Electronic health records enabled better management of obesity among children

Coleman KJ. J Pediatr. 2012;doi:10.1016/j.jpeds.2011.12.027.

Electronic health records and embedded tools improved the identification, diagnosis and counseling for overweight or obese children, according to study findings recently published online.

To evaluate the effect of computer-assisted decision tools intended to standardize pediatric weight management in an integrated health care system, researchers conducted a large-scale implementation study documenting the effect of the Kaiser Permanente Southern California Pediatric Weight Management Initiative.

The initiative, which began in 2008, was designed to follow the Expert Committee guidelines and create awareness among pediatricians and other primary care providers regarding the importance of child and adolescent overweight and obesity as a health concern and to assist them in documenting and managing the problem.

From 2007 to 2010, researchers analyzed outpatient visits for nearly 740,000 children aged 2 to 17 years and observed that extracting information — height and weight measurements, evidence of exercise and nutritional counseling, diagnosis of overweight and obesity — from the electronic health record substantially improved the identification and diagnosis of overweight and obesity among children.

“By using electronic medical record tools, we can diagnose and address obesity-related issues at a population level rather than just among a few families. These are great tools that could be implemented by physicians in a variety of clinical settings to better diagnose and manage obesity among children and adolescents,” researcher Karen J. Coleman, PhD, said in a press release.

According to the study results, before the initiative, 66% of all children had their height and weight measurements taken, which increased to 94% in 2010 after 3 years of the initiative (P< .001). Among children, diagnosis of overweight or obesity increased significantly from 12% in 2007 to 61% in 2010 (P<.001), and documented rates of counseling about exercise and nutrition increased significantly from 1% in 2007 to 50% in 2010 (P<.001).

“One of the highlights of the initiative was the EMR tools,” the researchers said. “These included graphic displays of BMI-for-age and gender percentiles on digitalized CDC growth charts, a ‘Best Practice Alert’ with instructions about counseling and screening for related conditions, including laboratory tests, automatic referral to programs for family lifestyle change, and a variety of after visit summaries with dietary and physical activity recommendations for families.”

Disclosure: The researchers report financial support from the National Institute of Diabetes and Digestive and Kidney Diseases.