Do you vape? Leveraging electronic health records to assess clinician documentation of electronic nicotine delivery system use among adolescents and adults

Kelly C. Young-Wolff, Daniella Klebaner, Bruce Folck, Lisa Carter-Harris, Ramzi G. Salloum, Judith J. Prochaska, Renee Fogelberg, Andy S.L. Tan

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Use of electronic nicotine delivery systems (ENDS) has increased substantially over the past decade. However, unlike smoking, which is systematically captured by clinicians through routine screening and discrete documentation fields in the electronic health record (EHR), unknown is the extent to which clinicians are documenting patients' use of ENDS. Data were gathered from medical visits with patients aged 12 and older (N = 9,119; 55% male) treated in a large, integrated healthcare system. We used natural language processing to assess the incidence rates of clinician documentation of patients' ENDS use in unstructured tobacco comments in the EHR, and the words most frequently documented in relation to ENDS, from 2006–2015. ENDS documentation in the EHR increased dramatically over time (from 0.01 to 9.5 per 10,000 patients, p < 0.0001), particularly among adults aged 18–24 and 25–44. Most prevalent were “e-cig,” “electronic cigarettes”, and “vape,” with much variation in spelling and phrasing of these words. Records of adolescent and young adult patients were more likely to contain the word “vape”, and less likely to have “e-cig” and “electronic cigarette” than records of adults (ps < 0.0001). The relatively low observed number of patients with ENDS terms in the EHR suggested vast under documentation. While healthcare providers are increasingly documenting patients' use of ENDS in the EHR, overall documentation rates remain low. Discrete EHR fields for standard screening and documentation of ENDS that reflect the language used by patients would provide more complete longitudinal population-level surveillance of ENDS use and its association with short- and long-term health outcomes.

Original languageEnglish (US)
Pages (from-to)32-36
Number of pages5
JournalPreventive Medicine
Volume105
DOIs
StatePublished - Dec 1 2017

Fingerprint

Electronic Health Records
Nicotine
Documentation
Natural Language Processing
Population Surveillance
Vaping
Health Personnel
Tobacco
Young Adult
Language
Smoking
Delivery of Health Care
Incidence
Health

Keywords

  • Adolescents
  • Clinicians
  • E-cigarettes
  • Electronic health record
  • Electronic nicotine delivery systems
  • Integrated healthcare
  • Natural language processing
  • Semantics
  • Vaping

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

Cite this

Do you vape? Leveraging electronic health records to assess clinician documentation of electronic nicotine delivery system use among adolescents and adults. / Young-Wolff, Kelly C.; Klebaner, Daniella; Folck, Bruce; Carter-Harris, Lisa; Salloum, Ramzi G.; Prochaska, Judith J.; Fogelberg, Renee; Tan, Andy S.L.

In: Preventive Medicine, Vol. 105, 01.12.2017, p. 32-36.

Research output: Contribution to journalArticle

Young-Wolff, Kelly C. ; Klebaner, Daniella ; Folck, Bruce ; Carter-Harris, Lisa ; Salloum, Ramzi G. ; Prochaska, Judith J. ; Fogelberg, Renee ; Tan, Andy S.L. / Do you vape? Leveraging electronic health records to assess clinician documentation of electronic nicotine delivery system use among adolescents and adults. In: Preventive Medicine. 2017 ; Vol. 105. pp. 32-36.
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