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<p class="MsoNormal" style="line-height:105%"><span style="font-size:13.0pt;line-height:105%">CDC’s Office on Smoking and Health (OSH) and Division for Heart Disease and Stroke Prevention are pleased to announce the release of the Million Hearts<sup>®</sup>
<b>Tobacco Cessation Change Package (TCCP)</b>, available at: <u><span style="color:#0563C1"><a href="https://urldefense.proofpoint.com/v2/url?u=https-3A__millionhearts.hhs.gov_files_Tobacco-5FCessation-5FChange-5FPkg.pdf&d=DwMFAg&c=7gilq_oJKU2hnacFUWFTuYqjMQ111TRstgx6WoATdXo&r=hXOTJUAl2nsljAgmELfTyYpyS1eUGJSDiT3O3SAeUfE&m=iyI7QiULzXw7J7eJ8blFin230Kl3MyJNb_4W-dxgreg&s=HPbJDTb9mu8fdpP6xOVhv01_a6FQw9j4H3aPoasTJAU&e=">https://millionhearts.hhs.gov/files/Tobacco_Cessation_Change_Pkg.pdf</a></span></u>.
This change package provides quality improvement resources designed to help health systems and clinical teams systematically address cardiovascular disease risk factors. The TCCP can assist healthcare teams in their efforts to prioritize treatment for tobacco
use and dependence to improve the health and wellbeing of their patients. This change package can be used in outpatient, inpatient, and behavioral healthcare settings to increase the reach and effectiveness of tobacco cessation interventions, and incorporate
these interventions into the clinical workflow.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height:105%"><span style="font-size:13.0pt;line-height:105%"><o:p> </o:p></span></p>
<p class="MsoNormal" style="line-height:105%"><span style="font-size:13.0pt;line-height:105%">Please reference pages 46 and 47 of the TPPC to read about
<b>Oregon’s efforts</b> to integrate tobacco cessation into clinical services to effectively implement closed-loop referrals to the Oregon Tobacco Quit Line and the Chronic Disease Self-Management Program. Some highlights from these efforts are listed below:<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height:105%"><span style="font-size:13.0pt;line-height:105%"><o:p> </o:p></span></p>
<p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;line-height:105%;mso-list:l1 level1 lfo1">
<![if !supportLists]><span style="font-size:13.0pt;line-height:105%;font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-size:13.0pt;line-height:105%">Oregon Public Health Division engaged the Oregon Primary Care Association (OPCA) to improve patient self-management among low-income populations through development of the Patient
Self-Management Collaborative. Specifically, OPCA provided technical assistance to FQHCs in Oregon on improving patient self-management through implementation of closed-loop referrals to self-management programs.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;line-height:105%;mso-list:l1 level1 lfo1">
<![if !supportLists]><span style="font-size:13.0pt;line-height:105%;font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-size:13.0pt;line-height:105%">Clinic staff received training on systems change and how to effectively implement tobacco cessation services through quality improvement strategies.
<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;line-height:105%;mso-list:l1 level1 lfo1">
<![if !supportLists]><span style="font-size:13.0pt;line-height:105%;font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-size:13.0pt;line-height:105%">An evaluation was administered of systematic protocols for closed-loop referrals to the Oregon Tobacco Quit Line and the Chronic Disease Self-Management Program, which identified
issues with electronic health record reporting and data collection. <o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;line-height:105%;mso-list:l1 level1 lfo1">
<![if !supportLists]><span style="font-size:13.0pt;line-height:105%;font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-size:13.0pt;line-height:105%">A success of this initiative was the integration of self-management program services into the Patient Centered Medical Home model, which enhanced team-based care.
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height:105%"><span style="font-size:13.0pt;line-height:105%"><o:p> </o:p></span></p>
<p class="MsoNormal" style="line-height:105%"><span style="font-size:13.0pt;line-height:105%">Addressing tobacco use and dependence in health systems:
<o:p></o:p></span></p>
<span style="font-size:13.0pt;line-height:105%;font-family:"Calibri",sans-serif;mso-fareast-language:EN-US"><br clear="all" style="page-break-before:always">
</span>
<p class="MsoNormalCxSpMiddle" style="margin-left:39.0pt;mso-add-space:auto;text-indent:-.25in;line-height:105%;mso-list:l0 level1 lfo2">
<![if !supportLists]><span style="font-size:13.0pt;line-height:105%;font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-size:13.0pt;line-height:105%">Reduces healthcare costs;<o:p></o:p></span></p>
<p class="MsoNormalCxSpMiddle" style="mso-margin-top-alt:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:39.0pt;mso-add-space:auto;text-indent:-.25in;line-height:105%;mso-list:l0 level1 lfo2">
<![if !supportLists]><span style="font-size:13.0pt;line-height:105%;font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-size:13.0pt;line-height:105%">Helps meet quality incentive measures for payers and clinics;
<o:p></o:p></span></p>
<p class="MsoNormalCxSpMiddle" style="mso-margin-top-alt:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:39.0pt;mso-add-space:auto;text-indent:-.25in;line-height:105%;mso-list:l0 level1 lfo2">
<![if !supportLists]><span style="font-size:13.0pt;line-height:105%;font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-size:13.0pt;line-height:105%">Can reduce hospital readmission;<o:p></o:p></span></p>
<p class="MsoNormalCxSpMiddle" style="mso-margin-top-alt:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:39.0pt;mso-add-space:auto;text-indent:-.25in;line-height:105%;mso-list:l0 level1 lfo2">
<![if !supportLists]><span style="font-size:13.0pt;line-height:105%;font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-size:13.0pt;line-height:105%">Can increase patient satisfaction with their care; and
<o:p></o:p></span></p>
<p class="MsoNormalCxSpMiddle" style="mso-margin-top-alt:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:39.0pt;mso-add-space:auto;text-indent:-.25in;line-height:105%;mso-list:l0 level1 lfo2">
<![if !supportLists]><span style="font-size:13.0pt;line-height:105%;font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-size:13.0pt;line-height:105%">Can save lives and help patients avoid preventable heart disease, stroke, peripheral vascular disease, and other smoking-related diseases.<o:p></o:p></span></p>
<p class="MsoNormalCxSpMiddle" style="margin-bottom:8.0pt;mso-add-space:auto;line-height:105%">
<span style="font-size:13.0pt;line-height:105%"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:13.0pt">Tobacco use and dependence is the leading preventable cause of disease and death in Oregon and in the United States. Although we have made progress in reducing tobacco use, more than 500,00 adults in Oregon
currently smoke cigarettes and marked disparities exist across population groups. Nearly one out of every four cardiovascular disease deaths is due to cigarette smoking, highlighting the importance of smoking cessation in the prevention of these diseases.
In addition to the human toll, tobacco use and dependence are also significant drivers of healthcare costs.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:13.0pt"><o:p> </o:p></span></p>
<p class="MsoNormal" style="line-height:105%"><span style="font-size:13.0pt;line-height:105%">The good news is that most people who smoke want to quit, and there are effective evidence-based treatments to help them. As of 2017, six out of 10 Oregon adults who
smoke want to quit and more than half of all Oregon adults who smoke try to quit each year. The challenge, however, lies in increasing people’s access to and use of these treatments. To that end, health systems play a critical role in providing effective treatment
for people who want to quit smoking. <o:p></o:p></span></p>
<p class="MsoNormalCxSpMiddle" style="margin-bottom:8.0pt;mso-add-space:auto;line-height:105%">
<span style="font-size:13.0pt;line-height:105%"><o:p> </o:p></span></p>
<p class="MsoNormalCxSpMiddle" style="margin-bottom:8.0pt;mso-add-space:auto;line-height:105%">
<span style="font-size:13.0pt;line-height:105%">I encourage you to share this out with your networks including healthcare and community partners, behavioral health organizations and CCOs.
<o:p></o:p></span></p>
<p class="MsoNormalCxSpMiddle" style="margin-bottom:8.0pt;mso-add-space:auto;line-height:105%">
<span style="font-size:13.0pt;line-height:105%"><o:p> </o:p></span></p>
<p class="MsoNormalCxSpMiddle" style="margin-bottom:8.0pt;mso-add-space:auto;line-height:105%">
<span style="font-size:13.0pt;line-height:105%">Thank you,<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:13.0pt"><o:p> </o:p></span></p>
<p class="MsoNormal" style="background:white"><b><span style="font-size:13.0pt;color:#232323">J. Hildegard Hinkel, MPH<br>
</span></b><i><span style="font-size:13.0pt;color:#232323">Health Systems Policy Specialist</span></i><span style="font-size:13.0pt;color:#232323"><br>
OREGON HEALTH AUTHORITY<br>
Public Health Division <br>
Health Promotion & Chronic Disease Prevention<o:p></o:p></span></p>
<p class="MsoNormal" style="background:white"><span style="font-size:13.0pt;color:#232323"><a href="mailto:janet.h.hinkel@state.or.us"><span style="color:blue">janet.h.hinkel@state.or.us</span></a>
</span><span style="font-size:13.0pt;color:#212121"><o:p></o:p></span></p>
<p class="MsoNormal" style="background:white"><span style="font-size:13.0pt;color:#232323">Desk: 971-673-3182<br>
Mobile: 971-212-1661<br>
</span><span style="font-size:13.0pt;color:#0000CC"><a href="http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbXNpZD0mYXVpZD0mbWFpbGluZ2lkPTIwMTYxMjIwLjY3OTEzNjMxJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE2MTIyMC42NzkxMzYzMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE2ODYxMTMzJmVtYWlsaWQ9YWxleGFuZHJhLmguYWxkYXlAZGhzb2hhLnN0YXRlLm9yLnVzJnVzZXJpZD1hbGV4YW5kcmEuaC5hbGRheUBkaHNvaGEuc3RhdGUub3IudXMmdGFyZ2V0aWQ9JmZsPSZtdmlkPSZleHRyYT0mJiY=&&&110&&&http://www.oregon.gov/OHA" target="_blank"><span style="color:#0000CC">http://www.oregon.gov/OHA</span></a></span><span style="font-size:13.0pt;color:#212121"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:13.0pt"><o:p> </o:p></span></p>
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