title: Impact of an Electronic Template on Documentation of Obesity in a Primary Care Clinic.
abstract: Identification of obesity at well-child care (WCC) examinations is a step toward intervention. Studies have shown suboptimal documentation in primary care clinics that can improve with the use of electronic health records (EHRs). This study investigated the impact of a standardized EHR template on documentation of obesity at WCC visits and its impact on physician behavior. A cohort of 585 children with severe early onset obesity (body mass index >99th percentile, age <6 years) was identified with an electronic algorithm. Complete records of visit notes were reviewed to extract history taking, counseling, and recording of obesity at a WCC visit. Use of a standardized EHR template for WCC visits is associated with improvement in rates of documentation of obesity (47% vs 34%, P < .01), without interruption of workflow. Documentation of obesity in the chart improved nutritional (66% vs 44%, P < .001) and physical activity counseling (23% vs 9%, P < .001).
authors.affiliation: Boston Children's Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA vidhu.thaker@childrens.harvard.edu.
authors.forename: Vidhu V
authors.initials: VV
authors.lastname: Thaker
authors.affiliation: Harvard Medical School, Boston, MA, USA.
authors.forename: Felix
authors.initials: F
authors.lastname: Lee
authors.affiliation: Boston Children's Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA.
authors.forename: Clement J
authors.initials: CJ
authors.lastname: Bottino
authors.affiliation: Boston Children's Hospital, Boston, MA, USA.
authors.forename: Cassandra L
authors.initials: CL
authors.lastname: Perry
authors.affiliation: Boston Children's Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA.
authors.forename: Ingrid A
authors.initials: IA
authors.lastname: Holm
authors.affiliation: Boston Children's Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA.
authors.forename: Joel N
authors.initials: JN
authors.lastname: Hirschhorn
authors.affiliation: Boston Children's Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA.
authors.forename: Stavroula K
authors.initials: SK
authors.lastname: Osganian
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003376:Counseling / Q000706:statistics & numerical data; D004282:Documentation / Q000379:methods* / Q000706:statistics & numerical data; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000175:diagnosis* / Q000628:therapy*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000379:methods*; D055815:Young Adult
keywords: documentation; electronic health records; pediatric obesity; severe obesity; template