Thursday, July 15, 2010 / By Matt Cover, Staff Writer / CNSNews.com

New federal regulations issued this week stipulate that the electronic health records--that all Americans are supposed to have by 2014 under the terms of the stimulus law that President Barack Obama signed last year--must record not only the traditional measures of height and weight, but also the Body Mass Index: a measure of obesity.

The obesity-rating regulation states that every American's electronic health record must: “Calculate body mass index. Automatically calculate and display body mass index (BMI) based on a patient’s height and weight.”

The law also requires that these electronic health records be available--with appropriate security measures--on a national exchange.

The new regulations are one of the first steps towards the government’s goal of universal adoption of electronic health records (EHRs) by 2014, as outlined in the 2009 economic stimulus law.  Specifically, the regulations issued on Tuesday by Health and Human Services Secretary Kathleen Sebelius and Dr. David Blumenthal, the National Coordinator for Health Information Technology, define the "meaningful use" of electronic records. Under the stimulus law, health care providers--including doctors and hospitals--must establish "meaningful use" of EHRs by 2014 in order to qualify for federal subsidies. After that, they will be subjected to penalties in the form of diminished Medicare and Medicaid payments for not establishing "meaningful use" of EHRs.

Section 3001 of the stimulus law says: "The National Coordinator shall, in consultation with other appropriate Federal agencies (including the National Institute of Standards and Technology), update the Federal Health IT Strategic Plan (developed as of June 3, 2008) to include specific objectives, milestones, and metrics with respect to the following: (i) The electronic exchange and use of health information and the enterprise integration of such information.‘‘(ii) The utilization of an electronic health record for each person in the United States by 2014."

Under this mandate in the stimulus law, Secretary Sebelius issued a regulation--developed by Dr. Blumenthal--that requires that all EHRs keep track of a person’s Body Mass Index (BMI) score. Body Mass Index is a ratio between a person’s weight and height, and is used to determine whether or not someone is overweight or obese. It is the preferred method of the Centers for Disease Control and Prevention (CDC) for measuring obesity.
Michelle Obama has made dealing with the problem of childhood obesity the main theme of her term as First Lady.

According to the CDC,  “BMI provides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems.”
A person’s BMI score is used as a tool to screen for obesity or excessive body fat that could lead to other health problems. While it does not actually measure body fat directly, according to CDC, the BMI scores generally correlate with a person’s body fat percentage.
The new regulations also stipulate that the new electronic records be capable of sending public health data to state and federal health agencies such as HHS and CDC. The CDC, which calls American society “obesogenic” – meaning that American society itself promotes obesity – collects BMI scores from state health agencies every year to monitor obesity nationwide.

“Electronically record, retrieve, and transmit syndrome based public health surveillance information to public health agencies,” the regulations read.
With the spread of electronic health records, the CDC apparently will be able to collect such data more efficiently and with greater accuracy because the electronic record keeping systems can send the data automatically, eliminating the need for government – both state and federal – to keep, send, and process physical records.