Updates from EIM

Hartford HealthCare Integrates Physical Activity as a Vital Sign System Wide

July 18, 2022 by Dale Bond, Ph.D.,Amanda Zaleski, Ph.D., ACSM-CEP, Lucas Carr, Ph.D.

Hartford HealthCare (HHC) in Connecticut has partnered with leaders at the American College of Sports Medicine (ACSM) to successfully integrate the Physical Activity Vital Sign (PAVS) into their electronic medical record system (EMR). This is an especially important milestone as HHC is the first integrated healthcare system in New England to launch the Exercise is Medicine® (EIM) solution.  “This is exciting news for the advancement of EIM and the inclusion of exercise/physical activity within routine clinical care, ultimately leading to improved patient health and well-being.  We applaud all the stakeholders at HHC for their vision, leadership and hard work,” say Robyn Stuhr, Vice President of EIM at ACSM.”  

With 400+ locations, HHC is a comprehensive, integrated care-delivery network and touches ~17,000 lives each day across two tertiary-level teaching hospitals, an acute-care community teaching hospital, an acute-care hospital and trauma center, three community hospitals, a behavioral health network, a multispecialty physician group, a clinical care organization, a regional home care system, an array of senior care services, a mobile neighborhood health program, and a comprehensive physical therapy and rehabilitation network.  

Despite the well-established clinical and economic benefits of regular physical activity (PA), 75% or 156 million U.S. adults do not achieve national guidelines, translating to $117B in excess annual health care costs. Why are so many Americans insufficiently active? There are a myriad of patient-level barriers, but the hard truth is that the default model of care offers very little resources or tools to support patients with evidence-based lifestyle interventions where it matters most; in the healthcare setting. All major public health organizations promote the importance of PA assessment, prescription, and referral as a standard of care in clinical practice, yet only 1 in 3 patients are asked about PA. This is particularly sobering given that exercise is the gold-standard, first-line treatment for the ~60% of U.S. adults with chronic, non-communicable disease.  

HHC seeks to upend the default care model and address this nationwide treatment gap by establishing validated PA assessment at every clinical point-of-care. Although many clinicians already assess PA, these data are not standardized and are often buried within patient narratives. Integrating an empirically validated PA assessment tool in the EMR system allows this information to be continually collected and leveraged to support clinical care, quality improvement, and multidisciplinary research. Therefore, HHC integrated ACSM’s Physical Activity Vital Sign (PAVS) into the EMR system. The PAVS consists of two questions, can be administered by any clinician in <1 minute, and provides immediate feedback on whether a patient is meeting national PA health guidelines.  

PAVS data will inform development of clinical and community PA interventions that connect patients to best-in-class, patient-centered, evidence-based resources, tools, and support where they live, work, and play. This effort is timely and well-aligned with HHC PA-related initiatives, such as the new Lifestyle Medicine department, “DominGO! Hartford”, an open streets community event, and “Walk with a Doc.” PAVS will also integrate the clinical and scientific missions of multiple HHC institutes (e.g., Heart and Vascular, Bone and Joint) and programs (e.g., Medical and Surgical Weight Loss) that emphasize PA as a critical component of clinical care. 

This effort would not have been possible without the leadership and expertise of a multidisciplinary team of stakeholders from ACSM, EIM, Hartford HealthCare, and the University of Iowa. 

Dale Bond, Ph.D.; Director of Research Integration; Departments of Surgery and Research, Hartford Hospital, Hartford, CT. Contact: Dale.Bond@hhchealth.org  

Amanda Zaleski, Ph.D., ACSM-CEP; Clinical Exercise Physiologist, Department of Preventive Cardiology, Hartford Hospital, Hartford, CT. Contact: amanda.zaleski@hhchealth.org 

Lucas Carr, Ph.D.; Associate Professor, Department of Health and Human Physiology, University of Iowa, Iowa City, IA. Contact: lucas-carr@uiowa.edu  

Support for the Exercise is Medicine® Initiative is provided by:

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