Use of Electronic Health Records for Addressing Overweight and Obesity in Primary Care - 2010
Target Population: Adults, Obesity
Summary: Obesity is widely recognized as a critical public health concern that is associated with increased risk of diabetes, cardiovascular disease, cancer, and all-cause mortality. Electronic health records (EHRs) have the potential to improve diagnosis and treatment of obesity by primary care clinicians. However, very few EHR-based tools have been developed or evaluated for this purpose.
The objectives of this research are to improve diagnosis and treatment of overweight and obese patients by working closely with primary care clinicians to develop better EHR-based tools for identification, diagnosis, and treatment. These may include reminders, clinical decision support, automatic e-mail referrals, and information for clinicians and patients. The EHR-based tools will be piloted in one primary care practice for three months. Based on the pilot, a larger randomized controlled trial at 12 diverse ambulatory clinics in the Boston, Massachusetts area will be conducted to assess the effectiveness of the EHR-based tools for the identification, evaluation, and treatment of overweight and obese individuals in the primary care setting.
Specific Aims:- Develop EHR-based tools to help primary care clinicians identify, evaluate, and treat patients who are overweight or obese. (Ongoing)
- Conduct a randomized controlled trial to assess the effectiveness of EHR-based tools for the identification, evaluation, and treatment of overweight and obesity in primary care. (Upcoming)
In addition to the specific research aims, as part of this Mentored Research Scientist Research Career Development Award, Dr. Baer is working toward the following long-term career goals: 1) to develop a multidisciplinary research program that is dedicated to developing and evaluating strategies to address obesity and other modifiable risk factors in the clinical setting; and 2) to teach and mentor other individuals who wish to pursue careers in clinical epidemiology or health services research.
2010 Activities: The team is learning more about the context of obesity management in adult primary care for which the EHR-based tools will be developed. They are talking to other experts in the field including obesity and EHR experts and, with the help of an expert panel that has been formed, are developing a detailed outline of the features that have the most potential to support obesity assessment and management. In 2011, Dr. Baer will formally present the proposed features to be added to the Longitudinal Medical Record (LMR) Executive Committee and the Clinical Content Committee. Based on their approval, the programming of the new tools in the LMR will begin in spring 2011, for launch in fall 2011. Some of the features under consideration are: 1) reminders to collect height and weight; 2) provider alerts asking the provider to add the diagnosis to the problem list when, based on body mass index, a patient is identified as obese or overweight; and 3) graphs to show weight trends over time and to calculate weight loss goals for patients.
Preliminary Impact and Findings: This project has no findings to date.
Strategic Goal: Develop and disseminate health IT evidence and evidence-based tools to improve health care decisionmaking through the use of integrated data and knowledge management.
Business Goal: Knowledge Creation