Regular exercise contributes to good health. It strengthens the heart and the lungs, tones the muscles, prevents or mitigates weight gain and contributes to brain health and mental health fitness. It is undisputed that Individuals who exercise regularly are healthier, are less dependent upon medical intervention by their physician, require less intensive management of hereditary chronic disease conditions, have lower rates of hospital admissions and shorter lengths of stays, when hospitalized.<\/p>\n
However, the benefit of regular exercise to good health is rarely a topic of discussion that a primary care physician initiates during an office visit with a patient, even during the patient\u2019s non-urgent \u201cannual physical examination appointment.\u201d This is, primarily, due to the fact that the primary \u201chealthcare\u201d services the physician provides are for the treatment of a patient\u2019s physical discomfort and sickness, the management of the patient\u2019s existing chronic disease conditions and the urgent treatment of the patient\u2019s injuries and physical trauma. Physicians solve \u201chealth problems.\u201d That is what physicians are educated and trained to do, how they are paid and how their performance is evaluated by the federal and commercial healthcare insurers that fund \u201chealthcare\u201d services. A physician\u2019s inquiry of a patient\u2019s good \u201chealth\u201d habits and their advice regarding the adoption or continuation of these habits is not what is expected by their patients. It is not required by the \u201cstandards of care\u201d established for the practice of medicine nor by the guidelines and policies for health insurance coverage of and payment for physician services.<\/p>\n
Nevertheless, all physicians acknowledge the benefit of self-motivated efforts and habits of patients for improving and preserving their health. Among healthcare professionals, these habits are generally described and categorized as \u201cpreventive health.\u201d Foremost among these acquired \u201cpreventive health\u201d habits is regular exercise. The \u201cgood health\u201d benefit to a patient who regularly exercises is apparent to their physician during a patient appointment. This is based upon the patient\u2019s physical appearance and the physician\u2019s review of their vital signs which provide evidence of their current physical condition. It is well known among physicians that those patients who exercise have better health. The awareness and recognition, within the medical profession, of the health benefit of regular exercise, is also supported by a significant volume of published and peer reviewed medical research devoted to this topic.<\/p>\n
If patients rely upon, and are confident of, their physician\u2019s advice, assistance and solutions for their health \u201cproblems,\u201d and if physicians acknowledge the value and benefit of regular physical activity to the patient\u2019s health, it seems reasonable to expect the physician to address the physical activity habits of the patient during a typical patient office visit at a reasonable level of frequency (eg. quarterly). This will enable the physician to become more actively involved in advising, motivating and managing even gradual increases in the regular physical activity habits of their patients, to the benefit of their overall health.<\/p>\n
The physician can begin the discussion regarding the physical activity habits of a patient, with a short, standardized multiple-choice questionnaire (eg. how often, how long, how hard do you exercise). The purpose is to raise the patient\u2019s awareness of the importance of regular physical activity to their health and to encourage the patient to describe their current regular exercise habits in the form of the specific measurable responses required by the questionnaire. The physician\u2019s review will also require a physical test which can provide a \u201cmeasure\u201d of the effect of the patient\u2019s regular physical activity habits on their \u201coverall\u201d health. This would be comparable to the measurement of current \u201cvital signs\u201d such as the pulse and blood pressure of the patient. This test will measure the effect of exercise in the form of a range of values within a scale of acceptability (eg. bad, good, better, best).
\nThe purpose for using a multiple choice, descriptive, \u201cphysical activity questionnaire\u201d in combination with a separate physical measure or \u201cvital sign\u201d is to assess the consistency between each patient\u2019s questionnaire responses and their actual physical test result. In addition, the test result will provide a ranking of \u201cregular exercise sufficiency\u201d to identify those patients who will require more active intervention and follow up by their physician.<\/p>\n
A patient\u2019s \u201cexercise habits\u201d can be regularly assessed as a \u201cpreventive health\u201d topic and requirement during an appointment with their primary care physician. As previously recommended, a short, multiple-choice questionnaire could fulfill this \u201cpreventive health\u201d requirement: (How often do you exercise? How long is your typical exercise session? How hard are you working \/ breathing while exercising?) This practice would be no different from the typical review, at every physician visit, of the existing chronic disease conditions of the patient and\/or the review of current medications which have been prescribed by the physician. By having the physician formally address a patient\u2019s \u201cregular exercise habits\u201d as a \u201cpart\u201d of their visit with the patient, this \u201cpreventive health\u201d habit becomes a mutually acknowledged element of the patient\u2019s \u201cmedical care.\u201d It also implies that the patient\u2019s \u201cregular exercise\u201d will be regularly monitored and addressed during a visit with their primary care physician. This is a necessary condition for assigning value to regular exercise, but it is not sufficient for establishing the implied \u201cpreventive health\u201d responsibility and compliance by the patient<\/p>\n
Therefore, an objective measure of the personal \u201cfitness level\u201d of the patient, as determined by their \u201cregular exercise habits,\u201d will also be required during their physician visit. This will identify the patient\u2019s current level of \u201cregular exercise compliance\u201d based on a \u201cresearch-validated\u201d standard and measure. That standard is the patient\u2019s Cardio-respiratory Fitness (CRF) level which can be easily measured, interpreted by their primary care physician and discussed with the patient during the physician visit.<\/span><\/p>\n Cardio-respiratory Fitness (CRF) describes the interdependence of the respiratory system (lung function) and the circulatory systems (heart and vascular function) to supply oxygen and nutrients to the large skeletal muscles of the body when those muscles are in active use during physical exertion (i.e. exercise). The measure of Cardio-respiratory Fitness is VO2max or \u201cmaximal oxygen uptake.\u201d The formula is milliliters of oxygen per kilogram of body mass per minute (ml \/ kg \/ min). The measurement of cardio-respiratory fitness has already been adopted by athletes for improving their speed and endurance in individual sports competitions (eg. running, cycling and swimming). Within the exercise physiology profession, it is considered as the single best measure of aerobic fitness.<\/p>\n The currently accepted standard for measuring cardio-respiratory fitness is an exercise stress test that is performed while the body is under physical exertion. It requires the use of a treadmill or stationary bicycle, a heart rate monitor and a metabolic cart, which measures respiration. However, advances in heart rate monitoring (HRM) technology have also included the research and development of an embedded algorithm, within the heart rate monitor, for evaluating the \u201cinter-beat interval\u201d variability of the \u201cmonitored\u201d resting heart rate. These advances have resulted in the development of a non-exercise Cardio-respiratory Fitness Test (neCFT). The neCFT requires the use of a heart rate monitor (HRM) that includes the embedded algorithm, which can provide an acceptable and reliable estimate of Cardio-respiratory fitness (CRF) while the individual is at rest. Consequently, the stress-free nature of the neCFT makes it the most practical, safe and risk-free \u201cdiagnostic test\u201d for measuring the individual\u2019s cardio-respiratory fitness (CRF) which reflects the individual\u2019s \u201chabitual\u201d physical activity.<\/p>\n During the past six (6) years, an increasing number of peer-reviewed medical research studies have proposed that a measure of a patient\u2019s Cardio-respiratory Fitness (CRF) should be included as an additional \u201cvital sign\u201d that is assessed and documented at every patient \/ physician visit. A key finding and conclusion of these research studies is that a measure of a patient\u2019s cardio-respiratory fitness provides the best indicator of the patient\u2019s total body health. All of these studies have recommended the use of a non-exercise test as the most practical and acceptable method for establishing the \u201cevaluation and management\u201d of Cardio-respiratory Fitness (CRF) within a physician office setting. The collection of a measure of a patient\u2019s physical activity habits will raise awareness regarding the importance of regular physical activity and will facilitate the regular review, discussion and intended patient compliance during a visit with their primary care physician.<\/p>\n The adoption and use of a non-exercise Cardio-respiratory Fitness Test (neCFT) as a \u201cpreventive health\u201d evaluation tool and measured \u201cvital sign\u201d during a physician appointment can provide the basis for a meaningful and focused discussion between the physician and the individual about the importance of the individual\u2019s regular physical activity to their health. The intended behavioral compliance by the patient, whether by the continuation of current \u201cregular\u201d physical activity habits or the necessity for, and challenge of, adopting reasonable and manageable levels of physical activity on a regular basis, can then become a \u201cpreventive care\u201d component, of their \u201cmedical care,\u201d which is regularly measured, monitored and positively influenced and guided by their primary care physician.<\/p>\n Implementation of this proposed \u201cpreventive care\u201d service, will require the provision of the non-exercise Cardio-respiratory Fitness Test (neCFT) to the patients of primary care physicians at reasonable levels of frequency. It will also require the administrative and procedural support for the physician\u2019s oversight and provision of equally, if not more, important physical activity counseling which will be provided to patients based on neCFT results showing low cardio-respiratory fitness levels. Health insurance coverage and payment for the neCFT will be required, subject to the submission of necessary applications. Similarly, coverage and payment for the professional counseling services of the primary care physician will also be required, subject to application. Both coverages will require the submission of a \u201cpreventive care service\u201d application to the Centers for Medicare and Medicaid Services (CMS) within the Department of Health and Human Services (HHS). CMS has the authority and ability to approve fee-for-service coverage of \u201cpreventive care services\u201d subject to the submission of an application.<\/p>\n Our company can perform a non-exercise Cardio-respiratory Fitness test (neCFT) on an individual which will provide a validated and ranked measure of the individual\u2019s regular physical activity habits. This will improve the health and health maintenance habits of the patient, as regularly evaluated by their primary care physician, reduce their need for medical intervention and reduce the cost of their medical care over time.<\/p>\n The non-exercise cardio-respiratory fitness test (neCFT) we are proposing is based on a research-validated algorithm which measures the resting heart rate variability of an individual. The \u201cinter beat interval variability\u201d of heartbeats within an individual\u2019s resting heart rate is indicative of the degree to which their heart is exerted during any form of physical activity, the range of heartrate exertion, and the frequency and duration of the individual\u2019s habitual physical activity over time.<\/p>\n Essentially, the neCFT evaluates and measures the most recent history of an individual\u2019s habitual physical activity in the form of an age and gender stratified, single value, ranked score. Consequently, the test can provide an evidence-based measure and record of \u201cregular exercise activity and sufficiency\u201d for the individual, regardless of their age and current physical condition. The measure of the individual\u2019s Cardio-respiratory Fitness (CRF) can be regularly monitored and managed by their primary care physician as a defined \u201cpreventive care\u201d service requirement.<\/p>\n The non-exercise cardio-respiratory fitness test (neCFT) will be offered to primary care physicians as a testing service for their patients. It can be performed within an exam room in the physician\u2019s office. Delivery of this service to patients at their primary care physician\u2019s office is intended to ensure that it is a physician-directed and supervised \u201cpreventive care\u201d service. Consequently, it will ensure the physician\u2019s oversight and participation to directly influence patient compliance and accountability for their personal \u201cregular exercise\u201d habits. The objective is for the patient to achieve and maintain an acceptable level of Cardio-respiratory Fitness (CRF).<\/p>\n Additional details about our capabilities and comprehensive service to actualize the value, importance and health benefit of “regular exercise” as a component of the medical care services an individual receives from their physician care physician can be found here:<\/p>\nTHE SOLUTION — CARDIO-RESPIRATORY FITNESS AS THE STANDARD AND MEASURE OF \u201cREGULAR EXERCISE\u201d<\/h4>\n
CARDIO-RESPIRATORY FITNESS AS \u201cPREVENTIVE HEALTH\u201d<\/h4>\n
PHYSICIANS PROVIDING NON-EXERCISE CARDIO-RESPIRATORY FITNESS TEST AND PATIENT FITNESS COUNSELING<\/h4>\n
EXERMETRX VALUE PROPOSITION<\/h4>\n