QuitWorks

QuitWorks is a patient referral and reporting service that allows healthcare and other providers to easily refer patients who use tobacco/nicotine to 1-800-QUIT-NOW, Massachusetts’ Quitline.

1-800-QUIT-NOW offers free telephone-based counseling, texting, and online resources for patients 12 and older who want to quit or cut down their tobacco/nicotine use, with the addition of nicotine replacement therapy (nicotine patch, gum, or lozenge) for patients 18 and older. Patients can access 1-800-QUIT-NOW services by telephone or online (and via text for 12–24-year-olds). The evidence-based service meets the needs of your patients using any type of nicotine product, including cigarettes, vapes/e-cigarettes, cigars, hookah, or smokeless tobacco.

Telephone coaching covers numerous topics including strategies to increase the motivation to quit, setting a quit date, and managing cravings. It also provides interpersonal support to participants to successfully become tobacco-free. Participants in telephone coaching receive up to five proactive calls from the Quitline and information tailored to their unique medical or demographic characteristics. Massachusetts residents seeking support can receive coaching over multiple quit attempts each year, if needed. 

Referring patients who use tobacco/nicotine to 1-800-QUIT-NOW is an easy way for you to help them take the first step toward a nicotine-free life. QuitWorks helps you keep track of their progress by sending you reports on your patients’ participation in services. Technical assistance is available to help integrate the program into your clinical setting to ensure you are reaching all your patients who may benefit from the service. 

"QuitWorks fills a huge gap in the continuity of care we can offer smokers. Office practices, hospitals and health centers need to provide counseling to smokers after they leave the health care setting. QuitWorks does this with an innovative system that reaches out to contact the patient, offers evidence-based services, and keeps the provider in the loop with patient progress reports."

Nancy Rigotti, MD, Director, Tobacco Research and Treatment Center Massachusetts General Hospital and Harvard Medical School Boston, Massachusetts

"The amount of time it takes to counsel patients to quit can limit an effective intervention as most patients have multiple other medical problems that need to be addressed in a 15 min appointment.  If the patient expresses any interest in quitting smoking, I find QuitWorks to be a useful place to refer them.  . . . We as physicians are fortunate to have this free program provided by the state for our patients." 

Nancy Drew, MD, internal medicine physician at Granite Medical Group in Quincy, Massachusetts

• Easily refer your patients who use tobacco/nicotine to 1-800-QUIT-NOW, an evidence-based service that offers counseling and nicotine replacement therapy (if approved) to patients to help them quit. Studies show that evidence-based quitlines are effective and can increase quit smoking rates by 20% to 30%. Learn more about 1-800-QUIT-NOW.
• In a 2020 survey of 1-800-QUIT NOW users, 28% self-reported abstinence from a tobacco product/vape for the past 30 days
• Referring patients to 1-800-QUIT NOW through QuitWorks can extend the services you provide during the patient visit.  Patients will receive coaching by trained tobacco treatment specialists, and you’ll be informed of their progress.
• Receive feedback reports on your patient’s progress. QuitWorks will send reports to you so you can track your patient’s enrollment, participation in services, and receipt of NRT.
• Assistance with implementing QuitWorks in your clinical setting is offered through the Center for Tobacco Treatment Research and Training at the University of Massachusetts Chan Medical School. Contact us at Quitworks@umassmed.edu to learn more about referral options, best practices for addressing tobacco use among patients, and how to use QuitWorks to meet your organization’s quality or community standards reporting needs. This service is funded by the Massachusetts Department of Public Health Tobacco Cessation and Prevention Program (MTCP).  

The heart of the QuitWorks program is a flexible referral process that can be used by any provider in health care and community service settings. Providers, including medical assistants, community health workers, social workers, dental hygienists, and others, can refer a patient or client aged 12 or older, regardless of health insurance status. Pediatric and family practitioners may also refer a child's parent or guardian if they use nicotine or tobacco. 

You can choose from a variety of options to refer your patients:

• Refer online by using Massachusetts Quitlogix, the 1-800-QUIT-NOW website. This referral route allows you to complete and submit the form online, ensuring accuracy and saving you time.
• Fax a paper referral form 
  • Download copies of the fax referral form
  • QuitWorks can pre-populate forms for your organization. These forms improve workflow and measure results. Contact QuitWorks to customize the form for your facility or explore the fully electronic process.
• Use your Electronic Medical Record (EMR) to fax a referral 
  • If the EMR has a referral module it can be used to electronically complete some or all the referral form details, such as patient or clinic information. Once the referral form is completed you have two options: print and fax the form to QuitWorks or fax directly through the EMR’s fax module program. These options are based on each EMR system’s available functionality. You can also create a link in your EMR to MA Quitlogix referral page, the website for 1-800-QUIT-NOW, to make an online referral.
• Electronic data transfer(eReferral) 
  • Some institutions/large practices that regularly use QuitWorks or that want to increase their QuitWorks referrals may opt to send referrals electronically from their EMR through our secure data exchange network. No paper or faxing is involved, and feedback reports will be sent directly to the patient record if desired. Contact QuitWorks if you are interested in exploring this option.

Resources for your patients include:

• The Massachusetts Health Promotion Clearinghouse to order free educational materials
• Mass.gov/quitting

In national surveys more than half of all tobacco users report an interest in quitting, but not all are interested in quitting at the time of their health care visit. We recommend that providers re-refer patients to 1-800-QUIT-NOW through QuitWorks as often as necessary.

Research shows that talking about tobacco use even briefly (3-5 minutes) can help people quit using tobacco/nicotine. The “AAR” model may be helpful, especially when clinicians are referring patients to an outside service for counseling.  A new way of talking about this model is AAC – ask/assess, advise, connect. Traditionally “refer” indicates referring patient to evidence-based tobacco treatment resources. “Connect” is a direct connection to the Quitline – linking the patient with the Quitline through an automated connection system such as EMR, website referrals, etc.  All these connections are available via QuitWorks.

1. Ask/Assess every patient at each encounter about their use of tobacco/nicotine products and document status. For example, “Do you currently use any type of tobacco or nicotine product, such as cigarettes, e-cigarettes or vapes, cigars, or smokeless tobacco?”
2. Advise every tobacco user to quit with a clear, strong personalized message about the benefits of quitting. For example, “One of the best things you can do for your health is to quit using tobacco.” “Continuing to smoke can make your COPD worse, and quitting will help you.”
3. Refer patients who are ready or considering quitting. For example, “1-800-QUIT-NOW can help you with a free plan to quit smoking or vaping. They can also talk about medications to help you quit. What are your thoughts about having someone from the Quitline call you?” If the patient agrees, CONNECT the patient to 1-800-QUIT-NOW via QuitWorks.

Watch a video example of a brief intervention.

Learn more about using the 5 As (Ask, Advise, Assess, Assist, Arrange) as a more in-depth approach to assist patients in quitting. This approach is often used by individuals trained in Tobacco/Nicotine Dependence Treatment.

Stopping the use of tobacco and nicotine involves a process of change that takes place in stages over time. Don’t worry if your patient isn’t ready to quit right now – you can still talk to them about their tobacco/nicotine use and advise them to quit. 1-800-QUIT-NOW can help your patients think about their reasons for quitting or help them cut down, even if they aren’t 100% sure they want to quit right now. 

Here are some tips for talking to your patients at different stages of their quitting:

• It often takes many quit attempts before someone who uses tobacco/nicotine achieves long-term success. Make sure to regularly ask ALL your patients who use tobacco/nicotine about quitting!

Patients will receive their first intake call (from phone number 617-262-2200) within one business day after the referral.

Up to five call attempts will be made to reach patients within 18 business days; typically, 50% to 60% of referred patients respond to calls.

During the first call, demographic and tobacco/nicotine use information will be collected, and the service will be described to patients. Patients agreeing to the service will receive a total of five coaching calls (more calls for special programs) at times that are convenient for them. Patients can opt-in to texting to allow for reminders regarding coaching calls and medication shipments. Patients will be mailed educational materials, can opt in to receive supportive texts, and can also access materials via Quitlogix, the 1-800-QUIT-NOW website. Patients can also call the Quitline for support and information beyond the 5 counseling calls, and there is no limit to the number of calls patients can make to the Quitline.

All patients who complete an intake with a Quitline coach receive a six-month follow-up evaluation call. The call is used to find out about patients’ quit status and determine what they thought about QuitWorks services. This information is reported aggregately.

Here’s what QuitWorks learned from the evaluation survey of calls completed from July 2019 through June 2020:

QuitWorks gets results

• 28% self-reported abstinence from a tobacco product/vape for the past 30 days
• 83% used some form of nicotine replacement therapy (NRT) to assist them with their quit attempt

Patients like QuitWorks

• 91% were satisfied with the services and assistance received from 1-800-QUIT-NOW

A variety of report options are available for provider practices and institutions to help track patient referrals and outcomes.  Standard reports are currently sent via paper fax. For larger practices and institutions, reports may be sent electronically. Contact QuitWorks if you are interested in exploring electronic options, would like to discuss aggregate reports for patient quality and utilization, or would like to see a sample of the reports sent. Reports are sent to providers through the fax number or electronic connection they originally used to submit the referral to QuitWorks.

Patient contact report

• Approximately three weeks after a referral is made, a Patient Contact Report is sent to the referring provider which includes information on the outcome of QuitWorks’ attempts to reach the referred patient, and if the patient is reached, the services selected.

QuitWorks’ goal is not just to treat individuals who use tobacco/nicotine, but to work with health care facilities to institute a continuum of effective treatment interventions in both inpatient and ambulatory practice settings consistent with the recommendations of the Treating Tobacco Use and Dependence: 2008 Update Guideline, a US Public Health Service-sponsored Clinical Practice Guideline.

The University of Massachusetts Chan Medical School Center for Tobacco Treatment Research and Training (CTTRT) provides technical assistance on workflow design to help health care organizations integrate QuitWorks and tobacco interventions into existing systems and electronic health records. CTTRT also offers provider and staff training for health care facilities that use QuitWorks, as well as aggregate reports for improved utilization. Contact us for more information. These services are funded by the Massachusetts Department of Public Health (MDPH) Tobacco Cessation and Prevention Program (MTCP).

QuitWorks can help in many other ways

• Conduct an initial institution readiness assessment developed by the Center for Tobacco Treatment Research & Training at the University of Massachusetts Chan Medical School.
• Help create a roll-out plan for a system to address tobacco/nicotine use and establish goals for the institution.
• Provide in-services on how to effectively use QuitWorks, including talking with patients about the service and making effective referrals.
• Provide free, provider-level identified disposition and outcome reports, as well as free aggregate reports to large health care systems and behavioral health organizations.
• Offer bi-directional eReferrals sent via a secure CCD Direct Messaging protocol that is HL7v3 compliant. (Fee involved)

Trainings

Customized Training for QuitWorks Users

Facilities that are working toward adopting QuitWorks in their clinical system may be eligible for free, customized training to help staff increase their knowledge of tobacco/nicotine dependence and how to utilize resources such as QuitWorks effectively. Staff at University of Massachusetts, Center for Tobacco Treatment Research and Training provide the training. Contact us for more information about how customized training can help you to integrate QuitWorks into your health care settings.

University of Massachusetts Chan Medical School

The Center for Tobacco Treatment Research and Training at the University of Massachusetts Chan Medical School has a long history of delivering high quality programs for health care professionals in Massachusetts and across the country. Two standard trainings are available.

• Basic Skills for Working with Tobacco Users is a 10-hour online course that gives staff basic information about conducting tobacco assessments and offering evidence-based treatment.
• Tobacco Treatment Specialist (TTS) Training is an intensive online and 3-day in-person or virtual program. This level of training provides a deeper understanding of tobacco/nicotine dependence and the behavioral and pharmacological methods to treat it. CMEs and CEUs are available for many specialties.

• For more information about QuitWorks or 1-800-QUIT-NOW, the Massachusetts Quitline:
  • The University of Massachusetts Chan Medical School’s Center for Tobacco Treatment Research and Training has technical assistance and trainings to assist in using QuitWorks at your site.
  • A bi-monthly newsletter for information on new Quitline services and other tobacco-related content. Sign up.
  • The Massachusetts Quitline website has resources for any provider working with clients who use tobacco, including QuitWorks referral forms, an explanation of services provided, and video examples of talking to clients about their tobacco use.
• For more information about tobacco use disorder treatment in general:
  • The Public Health Service’s Clinical Practice Guideline describes best practices for tobacco use disorder treatment, including integration into practices.
  •  Ask/Advise/Refer (AAR) model
  • 5 A’s model (Ask/Advise/Assess/Assist/Arrange)
  • Information about vaping
  • The Million Hearts Tobacco Cessation Change Packet offers tools to integrate tobacco cessation into your practice. UMass Chan Medical School staff are available to assist you in using this packet and determining what will work best for your site. Click here to contact them.
• For materials for your site and/or patients/clients:
  • Order free Quitline and cessation promotional materials such as posters and brochures from the Massachusetts Health Promotion Clearinghouse
  • The Center for Disease Control’s Healthcare Provider page has tools and resources for your practice, including posters and videos from the Tips campaign.
• For clinician training:
  • The University of Massachusetts Chan Medical School’s Center for Tobacco Treatment Research and Training offers training for individuals interested in becoming Tobacco Treatment Specialists. Scholarships may be available for training.
  • Motivational Interviewing training can increase your skills in talking with clients about their tobacco use and other medical issues. A list of national trainers can be found here. UMass Chan Medical School’s Center for Integrated Primary Care also offers training.