Healthcare Strategy

Objectives:

• By 2020, at least two nationally recognized healthcare systems, that combined serve at least 10 million individuals, will have developed and disseminated approaches for
  team-based careTeam-based care: The National Academy of Medicine defines team–based care as the provision of health services to individuals, families, and/or their communities by at least two health providers who work collaboratively with patients and their caregivers—to the extent preferred by each patient – to accomplish shared goals within and across settings to achieve coordinated, high-quality care.
  to address physical activity and sedentary behavior in the healthcare setting.
• By 2020, at least two nationally recognized healthcare systems, that combined serve at least 10 million individuals, will have implemented and evaluated evidence-based behavior change strategies that address physical activity and sedentary behavior in healthcare settings.
• By 2020, at least 1 high quality pilot program will utilize a team-based care model to increase physical activity assessment, counseling, and referral in ambulatory care settings.

Objectives:

• By 2020, at least two nationally recognized healthcare systems, that combined serve at least 10 million individuals, will have developed a standardized and validated approach (e.g. self-report instrument, objective physical activity measurement) to assess and document aerobic physical activity in children and adolescents, adults and older adults.
• By 2020 5
  integrated healthcare delivery systemsIntegrated healthcare delivery system: An organized, coordinated, and collaborative network that links various healthcare providers to provide a coordinated, vertical continuum of healthcare services (ambulatory, hospital and payment) to patients.
  will have implemented a physical activity vital sign in their electronic health record and clinical workflow.
• By 2020, at least one nationally recognized healthcare systems will pilot test clinical assessment for muscle strength training and sedentary behavior in ambulatory care settings.
• By 2020 75% of physicians will report providing specific guidance to increase physical activity often or always according to the National Physician Survey of Practices on Diet, Physical Activity and Weight Control Questionnaire or other appropriate surveillance systems .
• By 2020 50% of patients report being advised by their physician to engage in regular physical activity according to the National Health Interview Survey.

Objectives:

• By 2020, at least 5 nationally recognized healthcare delivery systems will have integrated physical activity vital signs into existing electronic health records.
• By 2020, at least 10 additional leading healthcare systems that serve at least 500,000 individuals each will have developed a plan for integrating physical activity vital signs into existing electronic health records.
• By 2020 at least 2 of the top electronic health record vendors include a physical activity vital sign in their electronic health record.

Objectives:

• By 2020, leading healthcare organizations will have partnered with the National Committee for Quality Assurance or the National Quality Forumto support the development of an acceptable healthcare quality measure for physical activity for adults.
• By 2020, measures of physical activity assessment and counseling will be included as a quality incentive in at least 2 value-based health models (e.g. Accountable Care Organizations).
• By 2020, 60% of all children and adolescents ages 3-17 will have received physical activity assessment and counseling by a healthcare provider, according to NCQA HEDIS collection data.
• By 2020, 60% of all older adults will have received physical activity assessment and counseling from a healthcare provider, according to
  NCQA HEDIS dataNCQA HEDIS data: National Committee on Quality Assurance Healthcare Effectiveness Data Information Set. The Healthcare Effectiveness Data and Information Set is a collection of quality measures used by more than 90% of America’s health plans to measure performance on important dimensions of healthcare delivery and service.
  .

Objectives:

• By 2020, at least three leading healthcare systems that serve at least 500,000 individuals each will have partnered with electronic health record vendors and wearable technology and mobile health companies to implement the integration of objectively measured physical activity data into healthcare settings.
• By 2020, at least two leading healthcare systems, that serve at least 500,000 individuals each, will pilot test integration of objectively measured physical activity data into clinical care.
• By 2020, at least two leading healthcare systems, that serve at least 500,000 individuals each, will have evaluated the impact of objective physical activity data on health outcomes in common health conditions (e.g. diabetes, coronary artery disease, depression)

Objectives:

• By 2020, at least two leading healthcare systems that combined serve at least 5 million individuals will have expanded, developed, disseminated, and evaluated programs that encourage their healthcare providers to engage in active lifestyles.
• By 2020, a recognition program for both exemplary “physically active clinicians” and “physical activity promoting healthcare systems” will be in place.

Objectives:

• By 2020, at least three healthcare systems that combined serve at least 500,000 individuals each will have partnered with research/academic institutions to build evidence (e.g., original research, systematic reviews and meta-analyses) on the cost-effectiveness of a systems approach to physical activity assessment and counseling in healthcare settings.
• By 2020, at least 2 peer-reviewed publications will address the cost-effectiveness of physical activity assessment and counseling in the U.S. healthcare system.

Objectives:

• By 2020, at least 5 leading medical professional societies will advocate for the inclusion of physical activity assessment and counseling in guidelines for conditions where there is moderate to strong evidence of health benefits associated with regular physical activity.
• By 2020, at least one professional society from each of the fields of physical therapy, nursing, dietetics, mental health, and exercise science will have an effort in place that examines their role in promoting physical activity assessment and counseling with patients across the care continuum.
• By 2020, clear roles will be delineated for the healthcare teams in physical activity assessment, counseling, and referral to community-based physical activity resources including standards and workflow, as evidenced by published recommendations from each team member’s respective professional organizations or other leading entity.

Objectives:

• By 2020, at least two healthcare systems, that combined serve at least 10 million individuals, will have in place an evaluation plan for how they promote physical activity in their highest risk patients (e.g., those with prediabetes and type 2 diabetes mellitus, risk for cardiovascular disease, etc.).
• By 2020, healthcare professional societies for clinicians who work in at least four different disease-specific areas (e.g., diabetes, mental health, cancer, cardiovascular disease) will each have task-forces in place that are identifying effective strategies in clinical settings to promote physical activity among their respective patient groups.

Objectives:

• By 2020, at least one systematic review of collaborations between healthcare systems and partners that identifies best practices in PA promotion of will be published in a peer-reviewed journal. This review will synthesize the evidence on the value of these collaborations and provide case studies of successful ones.
• By 2020, there will be at least two symposia at national meetings that discuss best practices for collaborations between healthcare systems and diverse community partners (e.g. schools, faith-based organizations).
  

• By 2020, at least 10 healthcare systems serving a combined population of 10 million individuals will have in place referral agreements with community providers of physical activity services.
• By 2020, 10% of patients eligible for intensive behavioral counseling for cardiovascular disease prevention participate in a community-based program covered by commercial insurers as a US Preventive Services Task Force (USPSTF) recommendation for counseling to increase physical activity.

Objectives:

• By 2020, Medicare and Medicaid will reimburse evidence-based programs that provide therapeutic physical activity (e.g., diabetes prevention programs, chronic disease self-management programs, Silver Sneakers).
• By 2020, at least 20 commercial payers serving a combined population of 20 million individuals will provide coverage for physical activity services provided by community providers.
• By 2020, there will be at least two symposia at national meetings that discuss overcoming financial barriers for collaborations between healthcare systems and partners of all types.

Objective:

• By 2020, the curriculum of 25% of medical schools will cover the health benefits of physical activity and training in physical activity assessment and promotion.

Objective:

• By 2020, the curriculum of 25% of health professional education (nursing, advanced practice clinician, physical therapy, and dietetics) programs will cover the health benefits of physical activity and training in physical activity assessment and promotion.

Objective:

• By 2020, the American Board of Medical Specialties examinations will assess knowledge/performance in acquisition related to physical activity assessment, brief counseling, and referral processes.

Objectives:

• By 2020, at least one professional society for physicians who serve each of the groups of children and adolescents, adults, and older adults will collaborate in the development and publication of a position stand on best practices for physical activity assessment, counseling, and referral strategies in healthcare settings.
• By 2020, professional societies representing at least the following five populations: children and adolescents, adults, older adults and those with diabetes/prediabetes and cardiovascular disease risk will have developed and disseminated physical activity educational resources (e.g., didactics, self-directed learning, videos) for different faculty and student audiences.

Objectives:

• By 2020, at least five professional societies will have partnered with educational institutions to offer physical activity training in continuing education professional development programs.
• By 2020, at least 2 professional societies will have created ‘Certificates of Completion’ for professional development programs that include physical activity training.
• By 2020 60% of physicians strongly agree that they are confident in their ability to counsel patients to be adequately physically active according to the National Physician Survey of Practices on Diet, Physical Activity and Weight Control Questionnaire or other relevant surveillance systems.