Electronic health record tools help physicians identify and counsel overweight patients
Health Information Technology
As the epidemic of obese and overweight people continues in the United States, physicians will need more ways to identify these patients and provide effective weight-loss counseling. Tools embedded in an electronic health record (EHR) may help, suggests a new study. Researchers randomized two groups of 15 physicians to receive the EHR tools or to continue with usual care. Their patients were eligible to participate in the study if they were overweight, but non-obese (with a body mass index between 27 and 29.9 kg/m2). Physicians in the intervention group received a set of EHR tools to use. These consisted of a point-of-care alert to identify a patient as overweight, a template used to counsel patients, and an order set designed to document an overweight diagnosis and to generate patient handouts.
During the 6-month study period, 958 patients were seen by the intervention physicians and 1,156 patients were seen by the control group physicians. The EHR-based alerts increased the documentation of overweight patients, as well as the frequency of counseling sessions. Patients also reported short-term behavior change when these tools were used. For example, patients in the intervention group were more likely than those of usual care physicians to be diagnosed as overweight (22 percent vs. 7 percent) and to receive weight-specific counseling (27 percent vs. 15 percent). Most patients who received counseling from their doctor reported increased motivation to lose weight (90 percent) and taking steps toward their goal (93 percent). Of the intervention physicians, 91 percent reported that the point-of-care alert helped them identify patients they did not consider to be overweight. The EHR tools also improved counseling efforts, with 55 percent reporting an increase in the frequency of counseling of overweight patients. Time was cited as the most frequent barrier to using the intervention, even though it only took 7.5 minutes to use. The study was supported by the Agency for Healthcare Research and Quality (T32 HS00078).
See "Electronic tools to assist with identification and counseling for overweight patients: A randomized controlled trial," by Joyce W. Tang, M.D., Robert F. Kushner, M.D., Kenzie A. Cameron, Ph.D., M.P.H., and others in the Journal of General Internal Medicine 27(8), 933-999, 2012.