Study: Exercise as a Vital Sign Improves Patient Care

Exercise is now a “vital sign” for all Kaiser Permanente members. While they have their weight, height and blood pressure measured before a doctor visit, patients are asked how often they exercise so that doctors can follow up.

A Kaiser Permanente study 'Initial Validation of an Exercise “Vital Sign” in Electronic Medical Records' published in the journal Medicine & Science in Sports & Exercise examined the electronic health records of 1,793,385 Kaiser Permanente Southern California patients ages 18 and older from April 2010 to March 2011 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.

“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, M.D., one of the authors. Kaiser Permanente began using the exercise vital sign in October 2009. Patients at Kaiser are routinely asked questions about their usual daily levels of activity and are assigned a minutes-per-week value based on their answer. Using a regression model, this study demonstrated that a greater disease burden increased the likelihood of physical inactivity among the sample patient population. As expected, researchers also found lower activity levels among patients who were older, obese or members of ethnic minorities.

"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 study lead author Karen J. Coleman, PhD, 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."

Check out the video below featuring Dr. Jed Weissberg, Senior Vice President for Hospitals, Quality, and Care Delivery.

"…The medical assistant asks the patient, ‘How many days a week do you exercise, and on those days, how many minutes do you exercise? So that is adding exercise to the set of vital signs, just like we added cigarette smoking as a vital sign so that it could be right up there at the top of the medical information for the doctor to engage in a discussion with the patient."