Keehbauch Jennifer, Miguel Gretchen San, Drapiza Leslie, Pepe Julie, Bogue Richard, Smith-Dixon Amelia
Florida Hospital, Winter Park, FL, USA.
Clin Pediatr (Phila). 2012 Jan;51(1):31-8. doi: 10.1177/0009922811417293. Epub 2011 Sep 1.
Overweight children are often not identified or counseled.
We assessed the documentation rate and clinical management of overweight children before and after an electronic medical record (EMR) upgrade calculating body mass index (BMI) percentile for age and gender.
Family Medicine resident and faculty physicians at two sites received an EMR upgrade; Site 1 physicians also received BMI training and education. From two years before to one year after the upgrade, randomly selected charts were reviewed for all encounters with overweight children for documentation of obesity and clinical management.
After the EMR upgrade, documentation and counseling rates significantly improved at both sites but the rate of change was greater for Site 1; postintervention documentation was significantly greater for Site 1 vs. Site 2 (40% vs. 28%, P<0.01).
We found an increase in documentation and management of overweight children following an EMR upgrade that calculates BMI percentiles for age and gender. Physician education was an important adjunct.
超重儿童常常未被识别或得到咨询。
我们评估了电子病历（EMR）升级前后超重儿童的记录率和临床管理情况，该升级计算年龄和性别的体重指数（BMI）百分位数。
两个地点的家庭医学住院医师和教员医生接受了EMR升级；地点1的医生还接受了BMI培训和教育。从升级前两年到升级后一年，对随机选择的图表进行审查，以了解与超重儿童的所有会诊中肥胖的记录和临床管理情况。
EMR升级后，两个地点的记录率和咨询率均显著提高，但地点1的变化率更大；干预后地点1的记录显著高于地点2（40%对28%，P<0.01）。
我们发现，在升级能计算年龄和性别的BMI百分位数的EMR后，超重儿童的记录和管理有所增加。医生教育是一个重要辅助手段。
