Stories from the Field
Implementation of Physical Activity as a Vital Sign (PAVS) at Mayo Clinic Health System in Mankato, Minnesota - Cheri Pettitt, Ph.D.
Recent research indicates positive patient outcomes when physical activity is assessed as a vital sign at primary care visits and tracked over time as a health indicator. Following the lead of the Exercise is Medicine initiative, Mayo Clinic Health System in Mankato, Minnesota adopted physical activity as a vital sign (PAVS) within their electronic medical record (EMR) in 2013. Primary care providers at 19 different clinical sites across southern Minnesota are now able to easily assess their patient’s physical activity levels and counsel patients that are not meeting minimum guidelines for aerobic exercise.
Primary care provider support was key to the success of the PAVS initiative at Mayo Clinic Health System. The initial support for integrating physical activity in the Mayo Clinic Health System began when health care providers from across the Mayo Clinic Health System attended a half-day Saturday training course as a sign of their commitment to improving their patients’ health outcomes. Using this momentum, a PAVS implementation team, consisting of Mr. Chip Gay, the Mayo Clinic Health System Exercise Specialist, and Dr. Cherie Pettitt, an Assistant Professor in Exercise Physiology at Minnesota State University - Mankato, approached Joel Gordon, M.D., CMIO, Family Medicine at Mayo Clinic Health System, to champion the PAVS effort. After 18 months, PAVS was established in the EMR on the standard vital signs page in November of 2013. “Without the commitment to fitness, my patients are fighting with one hand tied behind their back. When I say ‘fitness commitment,’ I’m not talking about running a 4½ minute mile or completing a half-marathon. I’m talking about 20–30 minutes out of each day that is specifically attending to your physical wellness by seeking the level of fitness that is beyond one’s previous day/week or month,” stated Dr. Gordon.
Capitalizing on previous efforts, Mr. Gay developed a healthcare provider referral program, called Exercise is Medicine, for community members that are sedentary and/or have chronic disease, and are seeking additional support to begin an exercise program at a reduced cost. Health care providers within Mayo Clinic Health System can “order” the program in the EMR for their patients. Mr. Gay and his colleagues help patients with a variety of health conditions that need a supervised exercise program. Community members of all ages with conditions, such as high-risk pregnancies, chronic kidney diseases, cancer, diabetes, and heart abnormalities, have successfully participated in the program.
Unique to Mayo Clinic Health System, PAVS implementation team members Mr. Gay and Dr. Pettitt felt it was important to also ask patients about their participation in resistance training. In addition to the standard PAVS questions, family practice providers now have the option of asking: How many days per week do you engage in muscle strengthening activities (i.e. yoga, bodyweight exercises, or lifting weights)? Evaluation of the impact of PAVS on patient health outcomes is ongoing and will continue to be promoted at all clinics within Mayo Clinic Health System.
For more information on the PAVS project or the Exercise is Medicine supervised physical activity program, contact Mr. Chip Gay (email@example.com) at Mayo Clinic Health System.