Every physician and nurse understands the meaning of "vital signs" and how to interpret them. Well, Kaiser seems to be putting a new spin on the term with its electronic Exercise Vital Sign initiative (see: Kaiser Permanente creates new electronic Exercise Vital Sign initiative). Here are some of the details from a recent article:
The new feature is successfully compiling accurate and valuable information that can help clinicians better treat and counsel patients about their lifestyles....[A recent] study examined the electronic health records of 1,793,385 Kaiser Permanente Southern California patients...and found that 86 percent of all eligible patients had an exercise vital sign in their record. Of those patients who had an exercise record, one third were meeting national guidelines for physical activity, and two thirds were not meeting guidelines. Of those not meeting guidelines, one third were not exercising at all. "Embedding questions about physical activity in the electronic medical record provides an opportunity to counsel millions of patients during routine medical care regarding the importance of physical activity for health," said [one of the study authors] "In addition, the Exercise Vital Sign has the potential to provide information about the relationship between exercise and health care utilization, cost and chronic disease that has not been previously available. Kaiser Permanente is one of the first - and largest - health care organizations to implement an Exercise Vital Sign in patient health records. The initiative was launched in the organization's Southern California region in 2009 and has since been implemented in several of Kaiser Permanente's regions. As part of these efforts, patients are asked about their exercise habits during routine outpatient visits and their responses are included in their electronic medical record, along with other traditional vital signs such as blood pressure, pulse and temperature....The guidelines state that regular physical activity reduces the risk of many adverse health outcomes.The Exercise Vital Sign is part of Exercise is Medicine, a multi-organizational initiative coordinated by the American College of Sports Medicine and the American Medical Association to encourage primary-care physicians and other health care providers to include exercise when designing treatment plans for patients.
What a great (and relatively simple) idea. Include a physical activity metric for each patient in the EHR called the Exercise Vital Sign. It's a perfect starting point and incentive for health professionals to coach patients about the need for exercise and even prescribe more exercise based on the patient's age and ability. Here's some more details about the Exercise is Medicine program referred to above and copied from the organization's charter (Exercise is Medicine Charter):
Co-launched by the American College of Sports Medicine and the American Medical Association in November 2007, Exercise is Medicine is an initiative committed to the belief that physical activity is integral to the prevention and treatment of disease, should be regularly assessed as part of all medical care, and should be a standard part of the disease prevention and treatment medical paradigm. Exercise is Medicine calls for all health care providers to consider physical activity a vital sign and for physicians to effectively counsel their patients and/or refer them to a qualified health-and-fitness or allied health professional for further counseling. Exercise is Medicine is also committed to the belief that the benefits of physical activity are not confined solely to the traditional health care settings. Exercise and physical activity strategies, as integral parts of prevention and treatment of disease, should be addressed at many levels including in the community, recreational settings, schools and the workplace.
I also want to comment briefly about Coca-Cola as a "global partner" of Exercise is Medicine. I know that Coke manufactures fruit juices and water in addition to unhealthy, sugary beverages. I think that the executives of health-oriented organizations like Exercise is Medicine should have enough cajones to occasionally refuse money from corporate sponsors. These alliances with worthwhile projects are used by the company to create a healthy aura around their products. I know what the rationale to this criticism will me -- the money from Coke allows the organization to pursue commendable health-related goals. Unfortunately and in my opinion, most people view this as a weak, self-serving argument. Most people also recognize the hypocrisy of seeing the Coke logo on the home page of the Exercise is Medicine web site.