Reminder cards improve physician documentation of obesity but not obesity counseling

Nicholas Shungu, Marshal N. Miller, Geoffrey Mills, Neesha Patel, Amanda de la Paz, Victoria Rose, Jill Kropa, Rina Edi, Emily Levy, Margaret Crenshaw, Chris Hwang

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

BACKGROUND AND OBJECTIVES: Physicians frequently fail to document obesity and obesity-related counseling. We sought to determine whether attaching a physical reminder card to patient encounter forms would increase electronic medical record (EMR) assessment of and documentation of obesity and dietary counseling. METHODS: Reminder cards for obesity documentation were attached to encounter forms for patient encounters over a 2-week intervention period. For visits in the intervention period, the EMR was retrospectively reviewed for BMI, assessment of “obesity” or “morbid obesity” as an active problem, free-text dietary counseling within physician notes, and assessment of “dietary counseling” as an active problem. These data were compared to those collected through a retrospective chart review during a 2-week pre-intervention period. We also compared physician self-report of documentation via reminder cards with EMR documentation. RESULTS: We found significant improvement in the primary end-point of assessment of “obesity” or “morbid obesity” as an active problem (42.5% versus 28%) compared to the pre-intervention period. There was no significant difference in the primary endpoints of free-text dietary counseling or assessment of “dietary counseling” as an active problem between the groups. Physician self-reporting of assessment of “obesity” or “morbid obesity” as an active problem (77.7% versus 42.5%), free-text dietary counseling on obesity (69.1% versus 35.4%) and assessment of “dietary counseling” as an active problem (54.3% versus 25.2%) were all significantly higher than those reflected in EMR documentation. CONCLUSIONS: This study demonstrates that physical reminder cards are a successful means of increasing obesity documentation rates among providers but do not necessarily increase rates of obesity-related counseling or documentation of counseling. Our study suggests that even with such interventions, physicians are likely under-documenting obesity and counseling compared to self-reported rates.

Original languageEnglish (US)
Pages (from-to)789-793
Number of pages5
JournalFamily medicine
Volume47
Issue number10
StatePublished - Nov 2015
Externally publishedYes

ASJC Scopus subject areas

  • Family Practice

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