Increased Documentation and Management of Pediatric Obesity Following Implementation of an EMR Upgrade and Education

Abstract

We found an increase in documentation and management of overweight children following an EMR upgrade that calculates BMI percentiles for age and gender. Physician education was an important adjunct.

Mismatch between the prevalence of overweight and obese children and adolescents and recording in electronic health records: a cross-sectional study

“…The availability of reminders or alerts may prompt actions to promote healthy lifestyle behaviours in the outpatient setting. 9,17 However, our results show that even in severely obese children (Z 3), a diagnosis was not registered in 66.1% of cases, suggesting that use of a more sensible anthropometric tool is not enough, and additional medical education is needed to increase the detection of overweight and obesity. By contrast, when the diagnosis was registered, most of the patients were referred to specialists.…”

“…Our findings not only show us that there is low awareness of the obesity burden among physicians, but also that further actions need to be taken in order to promote full use of the EHR's capabilities because recent studies have shown that use of EHR to facilitate the identification of nutritional status can help in the management of obesity in children, enhancing the quality of care provided when compared with not using an EHR. 17,18 The EHR used at HIBA is the only way physicians have to register events on patients under their care in the outpatient setting. Our EHR is patient-centred and problem-oriented; physicians enter terms into specific domains (problem list, procedures, discharge summary, etc.)…”

“…27 It has been demonstrated in the adult and paediatric populations that the automatic calculation of BMI can improve the documentation and management of obesity. 17,28 The implementation of alerts based on BMI values could help to increase the awareness of paediatricians about overweight at early stages so that they can start implementing specific interventions.…”

Student Column Improving Processes of Care for Overweight and Obese Children: Evidence from the 215-Go! Program in Philadelphia Health Centers

“…[21][22][23][24] Physician and staff training in these programs also involves education and awareness of the AAP guidelines, screening techniques, and counseling strategies. [21][22][23][24][25] Similarly, interventions involving the use of electronic medical records (EMRs) have proven successful in improving guideline adherence in physicians treating pediatric overweight and obesity. [25][26][27][28] The PDPH clinics are in the process of implementing an EMR system, which could further improve processes of care for all children.…”

Children's Report of Lifestyle Counseling Differs by BMI Status

“…The use of such medical records has been found to increase the diagnosis and counseling of overweight children. 30 Childhood overweight and obesity are more prevalent among racial minorities 1 ; however, evidence on lifestyle counseling differences by race remains limited and inconclusive. In a study of preventive obesity counseling in healthy weight children, non-Hispanic patients received more counseling than Hispanics.…”