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cds.ahrq.gov/sites/default/files/cds/artifact/106/HWI_2017.pptx
January 01, 2017 - Background
Methods
Impact of Multiple Clinician Focused Interventions on Childhood Obesity … Objective
Evaluate the impact of multiple interventions on appropriate obesity documentation and on adherence … application was developed to track QI goals:
Quality improvement (QI) goals: Determined by a Pediatric Obesity … based on expert recommendations (Barlow et.al., 2007)
GOALS:
1) Improve documentation* of overweight/obesity … Subgroup Analysis:
Practices receiving clinical decision support* (Figure 2) had improved AST/ALT/glucose screenings
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cds.ahrq.gov/sites/default/files/cds/artifact/106/AMIA_presentation.pptx
January 01, 2012 - The greatest predictor of adult obesity is childhood obesity
Childhood obesity uses Body Mass Index … and screening laboratory evaluations1 are over-reported
Unexplained clinical care and workflow variability … laboratory evaluation but only 50% of patients had screening laboratory evaluation ordered
4
Next … 18%-point increase in comorbidity screening lab evaluation
8
Clinical Use:
Unanticipated issues
Large … Targets were recognition of obesity and appropriate screening laboratory evaluation derived from the
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cds.ahrq.gov/sites/default/files/cds/artifact/1061/2024_CDS_Connect_IG_Diabetes_Part_One_Screening_0.pdf
January 01, 2024 - In addition to the overweight/obesity factor, the USPSTF defines risk factors for
prediabetes or type … in adults aged 35 to 70 years who
have overweight or obesity. … https://www.cdc.gov/obesity/php/data-research/adult-obesity-facts.html
https://www.cdc.gov/healthyweight … https://www.cdc.gov/obesity/php/data-research/adult-obesity-facts.html
https://www.cdc.gov/obesity/php … /data-research/adult-obesity-facts.html
https://www.cdc.gov/obesity/php/data-research/adult-obesity-facts.html
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cds.ahrq.gov/sites/default/files/cds/artifact/1061/Implementation%20Guide_Abnormal%20Blood%20Glucose%20and%20Type%202%20DM_Part%20One,%20Screening_Final.pdf
September 01, 2019 - or greater and less than 30 kg/m2, and “obese” as a BMI of 30 kg/m2 or higher
(https://www.cdc.gov/obesity … of a patient’s weight in kilograms divided by the square of height in
meters (https://www.cdc.gov/obesity … Inclusions “kg/m2” Kilograms/meters2 (the unit of measure for BMI)
https://www.cdc.gov/obesity/adult … /defining.html
https://www.cdc.gov/obesity/adult/defining.html
29
Location in
CDS Logic Concept … https://www.uspreventiveservicestaskforce.org/Page/Name/topics-in-progress
https://www.cdc.gov/obesity
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cds.ahrq.gov/sites/default/files/cds/artifact/1061/508_2022_CDS_Connect_IG_T2DM_Part_One_Screening_final.pdf
January 01, 2022 - and type 2
diabetes in adults aged 35 to 70 years who have overweight or obesity.” … or
greater and less than 30 kg/m2, and “obese” as a BMI of 30 kg/m2 or higher
(https://www.cdc.gov/obesity … of a patient’s weight in kilograms divided by the square of height in meters
(https://www.cdc.gov/obesity … https://www.cdc.gov/obesity/adult/defining.html
https://www.cdc.gov/obesity/adult/defining.html
32 … or greater and less than
30 kg/m2, and “obese” as a BMI of 30 kg/m2 or higher
(https://www.cdc.gov/obesity
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cds.ahrq.gov/sites/default/files/cds/artifact/1061/Implementation_Guide_Prediabetes_and_Type_2_Diabetes_Part_One_Screening.pdf
September 01, 2022 - and type 2
diabetes in adults aged 35 to 70 years who have overweight or obesity.” … or
greater and less than 30 kg/m2, and “obese” as a BMI of 30 kg/m2 or higher
(https://www.cdc.gov/obesity … of a patient’s weight in kilograms divided by the square of height in meters
(https://www.cdc.gov/obesity … https://www.cdc.gov/obesity/adult/defining.html
https://www.cdc.gov/obesity/adult/defining.html
32 … or greater and less than
30 kg/m2, and “obese” as a BMI of 30 kg/m2 or higher
(https://www.cdc.gov/obesity
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cds.ahrq.gov/sites/default/files/cds/artifact/106/Poster_AMIA_mid_atlantic_HWI_jm.pptx
February 08, 2012 - Background
Methods
Preparing for a Childhood Obesity … recognize obesity or overweight status
Clinicians do not consistently document obesity or overweight … CDS would be beneficial in our institution
Objectives
Characterize adherence to obesity … management
Determined baseline overweight/obesity prevalence within CHOP Care Network
Developed metrics … Actual EHR documentation rates:
Overweight – 13.30% Obese – 49.48%
85% of providers reported starting screening
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cds.ahrq.gov/sites/default/files/cds/artifact/1061/IG%20Abnormal%20Blood%20Glucose%20Type%202%20DM%20Screening.pdf
September 01, 2021 - or greater and less than 30 kg/m2, and “obese” as a BMI of 30 kg/m2 or higher
(https://www.cdc.gov/obesity … of a patient’s weight in kilograms divided by the square of height in
meters (https://www.cdc.gov/obesity … https://www.cdc.gov/obesity/adult/defining.html
https://www.cdc.gov/obesity/adult/defining.html
33 … or
greater and less than 30 kg/m2, and “obese” as a BMI of 30 kg/m2 or higher
(https://www.cdc.gov/obesity … www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/recommendations-in-progress
https://www.cdc.gov/obesity
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cds.ahrq.gov/sites/default/files/cds/artifact/1061/2023_CDS_Connect_IG_T2DM_Part_One_Screening_1.pdf
January 01, 2023 - includes “nonpregnant adults aged 35 to
70 years seen in primary care settings who have overweight or obesity … and type 2
diabetes in adults aged 35 to 70 years who have overweight or obesity.”2 Additional
inclusion … or
greater and less than 30 kg/m2, and “obese” as a BMI of 30 kg/m2 or higher
(https://www.cdc.gov/obesity … of a patient’s weight in kilograms divided by the square of height in meters
(https://www.cdc.gov/obesity … or greater and less than
30 kg/m2, and “obese” as a BMI of 30 kg/m2 or higher
(https://www.cdc.gov/obesity
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cds.ahrq.gov/sites/default/files/cds/artifact/106/Guide%20to%20the%20Healthy%20Weight%20Care%20Assistant.docx
February 15, 2018 - to children with overweight or obese body habitus who were at risk for developing complications of obesity … survey were used to target areas of clinician interest and gaps in knowledge surrounding pediatric obesity … Use of the Care Assistant Framework allowed our project team to design and develop an obesity module … The module includes a click-through documentation template, guided support for relevant screening questions … , diagnosis and evaluation support that is updated in real time in response to answers to screening questions
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cds.ahrq.gov/sites/default/files/cds/artifact/1066/Implementation%20Guide_Abnormal%20Blood%20Glucose%20and%20Type%202%20DM_Part%20Two%20Counseling_Final.pdf
September 01, 2019 - or greater and less than 30 kg/m2, and “obese” as a BMI of 30 kg/m2 or higher
(https://www.cdc.gov/obesity … of a patient’s weight in kilograms divided by the square of height in
meters (https://www.cdc.gov/obesity … Inclusions “kg/m2” Kilograms/meters2 (the unit of measure for BMI)
https://www.cdc.gov/obesity/adult … /defining.html
https://www.cdc.gov/obesity/adult/defining.html
29
Location in
CDS Logic Concept … searchresult=1
https://www.cdc.gov/obesity/adult/defining.html
35
Decision Category Concept Rationale
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cds.ahrq.gov/sites/default/files/cds/artifact/1066/Implementation%20Guide%20Abnormal%20Blood%20Glucose%20and%20Type%202%20DM%20Counseling.pdf
September 01, 2021 - or greater and less than 30 kg/m2, and “obese” as a BMI of 30 kg/m2 or higher
(https://www.cdc.gov/obesity … of a patient’s weight in kilograms divided by the square of height in
meters (https://www.cdc.gov/obesity … https://www.cdc.gov/obesity/adult/defining.html
https://www.cdc.gov/obesity/adult/defining.html
32 … or greater
and less than 30 kg/m2, and “obese” as a BMI of 30 kg/m2 or higher
(https://www.cdc.gov/obesity … https://www.cdc.gov/obesity/adult/defining.html
https://annals.org/aim/fullarticle/2466368/screening-abnormal-blood-glucose-type
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cds.ahrq.gov/sites/default/files/cds/artifact/1066/2024_CDS_Connect_IG_Diabetes_Part_Two_Counseling_1.pdf
January 01, 2024 - In addition to the overweight/obesity
factor, the USPSTF defines risk factors for prediabetes or type … recommendation to identify patients with
overweight/obesity and abnormal blood glucose levels. … artifact logic to identify individual
participants within designated age ranges with overweight or obesity … The USPSTF 2021 Gestational Diabetes
Mellitus, Screening recommendation addresses screening for diabetes … and type 2 diabetes in adults aged 35 to 70 years
who have overweight or obesity.
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cds.ahrq.gov/sites/default/files/workgroups/246/jul-2017-cholesterol-wg-notes.docx
January 01, 2017 - lot of different aspects to the disease and a lot to keep track of (e.g., when they are due for next screenings … Some specialties have differing opinions on what screening tools to use. … Childhood obesity:
This could be high yield. … In one practice, alerts for childhood obesity are triggered by BMI and suggests labs, consultation with … Hepatitis C
There is an option to provide screening CDS.
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cds.ahrq.gov/sites/default/files/cds/artifact/1066/2023_CDS_Connect_IG_T2DM_Part_Two_Counseling_0.pdf
January 01, 2023 - recommendation to identify patients with
overweight/obesity and abnormal blood glucose levels. … artifact logic to identify individual
participants within designated age ranges with overweight or obesity … and type 2
diabetes in adults aged 35 to 70 years who have overweight or obesity. … or
greater and less than 30 kg/m2, and “obese” as a BMI of 30 kg/m2 or higher
(https://www.cdc.gov/obesity … of a patient’s weight in kilograms divided by the square of height in meters
(https://www.cdc.gov/obesity
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cds.ahrq.gov/sites/default/files/cds/artifact/1066/2022_Intervention_Content_T2DM_Counseling.xlsx
January 01, 2022 - Preventive Services Task Force Recommendation on “Abnormal Blood Glucose and Type 2 Diabetes Mellitus: Screening … ” (https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-for-prediabetes-and-type … Diabetes: Counseling
Resource Name & location Description URL
Understanding Task Force Recommendations: Screening … tips with a disabilty https://healthfinder.gov/HealthTopics/Category/health-conditions-and-diseases/obesity … Information about the Affordable Care Act's coverage for obesity care.
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cds.ahrq.gov/sites/default/files/cds/artifact/1066/2023_Intervention_Content_T2DM_Part_Two_Counseling.xlsx
January 01, 2023 - Preventive Services Task Force Recommendation on “Abnormal Blood Glucose and Type 2 Diabetes Mellitus: Screening … ” (https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-for-prediabetes-and-type … Diabetes: Counseling
Resource Name & location Description URL
Understanding Task Force Recommendations: Screening … tips with a disabilty https://healthfinder.gov/HealthTopics/Category/health-conditions-and-diseases/obesity … Information about the Affordable Care Act's coverage for obesity care.
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cds.ahrq.gov/sites/default/files/workgroups/1251/CDS_Connect_WG_Jan2021_Slides.pdf
January 01, 2021 - artifact for ASCVD risk
calculation)
Adults age 40 to 75 years without a history of CVD who meet
the screening … criteria should consider use of a low- to
moderate-dose statin for the prevention of CVD
Screening … for Abnormal Blood Glucose
Part 1
Screening for abnormal blood glucose as part of CVD risk
assessment … in adults who are overweight or obese
Screening for Abnormal Blood Glucose
Part 2
Adults with abnormal … 1
educational
challenges
Number of users
who completed 1
action challenges
Glucose Part 1,
Screening
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cds.ahrq.gov/sites/default/files/cds/artifact/1061/2024_Intervention_Content_Prediabetes_and_Type_2_Diabetes_Part_one_Screening.xlsx
January 01, 2024 - Intervention Text
Example Patient-Facing Intervention Text: Prediabetes and Type 2 Diabetes: Part 1, Screening … embedded in the Clinical Quality Language (CQL) files for the Prediabetes and Type 2 Diabetes Part One: Screening … Intervention Text for Prediabetes and Type 2 Diabetes: Part 1, Screening
DISPLAY notification to patient … ” (https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-for-prediabetes-and-type … Resource Name & location Description URL
Understanding Task Force Recommendations: Screening for
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cds.ahrq.gov/sites/default/files/cds/artifact/1061/2022_Intervention_Content_Prediabetes_and_Type_2_Diabetes_Part_one_Screening.xlsx
January 01, 2022 - Intervention Text
Example Patient-Facing Intervention Text: Prediabetes and Type 2 Diabetes: Part 1, Screening … embedded in the Clinical Quality Language (CQL) files for the Prediabetes and Type 2 Diabetes Part One: Screening … Intervention Text for Prediabetes and Type 2 Diabetes: Part 1, Screening
DISPLAY notification to patient … ” (https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-for-prediabetes-and-type … Resource Name & location Description URL
Understanding Task Force Recommendations: Screening for