Major medical association seeks to build national digital infrastructure to support lifestyle-medicine practice

If lifestyle medicine is to help U.S. healthcare improve care while reducing costs, the specialty is going to need a hand collecting and coding data at various points of patient care and engagement. 

Or, as put in a new position paper running in the American Journal of Lifestyle Medicine, a journal of the 16,000-member American College of Lifestyle Medicine (ACLM):

“A critical need exists for terminological codes for data capture and interoperability to integrate lifestyle-medicine terminologies into existing biomedical terminologies, with an ultimate goal of national health digital infrastructure to support lifestyle-medicine practice.”

Senior author Micaela Karlsen, PhD, and colleagues underscore that hospitals benefit from consistent data when monitoring quality and operations. 

“Using the same codes for all departments means administrators can aggregate data on outcomes, resource utilization or quality metrics much more accurately,” the researchers write. 

Meanwhile the American Medical Association stressed just this month that lifestyle medicine is a recognized medical specialty and practice area. By focusing on using therapeutic lifestyle interventions—nutrition, exercise, sleep—it can help prevent, treat and reverse chronic disease. 

Lifestyle medicine, AMA points out, “functions both as a distinct field and as an adjunctive certification that physicians and allied health professionals can add to primary care or other core specialties.”

In the current ACLM position paper, senior ACLM researcher Karlsen and colleagues offer numerous points for consideration by patient-care stakeholders. Among them are these three.
 

The transformation from a sick-care system to a desired healthcare system necessitates a comprehensive approach to data collection and utilization. 

Central to this transformation is the capacity to collect discrete data on both health behaviors and the lifestyle-medicine interventions prescribed, at or near the point of care, the authors write.

“Capturing factors such as diet, physical activity, sleeping patterns, substance use, connectedness and stress allows healthcare professionals to provide more personalized, effective care and track it over time,” they add. Meanwhile, “capture of interventions prescribed will provide key data on how LM can effectively bring about health improvements.”

The benefits of lifestyle interventions and lifestyle medicine treatment specifically have been demonstrated to improve patient health and provider well-being—but full demonstration of achieving the Quintuple Aim by lifestyle medicine is still needed. 

Acknowledging and analyzing the influence of upstream drivers also known as social determinants of health (SDOH) on patient health and health behaviors “helps healthcare providers to better understand the patient experience and to deliver more personalized, contextually relevant recommendations,” Karlsen and co-authors point out, adding that SDOH analyses can help to make lifestyle interventions “accessible and effective for everyone, across all socio-economic backgrounds.”

“These data can also serve as an important supplement to our state and national public health surveillance systems, guiding evidence-based policy development and implementation, systems change and public health investments,” the researchers write. “Incorporating upstream driver data collection into EHRs marks a significant step toward health equity.”

A full integration of lifestyle medicine into mainstream healthcare requires the standardization of data collection across health systems. 

“This will foster benchmarking and will facilitate the identification of best practices among diverse patient populations and settings,” Karlsen and colleagues reiterate. “This will require engagement with Health Level 7 (HL7), and groups already working with HL7, to leverage healthcare data modernization efforts to standardize lifestyle medicine measures that are, or could be, captured in EHR systems.”

The paper is posted in full for free.