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September 3, 2014

The Healthy Weight Initiative: interoperability as a path to obesity prevention

Programs that encourage outdoor play, as pictured here, can be just one of the many interventions in childhood obesity.

Photo credit: CDC Public Health Image Library and Cade Martin

Diabetes. High blood pressure. Cardiovascular disease. Stroke. These are just some of the chronic diseases linked to obesity—a condition with an annual cost that has been estimated at $190.2 billion, or nearly 21 percent of medical spending in the U.S. Of course, the cost of obesity is not just measurable in dollars, but also in quality of life for millions of people, including 17 percent of the nation’s children.

Last year, the CDC’s Division of Nutrition, Physical Activity, and Obesity (DNPAO) reacted to this growing epidemic by inviting PHII to join them in developing a new surveillance initiative to monitor healthy weight. They also brought in health information technology (HIT) experts, as well as state and local public health agencies. Together, the team worked together to develop a technique for harnessing electronic health record (EHR) data captured during clinical encounters in order to track obesity prevalence over time. With these data, public health departments could strategically plan interventions—for example, considering from a city planning perspective how to make a community walkable, or improving dietary options in public schools.

Some public health departments have been exploring different approaches to this kind of data collection, so we examined their techniques to inform new HIT standards for communicating obesity data to public health. The team presented these standards at the 2014 Healthcare Information and Management Systems Society (HIMSS) conference in the Interoperability Showcase. This demonstration allowed us to introduce these concepts to a wider audience of health IT professionals using scenarios modeled on real life. In one scenario, a doctor helps a woman manage her weight in relation to her pregnancy; in another, a pediatrician monitored the weight of a young patient.

A screenshot of the prototype demonstrated at HIMSS

We recently released a report describing the Healthy Weight Surveillance Initiative and hope it serves as a useful starting point for agencies considering obesity surveillance using EHRs.  This report should help agencies think through the technical and social issues that emerge during the planning, design, and implementation phases of an EHR-based obesity surveillance project. These activities provide opportunities for public health to partner with the health care sector and describe the value public health can bring in advancing the triple aims of better care, lower costs and improved health. 

Jim Jellison, MPH

Director of Practice Support