Leaders from Milken School of Public Health, STOP Obesity Alliance, National Quality Forum (NQF), payers, industry and myself, representing The Obesity Society, came together at the third roundtable to discuss steps to secure obesity management coverage at the federal level. One outcome of the prior meetings included the Obesity Care Algorithm, which serves as a source for potential measurement concepts.
The current task of the roundtable is to both: 1) identify measures specific to weight loss and weight maintenance that can be adopted to ensure quality outcomes, and 2) to obtain these measures via the electronic medical record (EMR). The group discussed primary outcomes for consideration, including: weight measurement; intermediary outcomes relating to diet and exercise; patient satisfaction, and; well-being metrics specific to the burden of obesity.
As part of the task, the NQF conducted a search and identified 4 NQF endorsed measures related to obesity and weight assessment, two of which are for children. They include:
- Percentage of patients with BMI documented during encounter and when outside of a normal follow-up plan documented.
- Percentage of patients with mental illness who received a screen for BMI and follow up for those identified as having obesity.
- Child: age and gender specific calculation of BMI.
- Child: percentage of patients age 3-17 who had visit and evidence of following measurements: BMI percentile, nutrition counseling, physical activity counseling.
Studies for future outcome adoption are ongoing, including one based at Kaiser Permanente using the Edmonton Obesity Staging System looking for validation for intermediary risk factor improvements.
The ultimate goal of the series of roundtable discussions is system-level accountability for obesity to identify measurements for obesity outcome treatment at the healthcare system, health plan and population levels.
In this manner, obesity treatments can be monitored at these levels for improvements in health outcomes in a consistent and measurable way to inform research and policy for the future.