Re: Obesity Rating for Every American Must Be Included in Stimulus-Mandated Electronic Health Records, Says HHS

July 22, 2010

I agree, Merav. We already know how to determine, and interpret, BMI. We do

not need a law to decide its use!

Diane Preves, M.S., R.D.

N.E.W. LIFE (Nutrition, Exercise, Wellness for LIFE)

www.newlifeforhealth.com

e-mail: newlife4health@..., newlife@...

http://www.linkedin.com/in/newlifedianepreves

http://www.facebook.com/people/Diane-Preves/1357243185

http://twitter.com/DianePreves

Re: Obesity Rating for Every American Must Be

> > Included in Stimulus-Mandated Electronic Health Records, Says HHS

> > >

> > > Before we go off on a tangent here, I'd like to suggest that we jump

> > > for joy over the inclusion of BMI calculators in EMRs. It's what we

> > > wanted, folks. First, we complained that patients weren't being

> > > weighed or measured on admission to the hospital. You can build your

> > > system so that there's a stop if height and weight aren't entered.

> > If

> > > you're afraid that stated or " guessed " values will be entered, add a

> > > qualifier that says " actual " or " stated " or " estimated " , which puts

> > > the person entering information on alert that not actually measuring

> > > will be identified. So, now you have height and weight on admission!

> > > Second, we wanted to be included as a valued member of the

> > healthcare

> > > team. Here's the chance.

> > >

> > > Clinical systems are really just super duper calculators sometimes.

> > > So, rather than the RD or DTR spending time with a calculator

> > figuring

> > > out the BMI for all those inpatients, the system will do it for you.

> > > We are not the only providers who care about BMI. Systems don't

> > > diagnose, people do, so the affixing of a diagnosis associated with

> > > the BMI is the responsibility of the provider, hopefully with input

> > > from the RD.

> > >

> > > So rather than bemoaning this awful (????) turn of events, how about

> > > working with your system design team to include the information you

> > > want to diagnose appropriately? After all, there is additional

> > payment

> > > for obesity-related conditions under prospective payment. The flip

> > > side of that is you have to avoid misdiagnosing, so here's where the

> > > expert RD can really shine.

> > >

> > > Have a good day.

> > > pam

> > >

> > > Pam Charney, PhD, RD

> > > Affiliate Associate Professor

> > > Pharmacy

> > >

> > > MS Student

> > > Clinical Informatics and Patient Centered Technology

> > > School of Nursing

> > >

> > > University of Washington

> > > Seattle, WA

> > > pcharney@...

> > > http://www.linkedin.com/in/pamcharney

> > >

> > > > I work with Alaskan natives and the words wasted cacheix almost

> > > > always go with a BMI of 22 or less. When I worked in El Paso I

> > found

> > > > the older larger boned Hispanics also looked wasted etc at a BMI

> > of

> > > > 22. It is not the gold standard that the public is being lead to

> > > > believe.

> > > >

> > > > Jackie Chase RD

> > > > Dillingham AK

> > > >

> > > > >

> > > > > I agree Holly........on a related note............this was just

> > > > released this month.....an easy to read synopsis of the health

> > care

> > > > bill as written by Senators Tom Coburn MD and Barrasso

> > MD......

> > > > I've only skimmed it, but it looks like they have documented every

> > > > statement they make.........

> > > > >

http://www.drhotze.com/CMSPages/GetFile.aspx?nodeguid=751b6d91-ccfe-4e23-bd75-1d\

750a68eb31

> > > > >

> > > >

July 22, 2010

I agree, Merav. We already know how to determine, and interpret, BMI. We do

not need a law to decide its use!

Diane Preves, M.S., R.D.

N.E.W. LIFE (Nutrition, Exercise, Wellness for LIFE)

www.newlifeforhealth.com

e-mail: newlife4health@..., newlife@...

http://www.linkedin.com/in/newlifedianepreves

http://www.facebook.com/people/Diane-Preves/1357243185

http://twitter.com/DianePreves

Re: Obesity Rating for Every American Must Be

> > Included in Stimulus-Mandated Electronic Health Records, Says HHS

> > >

> > > Before we go off on a tangent here, I'd like to suggest that we jump

> > > for joy over the inclusion of BMI calculators in EMRs. It's what we

> > > wanted, folks. First, we complained that patients weren't being

> > > weighed or measured on admission to the hospital. You can build your

> > > system so that there's a stop if height and weight aren't entered.

> > If

> > > you're afraid that stated or " guessed " values will be entered, add a

> > > qualifier that says " actual " or " stated " or " estimated " , which puts

> > > the person entering information on alert that not actually measuring

> > > will be identified. So, now you have height and weight on admission!

> > > Second, we wanted to be included as a valued member of the

> > healthcare

> > > team. Here's the chance.

> > >

> > > Clinical systems are really just super duper calculators sometimes.

> > > So, rather than the RD or DTR spending time with a calculator

> > figuring

> > > out the BMI for all those inpatients, the system will do it for you.

> > > We are not the only providers who care about BMI. Systems don't

> > > diagnose, people do, so the affixing of a diagnosis associated with

> > > the BMI is the responsibility of the provider, hopefully with input

> > > from the RD.

> > >

> > > So rather than bemoaning this awful (????) turn of events, how about

> > > working with your system design team to include the information you

> > > want to diagnose appropriately? After all, there is additional

> > payment

> > > for obesity-related conditions under prospective payment. The flip

> > > side of that is you have to avoid misdiagnosing, so here's where the

> > > expert RD can really shine.

> > >

> > > Have a good day.

> > > pam

> > >

> > > Pam Charney, PhD, RD

> > > Affiliate Associate Professor

> > > Pharmacy

> > >

> > > MS Student

> > > Clinical Informatics and Patient Centered Technology

> > > School of Nursing

> > >

> > > University of Washington

> > > Seattle, WA

> > > pcharney@...

> > > http://www.linkedin.com/in/pamcharney

> > >

> > > > I work with Alaskan natives and the words wasted cacheix almost

> > > > always go with a BMI of 22 or less. When I worked in El Paso I

> > found

> > > > the older larger boned Hispanics also looked wasted etc at a BMI

> > of

> > > > 22. It is not the gold standard that the public is being lead to

> > > > believe.

> > > >

> > > > Jackie Chase RD

> > > > Dillingham AK

> > > >

> > > > >

> > > > > I agree Holly........on a related note............this was just

> > > > released this month.....an easy to read synopsis of the health

> > care

> > > > bill as written by Senators Tom Coburn MD and Barrasso

> > MD......

> > > > I've only skimmed it, but it looks like they have documented every

> > > > statement they make.........

> > > > >

http://www.drhotze.com/CMSPages/GetFile.aspx?nodeguid=751b6d91-ccfe-4e23-bd75-1d\

750a68eb31

> > > > >

> > > >

July 22, 2010

Exclusively on the bit about regulations and taxation etc that has been

mentioned here....

I always find it fascinating to hear poeple say that government shouldn't

regulate this or regulate that.Â A higher percentage of cancer deaths in this

country are related to obesity than to tobacco use (33% vs 30%), and yet is it

ok to regulate, tax and demonize tobacco (as it should be) but not ok to the

same with unhealthy foods. I am a food lover. IÂ am passionate about cooking and

eating. I too eat butter,Â red meat and cake in moderation.Â However I am

absolutely in favor ofÂ smart and efficient Â ways of regulating highly

processed

crap that should not evenÂ be called food. There is a huge difference and

pooling

it all together is a mistake, and that is what professionals like us should

advocate for.Â I hate fast foods not only for what that food means to the health

of its patrons but because of all the consequences it has had on our

agricultural system and food supply. The " oh let me choose what I eat what I

drive and all I do, stay out of my life " approach is a selfish point of view

that does not help better our society.

Â

________________________________

To: rd-usa

Sent: Thu, July 22, 2010 11:44:14 AM

Subject: Re: Obesity Rating for Every American Must Be Included in

Stimulus-Mandated Electronic Health Records, Says HHS

Â

I agree, Merav. We already know how to determine, and interpret, BMI. We do not

need a law to decide its use!

Diane Preves, M.S., R.D.

N.E.W. LIFE (Nutrition, Exercise, Wellness for LIFE)

www.newlifeforhealth.com

e-mail: newlife4health@..., newlife@...

http://www.linkedin.com/in/newlifedianepreves

http://www.facebook.com/people/Diane-Preves/1357243185

http://twitter.com/DianePreves

Re: Obesity Rating for Every American Must Be

> > Included in Stimulus-Mandated Electronic Health Records, Says HHS

> > >

> > > Before we go off on a tangent here, I'd like to suggest that we jump

> > > for joy over the inclusion of BMI calculators in EMRs. It's what we

> > > wanted, folks. First, we complained that patients weren't being

> > > weighed or measured on admission to the hospital. You can build your

> > > system so that there's a stop if height and weight aren't entered.

> > If

> > > you're afraid that stated or " guessed " values will be entered, add a

> > > qualifier that says " actual " or " stated " or " estimated " , which puts

> > > the person entering information on alert that not actually measuring

> > > will be identified. So, now you have height and weight on admission!

> > > Second, we wanted to be included as a valued member of the

> > healthcare

> > > team. Here's the chance.

> > >

> > > Clinical systems are really just super duper calculators sometimes.

> > > So, rather than the RD or DTR spending time with a calculator

> > figuring

> > > out the BMI for all those inpatients, the system will do it for you.

> > > We are not the only providers who care about BMI. Systems don't

> > > diagnose, people do, so the affixing of a diagnosis associated with

> > > the BMI is the responsibility of the provider, hopefully with input

> > > from the RD.

> > >

> > > So rather than bemoaning this awful (????) turn of events, how about

> > > working with your system design team to include the information you

> > > want to diagnose appropriately? After all, there is additional

> > payment

> > > for obesity-related conditions under prospective payment. The flip

> > > side of that is you have to avoid misdiagnosing, so here's where the

> > > expert RD can really shine.

> > >

> > > Have a good day.

> > > pam

> > >

> > > Pam Charney, PhD, RD

> > > Affiliate Associate Professor

> > > Pharmacy

> > >

> > > MS Student

> > > Clinical Informatics and Patient Centered Technology

> > > School of Nursing

> > >

> > > University of Washington

> > > Seattle, WA

> > > pcharney@...

> > > http://www.linkedin.com/in/pamcharney

> > >

> > > > I work with Alaskan natives and the words wasted cacheix almost

> > > > always go with a BMI of 22 or less. When I worked in El Paso I

> > found

> > > > the older larger boned Hispanics also looked wasted etc at a BMI

> > of

> > > > 22. It is not the gold standard that the public is being lead to

> > > > believe.

> > > >

> > > > Jackie Chase RD

> > > > Dillingham AK

> > > >

> > > > >

> > > > > I agree Holly........on a related note............this was just

> > > > released this month.....an easy to read synopsis of the health

> > care

> > > > bill as written by Senators Tom Coburn MD and Barrasso

> > MD......

> > > > I've only skimmed it, but it looks like they have documented every

> > > > statement they make.........

> > > > >

>http://www.drhotze.com/CMSPages/GetFile.aspx?nodeguid=751b6d91-ccfe-4e23-bd75-1\

d750a68eb31

>

> > > > >

> > > >

July 22, 2010

Exclusively on the bit about regulations and taxation etc that has been

mentioned here....

I always find it fascinating to hear poeple say that government shouldn't

regulate this or regulate that.Â A higher percentage of cancer deaths in this

country are related to obesity than to tobacco use (33% vs 30%), and yet is it

ok to regulate, tax and demonize tobacco (as it should be) but not ok to the

same with unhealthy foods. I am a food lover. IÂ am passionate about cooking and

eating. I too eat butter,Â red meat and cake in moderation.Â However I am

absolutely in favor ofÂ smart and efficient Â ways of regulating highly

processed

crap that should not evenÂ be called food. There is a huge difference and

pooling

it all together is a mistake, and that is what professionals like us should

advocate for.Â I hate fast foods not only for what that food means to the health

of its patrons but because of all the consequences it has had on our

agricultural system and food supply. The " oh let me choose what I eat what I

drive and all I do, stay out of my life " approach is a selfish point of view

that does not help better our society.

Â

________________________________

To: rd-usa

Sent: Thu, July 22, 2010 11:44:14 AM

Subject: Re: Obesity Rating for Every American Must Be Included in

Stimulus-Mandated Electronic Health Records, Says HHS

Â

I agree, Merav. We already know how to determine, and interpret, BMI. We do not

need a law to decide its use!

Diane Preves, M.S., R.D.

N.E.W. LIFE (Nutrition, Exercise, Wellness for LIFE)

www.newlifeforhealth.com

e-mail: newlife4health@..., newlife@...

http://www.linkedin.com/in/newlifedianepreves

http://www.facebook.com/people/Diane-Preves/1357243185

http://twitter.com/DianePreves

Re: Obesity Rating for Every American Must Be

> > Included in Stimulus-Mandated Electronic Health Records, Says HHS

> > >

> > > Before we go off on a tangent here, I'd like to suggest that we jump

> > > for joy over the inclusion of BMI calculators in EMRs. It's what we

> > > wanted, folks. First, we complained that patients weren't being

> > > weighed or measured on admission to the hospital. You can build your

> > > system so that there's a stop if height and weight aren't entered.

> > If

> > > you're afraid that stated or " guessed " values will be entered, add a

> > > qualifier that says " actual " or " stated " or " estimated " , which puts

> > > the person entering information on alert that not actually measuring

> > > will be identified. So, now you have height and weight on admission!

> > > Second, we wanted to be included as a valued member of the

> > healthcare

> > > team. Here's the chance.

> > >

> > > Clinical systems are really just super duper calculators sometimes.

> > > So, rather than the RD or DTR spending time with a calculator

> > figuring

> > > out the BMI for all those inpatients, the system will do it for you.

> > > We are not the only providers who care about BMI. Systems don't

> > > diagnose, people do, so the affixing of a diagnosis associated with

> > > the BMI is the responsibility of the provider, hopefully with input

> > > from the RD.

> > >

> > > So rather than bemoaning this awful (????) turn of events, how about

> > > working with your system design team to include the information you

> > > want to diagnose appropriately? After all, there is additional

> > payment

> > > for obesity-related conditions under prospective payment. The flip

> > > side of that is you have to avoid misdiagnosing, so here's where the

> > > expert RD can really shine.

> > >

> > > Have a good day.

> > > pam

> > >

> > > Pam Charney, PhD, RD

> > > Affiliate Associate Professor

> > > Pharmacy

> > >

> > > MS Student

> > > Clinical Informatics and Patient Centered Technology

> > > School of Nursing

> > >

> > > University of Washington

> > > Seattle, WA

> > > pcharney@...

> > > http://www.linkedin.com/in/pamcharney

> > >

> > > > I work with Alaskan natives and the words wasted cacheix almost

> > > > always go with a BMI of 22 or less. When I worked in El Paso I

> > found

> > > > the older larger boned Hispanics also looked wasted etc at a BMI

> > of

> > > > 22. It is not the gold standard that the public is being lead to

> > > > believe.

> > > >

> > > > Jackie Chase RD

> > > > Dillingham AK

> > > >

> > > > >

> > > > > I agree Holly........on a related note............this was just

> > > > released this month.....an easy to read synopsis of the health

> > care

> > > > bill as written by Senators Tom Coburn MD and Barrasso

> > MD......

> > > > I've only skimmed it, but it looks like they have documented every

> > > > statement they make.........

> > > > >

>http://www.drhotze.com/CMSPages/GetFile.aspx?nodeguid=751b6d91-ccfe-4e23-bd75-1\

d750a68eb31

>

> > > > >

> > > >

July 22, 2010

Exclusively on the bit about regulations and taxation etc that has been

mentioned here....

I always find it fascinating to hear poeple say that government shouldn't

regulate this or regulate that.Â A higher percentage of cancer deaths in this

country are related to obesity than to tobacco use (33% vs 30%), and yet is it

ok to regulate, tax and demonize tobacco (as it should be) but not ok to the

same with unhealthy foods. I am a food lover. IÂ am passionate about cooking and

eating. I too eat butter,Â red meat and cake in moderation.Â However I am

absolutely in favor ofÂ smart and efficient Â ways of regulating highly

processed

crap that should not evenÂ be called food. There is a huge difference and

pooling

it all together is a mistake, and that is what professionals like us should

advocate for.Â I hate fast foods not only for what that food means to the health

of its patrons but because of all the consequences it has had on our

agricultural system and food supply. The " oh let me choose what I eat what I

drive and all I do, stay out of my life " approach is a selfish point of view

that does not help better our society.

Â

________________________________

To: rd-usa

Sent: Thu, July 22, 2010 11:44:14 AM

Subject: Re: Obesity Rating for Every American Must Be Included in

Stimulus-Mandated Electronic Health Records, Says HHS

Â

I agree, Merav. We already know how to determine, and interpret, BMI. We do not

need a law to decide its use!

Diane Preves, M.S., R.D.

N.E.W. LIFE (Nutrition, Exercise, Wellness for LIFE)

www.newlifeforhealth.com

e-mail: newlife4health@..., newlife@...

http://www.linkedin.com/in/newlifedianepreves

http://www.facebook.com/people/Diane-Preves/1357243185

http://twitter.com/DianePreves

Re: Obesity Rating for Every American Must Be

> > Included in Stimulus-Mandated Electronic Health Records, Says HHS

> > >

> > > Before we go off on a tangent here, I'd like to suggest that we jump

> > > for joy over the inclusion of BMI calculators in EMRs. It's what we

> > > wanted, folks. First, we complained that patients weren't being

> > > weighed or measured on admission to the hospital. You can build your

> > > system so that there's a stop if height and weight aren't entered.

> > If

> > > you're afraid that stated or " guessed " values will be entered, add a

> > > qualifier that says " actual " or " stated " or " estimated " , which puts

> > > the person entering information on alert that not actually measuring

> > > will be identified. So, now you have height and weight on admission!

> > > Second, we wanted to be included as a valued member of the

> > healthcare

> > > team. Here's the chance.

> > >

> > > Clinical systems are really just super duper calculators sometimes.

> > > So, rather than the RD or DTR spending time with a calculator

> > figuring

> > > out the BMI for all those inpatients, the system will do it for you.

> > > We are not the only providers who care about BMI. Systems don't

> > > diagnose, people do, so the affixing of a diagnosis associated with

> > > the BMI is the responsibility of the provider, hopefully with input

> > > from the RD.

> > >

> > > So rather than bemoaning this awful (????) turn of events, how about

> > > working with your system design team to include the information you

> > > want to diagnose appropriately? After all, there is additional

> > payment

> > > for obesity-related conditions under prospective payment. The flip

> > > side of that is you have to avoid misdiagnosing, so here's where the

> > > expert RD can really shine.

> > >

> > > Have a good day.

> > > pam

> > >

> > > Pam Charney, PhD, RD

> > > Affiliate Associate Professor

> > > Pharmacy

> > >

> > > MS Student

> > > Clinical Informatics and Patient Centered Technology

> > > School of Nursing

> > >

> > > University of Washington

> > > Seattle, WA

> > > pcharney@...

> > > http://www.linkedin.com/in/pamcharney

> > >

> > > > I work with Alaskan natives and the words wasted cacheix almost

> > > > always go with a BMI of 22 or less. When I worked in El Paso I

> > found

> > > > the older larger boned Hispanics also looked wasted etc at a BMI

> > of

> > > > 22. It is not the gold standard that the public is being lead to

> > > > believe.

> > > >

> > > > Jackie Chase RD

> > > > Dillingham AK

> > > >

> > > > >

> > > > > I agree Holly........on a related note............this was just

> > > > released this month.....an easy to read synopsis of the health

> > care

> > > > bill as written by Senators Tom Coburn MD and Barrasso

> > MD......

> > > > I've only skimmed it, but it looks like they have documented every

> > > > statement they make.........

> > > > >

>http://www.drhotze.com/CMSPages/GetFile.aspx?nodeguid=751b6d91-ccfe-4e23-bd75-1\

d750a68eb31

>

> > > > >

> > > >

July 22, 2010

The devil is in the details . . . always has been, always will be. Anything can

be good or bad, depending on how it's used. As usual, that is the real

question.

Diane

Re: Obesity Rating for Every American Must Be

> > Included in Stimulus-Mandated Electronic Health Records, Says HHS

> > >

> > > Before we go off on a tangent here, I'd like to suggest that we jump

> > > for joy over the inclusion of BMI calculators in EMRs. It's what we

> > > wanted, folks. First, we complained that patients weren't being

> > > weighed or measured on admission to the hospital. You can build your

> > > system so that there's a stop if height and weight aren't entered.

> > If

> > > you're afraid that stated or " guessed " values will be entered, add a

> > > qualifier that says " actual " or " stated " or " estimated " , which puts

> > > the person entering information on alert that not actually measuring

> > > will be identified. So, now you have height and weight on admission!

> > > Second, we wanted to be included as a valued member of the

> > healthcare

> > > team. Here's the chance.

> > >

> > > Clinical systems are really just super duper calculators sometimes.

> > > So, rather than the RD or DTR spending time with a calculator

> > figuring

> > > out the BMI for all those inpatients, the system will do it for you.

> > > We are not the only providers who care about BMI. Systems don't

> > > diagnose, people do, so the affixing of a diagnosis associated with

> > > the BMI is the responsibility of the provider, hopefully with input

> > > from the RD.

> > >

> > > So rather than bemoaning this awful (????) turn of events, how about

> > > working with your system design team to include the information you

> > > want to diagnose appropriately? After all, there is additional

> > payment

> > > for obesity-related conditions under prospective payment. The flip

> > > side of that is you have to avoid misdiagnosing, so here's where the

> > > expert RD can really shine.

> > >

> > > Have a good day.

> > > pam

> > >

> > > Pam Charney, PhD, RD

> > > Affiliate Associate Professor

> > > Pharmacy

> > >

> > > MS Student

> > > Clinical Informatics and Patient Centered Technology

> > > School of Nursing

> > >

> > > University of Washington

> > > Seattle, WA

> > > pcharney@...

> > > http://www.linkedin.com/in/pamcharney

> > >

> > > > I work with Alaskan natives and the words wasted cacheix almost

> > > > always go with a BMI of 22 or less. When I worked in El Paso I

> > found

> > > > the older larger boned Hispanics also looked wasted etc at a BMI

> > of

> > > > 22. It is not the gold standard that the public is being lead to

> > > > believe.

> > > >

> > > > Jackie Chase RD

> > > > Dillingham AK

> > > >

> > > > >

> > > > > I agree Holly........on a related note............this was just

> > > > released this month.....an easy to read synopsis of the health

> > care

> > > > bill as written by Senators Tom Coburn MD and Barrasso

> > MD......

> > > > I've only skimmed it, but it looks like they have documented every

> > > > statement they make.........

> > > > >

>http://www.drhotze.com/CMSPages/GetFile.aspx?nodeguid=751b6d91-ccfe-4e23-bd75-1\

d750a68eb31

>

> > > > >

> > > >

July 22, 2010

â€œSelfishâ€? To demand that someone else not be given the opportunity to make

my decisions for me? Amazing conclusion! And who would that be that I can trust

to make my decisions for me? I canâ€™t think of anyone I want to trust with

that. The current administration in the Whitehouse? The next one? How in the

world can we know we can trust that they wonâ€™t take even more freedoms away?

Give them an inchâ€¦ Hmmm. Sounds like the history of the US government. I think

Iâ€™ll pass. And no, I donâ€™t think just because we have given tobacco, or

health insurance, or the postal service, or social security, etc, etc to the

government to regulate so poorly is a good excuse to give them more and more.

W. Rowell, RD, LN

Montana State Hospital, Warm Spring, MT

Consultant Dietitian, Long Term Care

Certified LEAP Therapist

Quote of the Day: " A government that is big enough to give you all you want is

big enough to take it all away. " --Barry Goldwater

From: rd-usa [mailto:rd-usa ] On Behalf Of yomari

cruz

Sent: Thursday, July 22, 2010 10:04 AM

To: rd-usa

Subject: Re: Obesity Rating for Every American Must Be Included in

Stimulus-Mandated Electronic Health Records, Says HHS

Exclusively on the bit about regulations and taxation etc that has been

mentioned here....

I always find it fascinating to hear poeple say that government shouldn't

regulate this or regulate that. A higher percentage of cancer deaths in this

country are related to obesity than to tobacco use (33% vs 30%), and yet is it

ok to regulate, tax and demonize tobacco (as it should be) but not ok to the

same with unhealthy foods. I am a food lover. I am passionate about cooking and

eating. I too eat butter, red meat and cake in moderation. However I am

absolutely in favor of smart and efficient ways of regulating highly processed

crap that should not even be called food. There is a huge difference and pooling

it all together is a mistake, and that is what professionals like us should

advocate for. I hate fast foods not only for what that food means to the health

of its patrons but because of all the consequences it has had on our

agricultural system and food supply. The " oh let me choose what I eat what I

drive and all I do, stay out of my life " approach is a selfish point of view

that does not help better our society.

________________________________

From: " Diane Preves M.S., R.D. "

<newlife4health@...<mailto:newlife4health%40aol.com>>

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

Sent: Thu, July 22, 2010 11:44:14 AM

Subject: Re: Obesity Rating for Every American Must Be Included in

Stimulus-Mandated Electronic Health Records, Says HHS

I agree, Merav. We already know how to determine, and interpret, BMI. We do not

need a law to decide its use!

Diane Preves, M.S., R.D.

N.E.W. LIFE (Nutrition, Exercise, Wellness for LIFE)

www.newlifeforhealth.com

e-mail: newlife4health@...<mailto:newlife4health%40aol.com>,

newlife@...<mailto:newlife%40newlifeforhealth.com>

http://www.linkedin.com/in/newlifedianepreves

http://www.facebook.com/people/Diane-Preves/1357243185

http://twitter.com/DianePreves

Re: Obesity Rating for Every American Must Be

> > Included in Stimulus-Mandated Electronic Health Records, Says HHS

> > >

> > > Before we go off on a tangent here, I'd like to suggest that we jump

> > > for joy over the inclusion of BMI calculators in EMRs. It's what we

> > > wanted, folks. First, we complained that patients weren't being

> > > weighed or measured on admission to the hospital. You can build your

> > > system so that there's a stop if height and weight aren't entered.

> > If

> > > you're afraid that stated or " guessed " values will be entered, add a

> > > qualifier that says " actual " or " stated " or " estimated " , which puts

> > > the person entering information on alert that not actually measuring

> > > will be identified. So, now you have height and weight on admission!

> > > Second, we wanted to be included as a valued member of the

> > healthcare

> > > team. Here's the chance.

> > >

> > > Clinical systems are really just super duper calculators sometimes.

> > > So, rather than the RD or DTR spending time with a calculator

> > figuring

> > > out the BMI for all those inpatients, the system will do it for you.

> > > We are not the only providers who care about BMI. Systems don't

> > > diagnose, people do, so the affixing of a diagnosis associated with

> > > the BMI is the responsibility of the provider, hopefully with input

> > > from the RD.

> > >

> > > So rather than bemoaning this awful (????) turn of events, how about

> > > working with your system design team to include the information you

> > > want to diagnose appropriately? After all, there is additional

> > payment

> > > for obesity-related conditions under prospective payment. The flip

> > > side of that is you have to avoid misdiagnosing, so here's where the

> > > expert RD can really shine.

> > >

> > > Have a good day.

> > > pam

> > >

> > > Pam Charney, PhD, RD

> > > Affiliate Associate Professor

> > > Pharmacy

> > >

> > > MS Student

> > > Clinical Informatics and Patient Centered Technology

> > > School of Nursing

> > >

> > > University of Washington

> > > Seattle, WA

> > > pcharney@...<mailto:pcharney%40mac.com>

> > > http://www.linkedin.com/in/pamcharney

> > >

> > > > I work with Alaskan natives and the words wasted cacheix almost

> > > > always go with a BMI of 22 or less. When I worked in El Paso I

> > found

> > > > the older larger boned Hispanics also looked wasted etc at a BMI

> > of

> > > > 22. It is not the gold standard that the public is being lead to

> > > > believe.

> > > >

> > > > Jackie Chase RD

> > > > Dillingham AK

> > > >

> > > > >

> > > > > I agree Holly........on a related note............this was just

> > > > released this month.....an easy to read synopsis of the health

> > care

> > > > bill as written by Senators Tom Coburn MD and Barrasso

> > MD......

> > > > I've only skimmed it, but it looks like they have documented every

> > > > statement they make.........

> > > > >

>http://www.drhotze.com/CMSPages/GetFile.aspx?nodeguid=751b6d91-ccfe-4e23-bd75-1\

d750a68eb31

>

> > > > >

> > > >

July 22, 2010