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17719

Effect of Health It Implementation On Specialty Pediatric Obesity Practice

Sunday, October 21, 2012
Room 270 (Morial Convention Center)
Patricia Irigoyen, M.D. and Joanna Dolgoff, M.D., Red Light Green Light Eat Right, Garden City, NY

Purpose: Analyze data from new CIT system to prove efficacy of intensive 12 week weight loss program and identify obstacles to patient success.

Methods: Retrospective analysis of CIT data for 721 patients enrolled in pediatric obesity program.  ANOVA, t-tests, chi squared tests in Minitab.

Results:   Statistically significant weight loss beginning at 4 weeks with dose-response for longer stay.  Completing program not associated with age, sex, obesity-related medical conditions, or family history of obesity.  No significant difference in % BMI decrease at 1 month or 2 months for program completers versus non-completers. Obtaining 2nd body measurement on schedule strongly associated with completing 12 week program (p value<0.001).

Conclusion:   CIT allowed clear evaluation of clinical data which can be used to counsel patients about the benefits of completing full 12 week program.  Strong association of longer duration with increased weight loss can be used to justify the length of program to health insurance providers. 

QI system to be implemented based on information revealed during data review.  For example, 43% of patients did not get repeat body measurements.  As time constraints likely main obstacle; reorganization of our schedule to allow time for measurements will hopefully increase the percentage of completers.

Our practice is affiliated with a multi-center group of 96 pediatricians undergoing transformation from paper charts to an integrated CIT system We can now easily identify new patients, streamline referral process and follow long term data within the system. CIT will also allow us to access growth curve data to evaluate weight gain history for gradual or sudden changes.  CIT allows access to PMD labwork, permitting immediate response to hyperlipidemia, pre-diabetes and NAFLD.  This will also save unnecessary repeat labs.  We will also be able to access simple PFT results done by PMD which will cut down on unnecessary repeat testing and save healthcare dollars.  PMDs can immediately see patient results and changes in treatment plans, and can address any health issues that arise.

Table 1: % change in BMI per duration of therapy.

# of weeks

% Δ BMI

N=

95% CI

t-test value

p-value

0-4

-1.53

34

(-1.99,-1.07)

-6.78

P<0.001*

4-8

-2.816

129

(-3.19,-2.44)

-14.99

P<0.001*

8-12

-4.00

129

(-4.59,-3.41)

-13.40

P<0.001*

12-16

-5.136

109

(-5.82,-4.45)

-14.92

P<0.001*

*p values derived from one sided t-test with H0=no change in % BMI

>16

-7.4

219

(-8.56,-6.25)

-12.63

P<0.001*

   

Table 2: Repeat Body Measurements Associated With Program Completion

 (p value<0.001)        

1 Body Measurement

2 Body Measurements

All

8 Weeks

88

60

148

12 Weeks

123

224

347

All

211

284

495