To meet their goals for chronic disease prevention and management, the Couchiching Family Health Team needed to improve its smoking and COPD screening. Their existing process was inconsistent, billing opportunities were being missed, and patient smoking status in the CPP was out of date for a large number of patients. Yet adding to the workload of their already-strained nursing and administrative staff was not a feasible option.
Using Ocean Tablets, CFHT, Healthcare Together Ltd and Boehringer Ingelheim (Canada) designed an automated, patient-driven approach to screening that starts in the waiting room. Not only does the process not require additional staff effort; it actually reduces administrative workload by allowing patients to update their contact information and complete email consent forms that automatically update the EMR. In just first four and a half months using Ocean, the team far exceeded their goals for screening and referrals, collected email consent from a third of its patients, and received overwhelmingly positive feedback from patients, clinic staff and physicians as patient care improved.
In the first 4.5 months, in a patient population of 7,500…
Current Smokers Identified
Canadian Lung Health Tests Administered
% Increase in Smoking Cessation Referrals
How it Works
Every patient over the age of fourteen is now given a touchscreen tablet in the waiting room to review their contact information, complete an email consent form, and answer a simple question about smoking habits. Almost all patients respond to the initial smoking screening question. Based on their response, rules are automatically applied to determine whether to display an invitation to a smoking cessation program, the Canadian Lung Health Test (CLHT) and the MRC Dyspnea.
By taking advantage of this automated approach, data can be collected from multiple forms sequentially, without adding additional work for staff. Ocean also allows patients to be asked about smoking cessation at multiple visits. This unobtrusive approach has resulted in a high rate of patient engagement and satisfaction.
Results with Ocean
After just four months using Ocean Tablets, the screening initiative results far exceeded expectations, with over 40% of patients completing screening in that period. Beyond the screening and referral numbers, satisfaction with the solution was also better than expected.
Clinic staff, physicians, and patients all report high levels of satisfaction with the Ocean-driven process. Patient engagement is up, and physicians report having more time to spend talking to patients rather than documenting in the EMR. Many patients have said they are impressed by the technology and the non-invasive screening approach; some patients even indicated that they would not have otherwise brought up smoking cessation, but the private, non-judgemental tablet approach opened the door to this conversation.
The automated screening process has led to improved accuracy in patient records as well as an increase in the number of E079 billing code opportunities.
For administrative staff, the Ocean Tablets save time previously spent collecting and updating demographics and collecting paper-based email consent forms. With data automatically updated in the EMR, there is no time-consuming printing or scanning required either.
As a result of the significant findings, CFHT is expanding the tablet program to further identify and support individuals with other chronic diseases including creating a more robust diabetes program, and using tablet-based screenings for depression and suicidal ideation.
Average time of 4 minutes with tablet per patient
3+ demographic updates per patient plus email consent and address collection
~ 3000 patients screened, 432 current smokers identified
33% increase in smoking cessation program referrals
445% increase in smoking cessation counseling billing
CLHT administered to 1300 patients vs. 45 in previous year
~ 500 patients at risk for COPD with positive CLHT identified
* Results collected over a 4.5 month period