P2.J196: The Elevated BMI Smart Set: Improving Identification, Assessment, and Treatment of Children and Adolescents with Overweight and Obesity

Purpose/Objectives: An increasing number of children and adolescents have overweight, obesity, and related comorbidities. In its 2023 Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity, the American Academy of Pediatrics advises general pediatricians to more aggressively and systematically identify, assess, and treat overweight and obesity. This quality improvement project integrates a Smartset into the Epic Electronic Health Record to help guide pediatricians in providing the highest quality of care in the identification, assessment, and treatment of overweight and obesity, based on the AAP clinical practice guideline.

Design/Methods: An algorithm and Smart Set was developed and implemented in the Epic electronic health record at Children’s Primary Care Medical Group (CPCMG), a 28-site single-specialty pediatrics practice in San Diego and Riverside Counties, based on the AAP Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity. The Smartset consists of an integrated patient-answered questionnaire which includes relevant findings on review of systems and health behavior (nutrition, physical activity, sleep, screen use, and social emotional wellness) screening, templated physical exam and lab evaluation, in-house intensive health behavioral lifestyle treatment and referral options, primary care-based supports to follow up with patients, clinician guidance for prescription of antiobesity medications, and patient education materials.
All CPCMG pediatricians receive a 1-hour training on the algorithm and smart-set and pediatricians participating in the MOC-4 quality improvement project also participate in a follow-up feedback session and further training, used the smart set at least 10 times, and review obesity smartset utilization data monthly.

Results: The MOC-4 quality improvement project is currently ongoing. Evaluation metrics include the number of pediatricians who use the Epic-based smartset more than 10 times and complete the requirements to receive 25 points of MOC 4 credit and a survey of pediatrician confidence in the identification and treatment of obesity.

Conclusion/Discussion: Integrating an Obesity Smart Set into the electronic medical record is a helpful way to operationalize the AAP clinical practice guideline for the identification, evaluation and management of overweight and obesity in the primary care setting.