Leveraging Clinical Decision Support System Tools for Childhood Overweight/Obesity Management.

Area of Science:

• Pediatric Endocrinology
• Health Informatics
• Clinical Decision Support Systems

Background:

• Pediatric overweight and obesity require evidence-based care, including BMI documentation and comorbidity screening.
• Existing electronic health record (EHR) systems may not adequately support these care processes.

Purpose of the Study:

• To evaluate the impact of a clinical decision support system (CDSS), OurPractice Advisory (OPA), on the documentation of elevated body mass index (BMI) and ordering of comorbidity screening labs in pediatric primary care.

Main Methods:

• Implementation of the OPA CDSS in 18 pediatric primary care clinics.
• Analysis of EHR data from 9,621 patients with overweight and obesity (2021-2023).
• Assessment of BMI problem list documentation and comorbidity screening rates, stratified by patient demographics and weight status.

Main Results:

• Mean BMI problem list documentation increased from 9.2% to 64%; mean comorbidity screening increased from 7.8% to 32%.
• Problem list BMI documentation and comorbidity screening were more likely for older children, non-Hispanic Black children, those with public insurance, and higher BMI percentiles.
• The CDSS intervention was associated with increased likelihood of evidence-based care processes.

Conclusions:

• Implementation of the OPA CDSS significantly improved the delivery of evidence-based care for pediatric overweight and obesity.
• CDSS can be an effective tool to enhance documentation and screening for pediatric weight conditions in primary care.