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

Research output: Contribution to journalArticle

10 Scopus citations


Background: Assessment ofweight and counselling on nutrition and physical activity is infrequently conducted during well child visits, despite recent expert recommendations. Objective: We investigated whether automatic calculation of body mass index (BMI) in an electronic health record improved assessment of weight and counselling on nutrition and physical activity. Methods: Retrospective review of well child visit records of children between two and 18 years of age (n=550) before and after implementation of an electronic health record system at an academic medical centre's paediatric clinic. Body mass index was automatically calculated and presented within the electronic health record. We measured clinicians' documentation of assessment of weight status, and assessment of and counselling for nutrition and physical activity risk factors. Results: Documentation of assessment of BMI and weight status did not increase. There were no consistent increases in assessment for or counselling on specific nutrition and physical activity behaviours, except with respect to high calorie food intake. Although overall assessment of physical activity decreased, physical activity counselling significantly increased. Documentation of the presence of highrisk family history increased significantly; the provision of counselling for high-risk family history did not show any corresponding increase. Patients with higher BMI percentile scores were more completely assessed for weight status. Completeness of weight status assessment was associated with increased counselling for nutrition and physical activity. Conclusions: Passive changes, such as automatic calculation of BMI, are insufficient to result in systematic improvements in assessment of weight and counselling for nutrition and physical activity.

Original languageEnglish (US)
Pages (from-to)235-244
Number of pages10
JournalInformatics in Primary Care
Issue number4
StatePublished - Nov 2011



  • Adolescent
  • Assessment
  • Body mass index
  • Child
  • Computerised medical record system
  • Counselling
  • Diagnosis
  • Documentation
  • Medical records
  • Obesity
  • Overweight
  • Paediatrics
  • Primary health care
  • Quality of health care

ASJC Scopus subject areas

  • Health Informatics
  • Family Practice
  • Leadership and Management

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