Measure Abbreviation
SMOK-02
Data Collection Method

This measure is calculated based on data extracted from the electronic medical record combined with administrative data sources such as professional fee and discharge diagnoses data. This measure is explicitly not based on provider self-attestation.

Measure Type
Process
Description

Percentage of patients, ≥18 years of age, who are documented as current tobacco smokers and also receive an approved smoking cessation intervention from an anesthesia provider 

Measure Time Period

30 days prior to anesthesia start through anesthesia end

Inclusions
Exclusions
  • Patients <18 years of age
  • Patients determined to be former or non smokers by the MPOG Smoking Tobacco Classification
  • Patients with unknown smoking status (not documented)
  • Non-operative procedures
  • Cases where the ‘Anesthesia End Time’ precedes ‘Anesthesia Start Time’ will be excluded and marked 'invalid'
Success

Smoking cessation intervention documented within 30 days prior to anesthesia start through anesthesia end

Other Measure Build Details
  • Measure start time determined by first assessing anesthesia start date/time and calculating 30 days prior to anesthesia start date
  • Documentation of smoking cessation intervention includes:
    • Counseling provided
    • Treatment offered
    • Referral for tobacco cessation counseling
    • Patient refusal or documentation suggesting ‘no interest in quitting’ or ‘patient declined’ 
  • For Michigan sites participating in the Value Based Reimbursement program: Please visit Smoking Cessation Frequently Asked Questions
Responsible Provider

 Provider signed in at anesthesia start

Threshold
10%
MPOG Concept IDs Required

MPOG Concept ID

Concept Description

Smoking Status Concepts

70126

History- Social History - Alcohol

70127

History- Illicit Drug Use

70128

History- Social History - Tobacco

70160

History- Social History - Tobacco (Current Smoker)

70161

History- Social History - Tobacco (Former Smoker)

70162

History- Social History - Tobacco (Non Smoker)

71100

History- Social History - Tobacco Details Pack Years

71110

History- Social History - Tobacco Details Current vs Past

71040

General - Past Medical History ICD-9 Code

71041

General - Past Medical History ICD-10 Code

70125

History - Social History - General

70338

General - PONV Risk Factors

Smoking Cessation Treatment Concept

70164

Tobacco Cessation Intervention

Data Diagnostics Affected
Rationale

Tobacco use is the single greatest preventable cause of disease and premature death in America today.1 In addition, smoking is an established perioperative risk factor impacting up to 25% of surgical patients.2 According to the Centers for Disease Control (CDC), 70% of smokers report they would like to quit however, only 15% of smokers in Michigan receive smoking cessation treatment.3,4 Making every contact count (MECC) is an approach to behavior change that is clinically proven to help patients quit smoking and results in better health outcomes.5 More so, there is evidence to support that the preoperative setting offers an opportunity to address smoking cessation options.6

Risk Adjustment

Not applicable

References
  1. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014
  2. Schmid M, Sood A, Campbell L, et al. Impact of smoking on perioperative outcomes after major surgery. Am J Surg 2015;210:221–9.
  3. Babb S, Malarcher A, Schauer G, Asman K, Jamal A. Quitting Smoking Among Adults - United States, 2000-2015. MMWR Morb Mortal Wkly Rep. 2017;65(52):1457-1464.
  4. Analysis provided by the Michigan Value Collaborative for Blue Cross Blue Shield of Michigan PPO Pharmacy plan members in 2019-2020.
  5. Public Health England. Making Every Contact Count (MECC): Consensus statement.  Public Health England, NHS England, Health Education England, and the national MECC advisory group, April 2016 (https://www.england.nhs.uk/wp-content/uploads/2016/04/making-every-contact-count.pdf)
  6. Nayan S, Gupta MK, Strychowsky JE, Sommer DD. Smoking cessation interventions and cessation rates in the oncology population: an updated systematic review and meta-analysis. Otolaryngol Head Neck Surg 2013;149:200–11.