Table 1.

Description of tobacco treatment programs at three NCI-Designated Cancer Centers funded through the Cancer Center Cessation Initiative.

	Washington University	Yale University	Case Western Reserve University
Setting (s)	Siteman Cancer Center, St. Louis, MO	Smilow Cancer Hospital, New Haven, CT and Smilow Cancer Care Centers throughout CT	University Hospitals Seidman Cancer Center, MetroHealth Cancer Center, Cleveland Clinic Taussig Cancer Center, Cleveland, OHb
Patients with visits to the settinga, N	27,728	43,264	41,405
Patients screened for tobacco usea, N	25,779	21,424	32,541
Patients identified as current smokersa, N	3,224	3,882	4,316
Current smokers who engaged in at least one type of evidence-based cessation treatmenta, N	1,390	277	907
Tobacco treatment program components	ELEVATE (Electronic Health Record-Enabled Evidence-Based Smoking Cessation Treatment) • Deliver smoking cessation counseling (5A's) and pharmacotherapy at the point of care. • Enhance the EHR to identify and refer current smokers to the Quitline and SmokefreeTXT. • Training and video-based demonstrations and simulated patient scenarios with clinical care providers using test patients in the EHR. • Monthly provider performance data feedback, in comparison to department- and/or clinic-level data and clinical benchmarks.	Tobacco Treatment Service (TTS) at Smilow Cancer Hospital • In-person counseling program including medication management, and training providers. • Phone/tele-health counseling also delivered. • Smokers are also referred to SmokefreeTXT. • Monthly audit and feedback reports on Care Center performance are prepared and reviewed by the Tobacco Treatment Service and shared with Smilow Cancer Hospital and Care Center leadership.	Tobacco Intervention & Psychosocial Support (TIPS) Service • Face-to-face cognitive behavioral therapy combined with pharmacotherapy. • Tailored to cancer patients by including cancer-specific psychoeducation, emotional vulnerability content, and flexible intervention formats (e.g., in-clinic, telephone). • Caregivers and/or significant others may also be treated. • Smokers may also be referred to the SmokefreeTXT.
Smoker identification and referral method(s)	• Current smokers identified through the EHR during visit. • Patients with a current smoker status or documented as using a cessation medication will trigger a BPA that prompts the clinician to deliver counseling and pharmacotherapy at the point-of-care. • Referrals to the Quitline and SmokefreeTXT generated through the EHR.	• Current smokers identified through the EHR. • A list of current smokers sent to program staff who contact patients to schedule appointments. • eReferral to SmokefreeTXT is in development.	• Current smokers identified through the EHR during visit. Patients who indicate motivation to quit are referred via email, pager, or through eReferral (in select clinics). • Patients are contacted by TIPS staff for the initial assessment, treatment planning, and schedule for counseling appointments. • Patients may be signed up for SmokefreeTXT by program staff or may self-enroll. • Caregivers/significant others may be seen with the patient or contacted independently by program staff
EHR modifications implemented	Developed new clinical workflow, BPAs, and eReferral systems.	• Modified clinical workflow. • Enhanced the EHR to standardize tobacco use assessment. • eReferral sends prompt to Tobacco Treatment Service for current smokers.	• Standardized tobacco use assessments based on NCCN guidelines. • EHR provider notes generated to summarize tobacco treatment services delivered. • EHR eReferral generated to send patient information to TIPS

^aReported for a 6-months period at 1 year post-implementation.

^bSum across the three healthcare systems.