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How to use digital measures of physical activity for Healthcare Providers & Decision Makers

Why use digital measures of physical activity?

The health benefits of physical activity (PA) for patients are indisputable. In the short term, engaging in PA improves anxiety, blood pressure, and sleep. In the long term, the benefits only continue to stack – including the prevention of chronic diseases and improvements in mental health, overall health, and quality of life.

Sensor-based technology provides opportunities to capture patient progress and performance of physical activity with high resolution and during their daily lives, enabling clinicians, advanced practice providers, and other allied health professionals to engage in more informed discussions with patients on their care plan.

Get started using these resources to select the right digital measure(s) of physical activity for your clinical patients

Step 1: Based on your patient’s needs, select measure(s) from the core set of digital measures of physical activity to track their physical activity.
  • Based on the patient’s functional capabilities, determine the most appropriate digital measure(s) of physical activity that would help patients keep track of their PA goals and general health.
    • A prescription of time spent in moderate to vigorous physical activity (MVPA) is recommended to support general health and prevention or maintenance of chronic diseases, with specific guidelines for different patient populations.
    • However, in instances where patients are unable to get to moderate-to-vigorous intensities of PA, step count is a widely available measure on consumer technologies and can be used as a proxy.
    • Monitor relevant physical activity measures to support patient care. For example, with older patients who are at a higher risk of falls, monitoring walking speed or postural sway would be key to measure, if patients’ consumer technologies are able to capture these measures.
Step 2: Discuss with patients their use of technologies to monitor their health.
  • During patient consultations, ask patients whether they are tracking their physical activity with consumer wearable technologies. If they are, empower them to use technologies to support their PA journey.
  • Talk to patients about available consumer technologies measuring physical activity that may suit their needs and can potentially integrate with patient portals.
Step 3: Refer patients to patient engagement apps or service providers, if appropriate with their care plan.
  • Advocate for digital behavioral change programs for physical activity, which can integrate summarized data from patients’ wearables to their patient portal and your electronic health record (EHR), in your practice (see illustrative scenario below).
  • Refer patients to service providers, such as physiotherapists or trainers, who facilitate behavior change interventions to help patients reach their physical activity goals.
Step 4: Identify how you can get paid for virtual care and physical activity provided
  • Explore options for payment of virtual monitoring and physical activity management services and interventions. Check out IMPACT’s Payment & Coding Toolkit and search through the various Current Procedural Terminology (CPT) codes specific to physical activity.
Interested in learning more about digital measurement of physical activity?

Step Into Action: Adopting core measures of physical activity in clinical care

Dr. Felipe Dominguez is a family doctor who often assesses, prescribes, and refers patients for physical activity (PA). 

Dr. Dominguez is caring for a 51-year-old patient, Mr. Richard Chan, who is overweight and has hypertension, putting him at a higher risk of cardiovascular disease and type 2 diabetes. Mr. Chan’s intake form reveals that he is not meeting the recommended weekly amount of physical activity for adults. During consultation, Mr. Chan reveals that with his office job, he lives a relatively sedentary lifestyle, but would like to make changes to have a healthier lifestyle. He mentions a wearable his daughter gifted him and how he uses it to track his physical activity.

    Dr. Dominguez prescribes him at least 100 minutes of moderate to vigorous physical activity (MVPA) a week and they discuss how Mr. Chan can potentially achieve this goal and even have fun doing so. Mr. Chan also mentions that he’s been trying to walk more every day and Dr. Dominguez encourages him to monitor his step count with his wearable.

    At the end of the consultation, Dr. Dominguez provides Mr. Chan with a pamphlet containing a QR code for a health app with behavioral nudges and a care management plan affiliated with his personal health record. The app captures physical activity measures and vitals from his wearable and allows Mr. Chan to give permission for Dr. Dominguez to see a summary of Mr. Chan’s progress in his electronic health record system, allowing greater management of care and informed decision-making related to his specific physical activity goals and plans. At a six-month touchpoint, Mr. Chan has lost ten pounds and his blood pressure has improved. Together, they review a summary of his progress of time spent in MVPA per week and daily step count. Mr. Chan shares that he walks with his daughter at least once a week and has registered in a pickleball league in a local community center.

    Dr. Dominguez congratulates him and they discuss raising his goal to 150 minutes of MVPA a week, based on recommended guidelines. Mr. Chan is motivated and determined to continue on his health journey, empowered by the ability to set goals and receive feedback on this progress, which is made possible through digital measurement of physical activity.

    Question corner:

    In practice, how can these systems (e.g., Dr. Dominguez’s EHR system, the patient engagement app, etc.) work together? 

    A Physical Activity Implementation Guide was recently published in HL7, in accordance with Physical Activity Guidelines for Americans. It outlines the workflow and potential players and systems in physical activity prescription, goal setting, and referral. (Check out section 1.2.1 for further details of the scenario)

    {note: adapted from scenario in section 1.2.1 of the HL7 physical activity implementation guide}

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