National Working Group for ACTTION

July 20, 2009

The Multi-State Health Systems Change Collaborative (HSC Collaborative) was formed in 2007 by state tobacco control programs to identify, document and share promising state-level practices to reduce tobacco use through sustainable improvements in health care systems both at a state and national level. The HSC Collaborative now includes 13 states (Massachusetts, Maine, New Hampshire, Vermont, Rhode Island, New York, Wisconsin, Colorado, Iowa, Ohio, Oklahoma, Minnesota, and Washington) and several national organizations. Below we have provided a Q&A with Ann Wendling, MD, MPH, Director of Cessation Programs for ClearWay Minnesota, an organization leading the HSC Collaborative efforts.

Q.   What have been some of the major achievements/accomplishments of the HSC Collaborative since its inception?

A.   The HSC Collaborative has been gathering practical evidence on how state tobacco control programs can support widespread, sustainable changes in provider practices, hospitals and health centers.

With support from CDC, the HSC Collaborative developed Improving Health Care Systems to Reduce Tobacco Use: Lessons Learned from States, and its companion document, Improving Health Care Systems to Reduce Tobacco Use: Promising Practices Case Studies. Lessons Learned from States synthesizes strategies used, barriers experienced and lessons learned across 23 projects. Promising Practices Case Studies provides in-depth case studies of the projects. The projects are grouped into four main categories:  

·         Influencing insurers, purchasers and employers to provide comprehensive cessation benefits

·         Educating and motivating clinicians to treat tobacco use as a chronic disease

·         Helping health care organizations and practices improve tobacco cessation interventions

·         Promoting systems changes in mental health and substance abuse services institutions and departments

Q.   What are the biggest challenges facing the HSC Collaborative in terms of accomplishing your articulated goals?

A.   The HSC Collaborative is in need of financial backing to expand its membership, support and build its information clearinghouse, provide technical assistance to other states, and to collaborate with partners on national agenda issues. The members of the Collaborative largely participate on a voluntary in-kind basis, and an expanded membership will allow task groups to accomplish their work more expeditiously by sharing information and practices through the HSC Collaborative. The Collaborative also seeks to partner with national organizations to achieve common goals.

Q.   What are some examples of how the work of the HSC Collaborative can make a difference in the delivery of and access to tobacco cessation services?

A.   The HSC Collaborative is now positioned to serve all states and to grow as a collection point and clearinghouse for the latest state initiatives to advance change in health care systems. Task groups have identified five important areas for action:

·         Influence insurers to improve health care benefits for tobacco use

·         Support changes in health care systems at the organizational level, including examples of how tobacco interventions are integrated into patient care and electronic health records, and how data are used for performance improvement

·         Market effectively to clinicians to encourage an increase in tobacco interventions

·         Pursue improvements in clinician education to address tobacco use

·         Influence Healthy People 2020 to include key concepts about health care systems change to improve longevity and to reduce health disparities related to tobacco use

Q.   How do you see the HSC Collaborative furthering the goals and recommendations of the Call for ACTTION?

A.   The goals of the HSC Collaborative for implementing health care systems changes, supporting provider intervention and referral, and expanding tobacco cessation insurance coverage, including quitline support, are well aligned with those of the Call for ACTTION. The efforts and learnings of the HSC Collaborative members at the local and state levels will incrementally contribute to increasing access to barrier-free cessation services and inform the Call for ACTTION issues that need to be addressed at a national level.

Q.   How can people learn more about the HSC Collaborative or get more involved in your project?

A.   The HSC Collaborative warmly invites state tobacco control programs, health care partners, and national partners that have or are working on a systems level change projects to learn about its work and to become involved. Visit at www.MultiStateCessationCollaborative.org or contact Caroline Cranos, Coordinator, at caroline.cranos@umassmed.edu or Donna Warner, Director of Cessation Policy and Program Development, Massachusetts Tobacco Control Program, at donna.warner@state.ma.us.

Your Call to Action: Learn more about the Multi-State Health Systems Change Collaborative and identify synergies in the activities that you are working on at the state level.