Background: Nearly half of American adults fail to meet national guidelines for physical activity (PA). As a major contributor to the development of preventable chronic diseases, insufficient PA is an important target for health behaviour interventions. Exercise is Medicine (EIM) aims to increase PA levels among primary care patients through routine PA evaluation, prescription, brief counselling, and referral to community resources. PA is treated as a vital sign with the goal of increasing PA levels in prescribed manageable doses. EIM is currently being implemented in UC San Diego Health System's primary care clinics.
Objective: (i) To collect and summarize patient perceptions of EIM and its components. (ii) To identify discrepancies between patient-reported feedback and primary care provider (PCP) documentation in corresponding visit notes in the electronic medical record (EMR).
Methods: Patient recall of EIM components was measured using a 10-item survey distributed via MyChart. PCP documentation of EIM was tracked in the EMR system.
Results: Patient feedback (n = 316) about EIM components was positive and reinforced patients' confidence in their ability to increase PA. Approximately 70% of patients reported having a PA discussion with their PCP at their most recent visit, but only approximately 21% of these discussions were documented by PCPs using the preprogrammed smartphrase in the EMR.
Conclusion: Overall, patients reported positive perceptions of EIM. While patient perceptions of EIM suggested that PA discussions with PCPs are happening during the majority of visits, PCP documentation fell behind. Documentation via smartphrase may need to be modified for physicians to use.
Keywords: Exercise is Medicine; electronic medical record; evaluation research; physical activity; physician documentation; primary care.
The Exercise is Medicine (EIM) program encourages primary care patients to increase their weekly physical activity (PA). The program includes an initial PA evaluation, prescription, counselling, and referral to community resources. EIM is currently active at UC San Diego Health System’s primary care clinics. In this study, patient feedback of program components is collected and physician documentation in the electronic medical records system is evaluated. Overall, feedback was positive with patients reporting high levels of self-confidence in their ability to increase their weekly PA. Patients indicated that PA was discussed at roughly 70% of all recent visits. However, physician documentation indicated that PA was discussed at approximately 21% of all recent visits. Although PA was successfully addressed, documentation may need to be modified to more accurately reflect EIM program usage.
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