EHRs increase obesity diagnosis and management in pediatric patients

Use of electronic health record (EHR) computer-assisted decision tools can increase identification, diagnosis, and counseling for overweight and obese children and adolescents, a study of a large pediatric population suggests.

A pediatric weight management initiative based on the latest expert guidelines was implemented in a large, integrated health care system in 2008. A height-and-weight vital sign incorporated in the EHR alerted clinicians when a patient’s body mass index exceeded the 85th percentile for age and sex and provided reminders about weight management counseling and screening for related conditions. An online continuing medical education course was also developed.

Researchers analyzed data from 2007 through 2010 on an average of 739,816 outpatient visits per year by children aged 2 to 17 years. The percentage of children with recorded height and weight measurements increased from 66% before implementation of the EHR initiative to 94% in 2010. Among patients who were overweight or obese, documentation in the EHR increased from 12% in 2007 to 61% in 2010, and documented exercise and nutrition counseling rates increased from 1% to 50%.

Studies have shown that primary care physicians do not consistently follow guidelines on weight management for children and adolescents, citing multiple barriers. The researchers say the findings show that incorporation of computer-assisted decision tools in the EHR and concurrent education can promote implementation of evidence-based strategies for management of obesity.

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