Electronic health records (EHRs) and embedded tools can alert and direct pediatricians so they can better manage the weight of children and teenagers, according to a new study.

Researchers at Kaiser Permanente (Oakland, CA, USA) conducted a large-scale implementation study reviewing 739,816 outpatient visits per year in children and adolescents from 2007 to 2010. Height, weight, evidence of exercise and nutrition counseling, and diagnoses of overweight, and obesity were extracted from EHRs. The results were analyzed to document the impact of the Kaiser Permanente Southern California Pediatric Weight Management Initiative, a set of computer-assisted decision tools that standardize pediatric weight management for the diagnosis and management of child and adolescent obesity.

The results showed that before the initiative, 66% of all children and adolescents had height and weight measured; this increased to 94% after three years of the initiative. Diagnosis of overweight or obesity increased significantly from 12% in 2007 to 61% in 2010, and documented counseling rates for exercise and nutrition increased fifty-fold between 2007 and 2010. The rate of clinical diagnosis of overweight and obesity increased across all age and racial and ethnic group, and was highest among children 2-5 years old (13% to 75%) and in extremely obese children and young adults across all ages (23% to 75%). The study was published early online on January 10, 2012, in the Journal of Pediatrics.

“One of the first steps in dealing with any epidemic is finding successful ways to identify the patients at risk,” said study coauthor pediatrician Amy Porter, MD, of Kaiser Permanente Southern California. “The pediatric obesity epidemic is no exception. Tools such as these will be a great help to the primary care pediatrician, and will allow not only earlier assessment, but can help direct the providers to the recommended testing and treatment.”

The Kaiser Permanente Southern California Pediatric Weight Management Initiative was realized in 2008 to improve adherence to the American Academy of Pediatrics (AAP; Elk Grove Village, IL, USA) expert committee guidelines that recommended standardized approaches to the identification and treatment of overweight and obese children and adolescents, as well as prevention of overweight and obesity among an at-risk population in clinical settings.

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