Researchers at the UC Davis School of Medicine in Sacramento recently discovered that using alerts in an electronic health record (EHR) system can help clinicians intervene more aggressively with obese children, although they say the method is not a perfect solution.
The researchers at UC Davis, led by Ulfat Shaikh, M.D., pediatrician and director of Healthcare Quality at the UC Davis School of Medicine, added obesity-related alerts to health records at the UC Davis Health System's outpatient clinic, which provides care to 12,000 children each year. The alert warned clinicians patient’s weight hit the 85th percentile, which is considered "overweight."
According to the researchers, the EHR alerts "definitely changed" physician behavior when providing care to overweight and obese children. However, the improvements were not as dramatic as they would have liked.
The proportion of children diagnosed as overweight or obese from 40 percent in the pre-alert group to 57 percent in the alert group. Lab tests for diabetes and dyslipidemia (abnormal cholesterol and fat levels in the blood) jumped from 17 to 27 percent, and follow-up appointments went up from 24 percent to 42 percent. However, referrals to dieticians stayed at 13 percent.
“There are workflow issues that must be considered,” Shaikh said in a statement. “For example, in a busy outpatient clinic, physicians may not update the EHR while the patient is in the exam room. Sometimes they don’t see the alert until the family has left the clinic.”
While the researchers provided group training for an hour, Shaikh says one-on-one training might be more effective. Ultimately though, she says the EHR alert must be combined with other interventions. The researchers did not have a follow-up to see if the children actually lost weight.