Implementing a Clinical Decision Support Tool to Improve Physical Activity.

Area of Science:

• Preventive Cardiology
• Digital Health Interventions
• Health Behavior Change

Background:

• Many U.S. adults do not meet physical activity guidelines.
• Physical activity is often not assessed or discussed in routine healthcare.
• The physical activity vital sign (PAVS) assesses activity and identifies those not meeting guidelines.

Purpose of the Study:

• To evaluate the feasibility and clinical utility of integrating PAVS and best practice advisories into an EHR.
• To alert providers to patients with low physical activity and prompt counseling.
• To assess remote patient monitoring of physical activity within an EHR system.

Main Methods:

• Integrated EHR components: patient portal PAVS, provider best practice advisory, and remote patient monitoring (Fitbit).
• Pilot-tested in an ambulatory preventive cardiology practice for one year.
• Collected qualitative feedback from patients and providers.

Main Results:

• Patient completion of PAVS ranged from 35% to 48% monthly.
• Provider acknowledgment of the best practice advisory varied significantly (2%-22% monthly).
• 58% of patients successfully synced Fitbit devices for remote monitoring.

Conclusions:

• This pilot demonstrated the feasibility of incorporating a physical activity promotion intervention into the EHR.
• Uptake of all intervention components requires improvement for wider implementation.
• Qualitative feedback is crucial for refining future strategies.