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 Citations (Scopus)

Abstract

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
Volume18
Issue number4
StatePublished - Nov 2011

Fingerprint

Electronic Health Records
Nutrition
Counseling
Body Mass Index
Health
Exercise
Weights and Measures
Documentation
Pediatrics
Nutrition Assessment
Eating

Keywords

  • 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

Cite this

@article{1d453187c3c14f7f8ed00ba395528ed3,
title = "Presentation of body mass index within an electronic health record to improve weight assessment and counselling in children and adolescents",
abstract = "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.",
keywords = "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",
author = "Ulfat Shaikh and Rachel Nelson and Tancredi, {Daniel J} and Byrd, {Robert S}",
year = "2011",
month = "11",
language = "English (US)",
volume = "18",
pages = "235--244",
journal = "BMJ Health and Care Informatics",
issn = "2058-4555",
publisher = "BMJ Publishing Group",
number = "4",

}

TY - JOUR

T1 - Presentation of body mass index within an electronic health record to improve weight assessment and counselling in children and adolescents

AU - Shaikh, Ulfat

AU - Nelson, Rachel

AU - Tancredi, Daniel J

AU - Byrd, Robert S

PY - 2011/11

Y1 - 2011/11

N2 - 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.

AB - 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.

KW - Adolescent

KW - Assessment

KW - Body mass index

KW - Child

KW - Computerised medical record system

KW - Counselling

KW - Diagnosis

KW - Documentation

KW - Medical records

KW - Obesity

KW - Overweight

KW - Paediatrics

KW - Primary health care

KW - Quality of health care

UR - http://www.scopus.com/inward/record.url?scp=80054994602&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80054994602&partnerID=8YFLogxK

M3 - Article

C2 - 22040850

AN - SCOPUS:80054994602

VL - 18

SP - 235

EP - 244

JO - BMJ Health and Care Informatics

JF - BMJ Health and Care Informatics

SN - 2058-4555

IS - 4

ER -