14 Apr, 2020
Tales from the Front Desk
Vaping and COVID-19: Use EHR Integrated Chatbots to Reduce Risk
Beginning in the fall of 2019, the Centers for Disease Control (CDC), US Food and Drug Administration (FDA), and various public health organizations began deeper investigation of a surge in cases of EVALI – e-cigarette or vaping product use-associated lung injury. As patient cases climbed, researchers identified likely culprits including vaping products that contained tetrahydrocannabinol (THC) or Vitamin E acetate. As of February 18, 2020, more than 2,800 patients have been hospitalized with EVALI and 68 deaths have been confirmed across 29 states and the District of Columbia. The outbreak of disease related to novel Coronavirus (COVID-19) has brought new attention to the role of vaping in lung disease with recommendations from provider organizations for individuals to discontinue vaping as well as renewed calls for bans on tobacco and vaping products.
EHRs and SDOH
Most healthcare delivery organizations in the United States have Electronic Health Records (EHRs) yet their capability of identifying patients for intervention are significantly underused. Public health experts continue to acknowledge the impact of Social Determinants of Health (SDOH) in both individuals and populations. This has become particularly acute during the COVID-19 crisis as the disease disproportionately affects African-Americans compared with other groups. Major EHR vendors have included functionality around SDOH for years however documentation of vaping behaviors is more complicated than that of other nicotine products. Although initially vaping was treated like smoking, fields to document vaping specifics were lacking. Product teams have worked diligently to create documentation pathways for vaping. This is difficult due to the lack of regulation of vaping products and contamination of those with known composition. Although identification of specific vaping chemicals used by a patient would be helpful, basic functionality to identify and deliver outreach to vape users is still underused by many healthcare providers.
Vaping and COVID-19 Prevention
Although most people around the world are focusing on social distancing as a mechanism to reduce COVID risk, it's clear that patients with specific health conditions and unhealthy behaviors are at higher risk for complications including hospitalization and death. Current risks include: advanced age; lung, heart, liver, or kidney disease; diabetes; severe obesity; HIV; immune compromise; and/or residence in a care facility. A growing body of evidence ties smoking and vaping to increased risk as well. The risk is not only to the damaged lungs, where the coronavirus creates additional damage, but also in the behaviors involved in nicotine use such as increased risk of touching the face after touching objects. Smoking and vaping also increase coughing which contributes to viral spread, along with forcibly exhaled smoke or vapors.
Leverage EHR for Targeted Interventions
EHRs offer robust reporting platforms that enable identification of patient groups for targeted intervention. Patient lists can be created of those who have tobacco or vaping-related diagnoses codes on their charts or where those behaviors are documented in the social history. It's easy to make those lists actionable with technology solutions such as interactive text messaging using chatbot solutions. A sample patient campaign might look like this:
Asparia solutions can be implemented in a matter of hours, with minimal staff burden. At-risk patients who receive messaging know that their healthcare team cares about their health and reducing their personal risk of illness. Additionally, patients who are engaged in smoking or vaping cessation efforts can reduce overall healthcare expenditures and improve clinical outcomes. Follow-up campaigns can be created to track patients and encourage their efforts. Asparia allows you to manage your patient outreach messages in real-time – providing maximum flexibility in rapidly changing circumstances. For more information on how we can help you reduce your patients' risk, contact Asparia at www.asparia.com