A new initiative to systematically integrate a patient's physical activity data into their electronic health record (EHR) has shown considerable promise for improving patient treatment and care quality, according to a Kaiser Permanente study published in the journal Medicine & Science in Sports & Exercise.

Study findings, officials say, reveal that the electronic Exercise Vital Sign initiative developed by Kaiser Permanente has successfully compiled accurate and valuable information that can help clinicians better treat and counsel patients about their lifestyles.

The study examined the EHRs of some 1.8 million Kaiser Permanente Southern California patients, aged 18 and older 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 incorporated in their EHR, one-third were meeting national guidelines for physical activity, and two-thirds were not meeting guidelines. Of those not meeting guidelines, one-third was not exercising at all.

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“Embedding questions about physical activity in the electronic health record provides an opportunity to counsel millions of patients during routine medical care regarding the importance of physical activity for health,” said study lead author Karen J. Coleman of the Kaiser Permanente Southern California Department of Research & Evaluation. “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.”

The Kaiser initiative was launched in the organization’s Southern California region in 2009 and has since been implemented in several regions. As part of these efforts, patients are asked about their exercise habits during routine outpatient visits and their responses are included in their EHR, along with other traditional vital signs such as blood pressure, pulse and temperature.

The U.S. Department of Health and Human Services recommends that Americans engage in at least 150 minutes per week of moderate-to-vigorous intensity physical activity, such as brisk walking, to receive maximal health benefits. The guidelines state that regular physical activity reduces the risk of many adverse health outcomes.

“There is no better indicator of a person’s health and longevity than the minutes per week of activity a patient engages in,” said Robert E. Sallis, MD, co-author and chairman of the Exercise is Medicine advisory board. “When incorporated in a healthcare setting, the exercise vital sign can be an important tool for prevention and management of disease.”

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.

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Researchers validated the findings of the study by comparing exercise levels reported by the Kaiser Permanente adult patients in Southern California with those reported in U.S. population surveys. The researchers also examined the ability of these reports to discriminate between groups of patients with differing demographics and health status. The patient reports of physical activity were lower than national surveys, but followed similar patterns to those reported in the scientific literature: Members who were older, female, obese, belonging to a racial or ethnic minority or had more chronic health conditions were more likely to be inactive.

“Given that health care providers have contact with the majority of Americans, they have a unique opportunity to encourage physical activity among their patients through an assessment and brief counseling,” said Coleman. “Future studies will examine if adding a physical activity assessment during clinic visits actually leads to higher rates of physician counseling and eventually increases the rates of physical activity in our patients.”

Officials say this kind of additional patient data can only improve care quality as it gives the clinician a more holistic account of a patient’s health record. Kaiser Permanente has the largest private electronic health system in the world. The organization’s integrated model and electronic health record system connects 9 million people, 611 medical offices, and 37 hospitals, linking patients with their health care teams, their personal health information, and the latest medical knowledge. It also connects its researcher scientists to one of the most extensive collections of longitudinal and medical data available, facilitating studies and important medical discoveries that shape the future of health and care delivery for patients and the medical community.