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Developing an electronic clinical decision support system to promote guideline adherence for healthy weight

Sara M Naureckas1, Rachel Zweigoron, K Susan Haverkamp

  • 1Erie Family Health Center, 1701 W. Superior Street, Chicago, IL 60622 USA ; Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL USA.

Translational Behavioral Medicine
|September 28, 2013
PubMed

Insights

Customized electronic health records (EHRs) with decision support improved pediatric clinicians' identification and management of childhood overweight and obesity. Clinician feedback indicates usefulness, especially for screening tests.

Area of Science:

  • Pediatric Health
  • Health Informatics
  • Clinical Decision Support

Background:

  • Childhood overweight and obesity present significant challenges for pediatric clinicians.
  • Electronic health records (EHRs) offer potential to influence clinician behavior and improve care for pediatric obesity.
  • Limited research exists on EHR-facilitated decision support for childhood obesity treatment.

Purpose of the Study:

  • To develop customized, evidence-based decision support within an EHR system.
  • To assess the impact of this decision support on identifying and treating overweight/obese children.
  • To enhance clinician screening for obesity-related comorbidities.

Main Methods:

  • A clinician-led consensus process was used to customize EHR templates at an urban community health center.
  • Evidence-based decision support was integrated into EHR screens to prompt clinicians.
  • Pre/post measures were employed to evaluate changes in clinician behavior.

Main Results:

  • Customized EHR templates were developed and implemented, with positive clinician feedback on usefulness at the point of care.
  • Decision support was particularly beneficial for ordering recommended screening tests for obesity-related comorbidities.
  • Development time exceeded initial estimates, highlighting the complexity of EHR modifications.

Conclusions:

  • Clinician involvement in designing decision support is crucial for behavioral impact.
  • Off-the-shelf EHRs require modification to effectively support evidence-based interventions for childhood obesity.
  • Health information technology customization is vital for high-quality, patient-centered care, especially for underserved populations.

Keywords:
ChildrenClinical decision supportElectronic health recordsGuidelinesObesityPediatricianPrimary careScreening

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