outreach strategy increases the proportion of smokers who receive tobacco cessation treatment over 6 months, compared to usual care, and explore which of the two intervention strategies is more effective. The goal is to build an effective, sustainable, scalable strategy for delivering tobacco cessation treatment that health care systems will adopt.