The EIM solution describes an approach to activating Exercise is Medicine® through partnerships between local health care systems/medical practices and community fitness resources, building a “bridge of trust” for coordinated care.
Patients are more likely to be referred for exercise guidance and to engage in recommended levels of physical activity when health care systems and community fitness enterprises work together, developing smooth referral and communication pathways. The goal is to implement physical activity interventions that will slow, stop and reverse the progression of chronic diseases.
The adoption of Population Health Management strategies by health care stakeholders has created a significant opportunity for physical activity to be established as a standard in health care. Population health seeks to identify and invite groups of patients with similar diagnoses or medical challenges to participate in a healthy lifestyle or physical activity intervention. The objective is to improve health outcomes, cost-effectiveness and care coordination. Changing reimbursement models (the transition from volume-based to value-based care) and the consolidation of health systems will accelerate the adoption of this model.
An EIM solution requires the commitment of collaborating health care and community leaders and champions and is achieved by:
EIM Greenville is a multidisciplinary team of stakeholders from a local health system, university, medical school and YMCA in Greenville, South Carolina that has successfully implemented an EIM solution. EIM Greenville has developed a comprehensive toolkit and offers consulting services that can be purchased by interested health care systems and community partners. Contact eim@acsm.org for purchasing details.
Three different domains are essential in bringing about the vision of EIM:
1. Health Care Systems and Providers. Health care providers include physicians, nurse practitioners, physician assistants, nurses, physical therapists and others working together to provide optimal care and disease prevention. With the assistance of tools embedded in the EHR, providers can more easily integrate physical activity assessment and promotion into routine clinical care. Other members of the health care team play a critical role in creating a smooth workflow for EIM, including physician extenders, medical assistants and front desk staff. See EIM resources for clinicians.
2. Physical Activity Resources: Places, Programs and Professionals. Community partners can serve as an extension of the health care team through qualified exercise professionals and evidence-based programs.
3. Digital Health Technology. Health care systems have a wide spectrum of technologies that can be used to accelerate the successful integration of healthy lifestyle interventions. These technologies allow for integration of the physical activity vital sign and referral pathways, identification of patients who would benefit from lifestyle interventions, and tracking patient data. Examples include:
On the community/fitness side, there has been an explosion in technology platforms, devices, and applications to facilitate activity tracking, promote participant engagement and monitor outcomes.