Presentation of body mass index within an electronic health record
to improve weight assessment and counselling in children and
adolescents

Shaikh, Ulfat; Nelson, Rachel; Tancredi, Daniel J.; Byrd, Robert S.

doi:10.14236/jhi.v18i4.779

Cited by 9 publications

(7 citation statements)

References 27 publications

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“…Most overweight children and a large portion of obese children are not identified or treated by their primary care providers, 9,14-22 even with the use of automatic BMI calculations in the electronic medical records. 23 Past retrospective chart reviews have revealed poor diagnosis and management of pediatric obesity in the academic primary care setting. A 2004 retrospective paper chart review within an academic general pediatric clinic demonstrated that only half of all obese children were given a diagnosis of obesity.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Correctly Identified Pediatric Obesity and Overweight Status and Management in an Academic General Pediatric Clinic

Morais

Kelly

Bost

et al. 2018

Clin Pediatr (Phila)

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This study identified and characterized the rates of documentation and guideline-based management of overweight and obese children within an academic pediatric clinic through a retrospective electronic medical record review of 7422 well-child visits in 2016. Diagnosis and treatment were analyzed by patient's weight diagnosis, sex, age, and provider training level. The percentages of correctly identified severely obese (90.2%), obese (77.0%), and overweight (42.0%) children were much higher than in previous retrospective chart reviews; however, less than 30% of children were referred for more intensive weight management to a dietitian or pediatric obesity weight management program. Increased provider training level was associated with a lower adherence to pediatric obesity guidelines. Strategic modifications to electronic medical records that automatically offer body mass index-associated weight diagnoses with a link to treatment pathways and resources are needed to facilitate improved compliance with current pediatric obesity guidelines in the primary care setting.

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Section: Introductionmentioning

confidence: 99%

Characteristics of Correctly Identified Pediatric Obesity and Overweight Status and Management in an Academic General Pediatric Clinic

Morais

Kelly

Bost

et al. 2018

Clin Pediatr (Phila)

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“…12 The goal of the present study was to test the hypothesis that clinical decision support at the point of care-specifically an alert for high BMI, a checklist, and standardized documentation templates-increases adherence to clinical recommendations for overweight and obesity.…”

mentioning

confidence: 99%

Impact of Electronic Health Record Clinical Decision Support on the Management of Pediatric Obesity

et al. 2014

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Clinicians vary significantly in their adherence to clinical guidelines for overweight/obesity. This study assessed the impact of electronic health record-based clinical decision support in improving the diagnosis and management of pediatric obesity. The study team programmed a point-of-care alert linked to a checklist and standardized documentation templates to appear during health maintenance visits for overweight/obese children in an outpatient teaching clinic and compared outcomes through medical record reviews of 574 (287 control and 287 intervention) visits. The results demonstrated a statistically significant increase in the diagnosis of overweight/obesity, scheduling of followup appointments, frequency of ordering recommended laboratory investigations, and assessment and counseling for nutrition and physical activity. Although clinical guideline adherence increased significantly, it was far from universal. It is unknown if modest improvements in adherence to clinical guidelines translate to improvements in children's health. However, this intervention was relatively easy to implement and produced measurable improvements in health care delivery.

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“…Certainly, the use of vaccines to prevent life-threatening illness has been well-established 17 ; in contrast, documentation of BMI has not clearly been linked to weight reduction, or even to the provision of more nutritional counseling. 18,19 Similarly, annual physical exams have not been distinctly linked to improved health outcomes in adult populations. 20 Within the category of process measures, we found that over threequarters were intended to address underuse of services.…”

Section: Discussionmentioning

confidence: 99%

Categorization of National Pediatric Quality Measures

et al. 2017

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Presentation of body mass index within an electronic health record to improve weight assessment and counselling in children and adolescents

Cited by 9 publications

References 27 publications

Characteristics of Correctly Identified Pediatric Obesity and Overweight Status and Management in an Academic General Pediatric Clinic

Characteristics of Correctly Identified Pediatric Obesity and Overweight Status and Management in an Academic General Pediatric Clinic

Impact of Electronic Health Record Clinical Decision Support on the Management of Pediatric Obesity

Categorization of National Pediatric Quality Measures

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