The American College of Sports Medicine provides recommendations for exercise preparticipation screening. Previous pre-exercise screening protocols included risk factor identification; however, this has not been shown to reduce the risk of a cardiac event during exercise and creates unnecessary barriers for patients who will benefit most from a routine of light to moderate intensity physical activity.
Step 2: Provide Brief Advice or a Basic Exercise Prescription
For patients who are in the Preparation, Action (or even Contemplation) stages, the next step is to provide them with a physical activity prescription.
The Exercise is MedicineRx form or EIM patient handouts may be given to the patient or scanned into the EHR and included in the after-visit summary (AVS). Indicate your recommendation on the PA Rx form or enter them directly into the PDF data fields. Note the fields are not structured, mineable or trackable for doctors in a report.
The simplest advice that you can provide is to participate in 150 minutes of moderate intensity physical activity each week as recommended in the 2018 Physical Activity Guidelines for Americans. Studies have shown that simply providing a written prescription is an effective means of motivating patients to be more physically active, sometimes by as much as one hour per week.
Consider offering the Exercise is Medicine “Sit Less. Move More.” or “Being Active for a Better Life” handouts. Both are designed to help patients take manageable first steps toward reducing sedentary behavior and/or becoming more active. These may be particularly helpful for those who are in the Contemplation and Preparation stages.
Step 3: Offer a More Advanced Exercise Prescription
If you take a few minutes to discuss becoming more physically active, you may be able to bill for this service. See the Provider Coding and Billing Tip Sheet. If you practice in a value-based health care model, there are likely incentives for improving patient health through access to healthy lifestyle interventions. We encourage you to use the Rx for Health Series developed by EIM and leading experts from ACSM. This series consists of exercise prescriptions specifically developed for individuals with a variety of health conditions like diabetes, cardiovascular disease, osteoarthritis, lower back pain and our basic exercise prescription for inactive patients.