Watching the Weight of the Community: Use of An IIS for BMI Tracking and Intervention

Background: At the request of the San Diego County Childhood Obesity Initiative (SD COI), the San Diego Regional Immunization Registry (SDIR) added a height/weight and BMI calculation/ chart. In mid 2009, the Altarum Institute began providing technical assistance to SDCOI and SDIR on how to promote this functionality to registry users. Pilot efforts with health care providers suggest that this information can be used both for tracking patient BMI as well as for community surveillance.

Setting: San Diego County has approximately 3.2 million residents. SDIR is part of the California Immunization Registry (CAIR. There are approximately one million immunization records in SDIR and over 50% % of records for children 18 years and under are in the registry.

Population: Height/weight data can be entered and BMI calculated in the SDIR starting at birth.

Project Description: The pilot project focused on a small community health center in the southwestern region of the county. Height/weight data for children coming into the clinic for scheduled visits during August 2009 was entered into SDIR.  The Altarum Institute, with the SDCOI, conducted a focus group and  interviews with pediatricians and other clinic staff.

Results/Lessons Learned: Issues regarding data entry, clinic processes, county program requirements were identified after analyzing the height/weight data and focus group findings. Some of the recommendations include use of a data interface to eliminate double data entry, reconciliation of program requirements to manually calculate BMI,  reworking patient chart flow and protocols, and the development of relevant BMI reports. A logic model has been developed using the detailed analysis from the pilot project and will be used as a roadmap for future SDIR software changes related to height/weight/BMI and its utilization by other health care providers in the region.