Towards the Standardized Documentation of E-Cigarette Use in the Electronic Health Record for Population Health Surveillance and Research

The debate regarding potential negative health effects of electronic nicotine delivery systems (ENDS), which include electronic cigarettes, has received much recent attention. Currently, it is unknown whether ENDS pose a real health risk to users or those passively exposed to their vapor. With the increased use of these devices, the goal of this study was to examine if and how their use is being documented in the electronic health record (EHR) and the associated implications for clinical research. Analysis of five years of progress notes and tobacco use comments revealed that ENDS use is documented at an increasing rate with variable associated information, most often consisting of the status, purpose, and side effects of ENDS use. These results highlight that improved and consistent EHR discrete data entry for ENDS with associated clinical standards for documentation and representation of potential exposures are needed for enabling effective population health surveillance and research.