GREENVILLE, SC – Lack of exercise isn’t just a matter of being a couch potato, it’s frequently a direct contributor to chronic diseases that kill more than 1.7 million Americans every year and cost more than $24 billion in healthcare expenditures.
Now, from the heart of the stroke belt, comes a first-in-nation coalition that brings together medical school-based research with doctors, community resources and exercise professionals in an audacious partnership to slow the progression of chronic disease.
Greenville Health System (GHS), the University of South Carolina School of Medicine Greenville, the YMCA of Greenville and the American College of Sports Medicine have partnered on this innovative program. The Exercise is Medicine Greenville program goes beyond prescribing exercise to also tracking it as part of the patient’s electronic medical record – as a vital sign comparable to blood pressure or cholesterol – so that the clinician and fitness team has nearly real-time access to exercise progress and can intervene with the patient to get them back on track as needed.
“We’re trying to change the whole culture of not only how healthcare professionals view exercise but also how they can use exercise as a first line of prevention and treatment for their patients’ fitness and health. Getting enough exercise each week shouldn’t be seen simply as a nice option or luxury if people have time; we need to make it a priority and better help patients truly understand the scientific health benefit that we see as researchers and doctors,” said Jennifer Trilk, Ph.D., director of the Human Performance Lab at the USC School of Medicine Greenville and a national leader in exercise and lifestyle medicine.
The Greenville med school was one of the first institutions in the nation to lead that charge; clinical exercise physiology is already required teaching in all four years of the Greenville med school’s curriculum as a way to educate future physicians on the health benefits of exercise.
“Lifestyle behaviors – and, in particular, exercise – produce healthy heart and metabolic effects in the body which improve patient health, independent of significant weight loss,” said Trilk. “Many people struggle with body weight, and significant weight loss sometimes takes months and even years to achieve. The good news is that effects of exercise on the patient who has low back pain, diabetes, high cholesterol, high blood pressure or early cardiovascular disease occurs much more quickly. These sometimes less-obvious but vital improvements can be reinforced in the doctor/patient relationship as a measurable success while the patient-doctor team continue to work together to decrease the patient’s body weight over time.”
Patient Patricia Manley called the pilot program a “blessing in disguise.”
“If I wasn’t offered the opportunity to be in the program, I don’t think I would be here today,” said Manley. “I think I would be laid back in a bed somewhere. So, when the pilot program was offered to me, I had to take that chance. I knew life wasn’t going to be easy if I didn’t try to do something different. Trying something different changed my life. I want to keep at it until I can’t keep at it anymore.”
Manley, who has chronic kidney disease, has found that exercise has improved her kidney function as well as glucose and cholesterol levels. She’s also lost 26 pounds. Before the program, she had times when she would spend three days in bed because she just didn’t feel like getting up and being active. Now, she has days when she wants to spend the entire day at the YMCA, she said.
Through GHS’ Epic-based patient electronic record, clinicians are prompted to ask how much exercise patients get each week. Anyone getting less than the U.S. Physical Activity Guidelines recommendation of 150 minutes/week of moderate-intensity exercise would be targeted to receive physician-based counseling along with detailed health tutorials developed as part of the program. Patients at-risk or already with chronic conditions such as hypertension, high cholesterol, diabetes and obesity, as well as chronic musculoskeletal issues like chronic low back pain, can be referred into the specially-developed 12-week exercise and support program.
Exercise is Medicine Greenville’s lofty goal has already drawn praise from U.S. Surgeon General Regina Benjamin, who called prevention “imperative” as more American families struggle to deal with chronic diseases like diabetes, hypertension and strokes.
“Much of the illness and early death related to these chronic diseases can be prevented by increased physical activity,” said Benjamin, who served as the 18th U.S. Surgeon General. “This is an innovative approach that, through a prescription and then a tested referral-feedback process, links the medical profession with physical activity professionals and community resources. I commend these organizations for their vision and leadership.”
The just-launched program is currently limited to four GHS practices: the Center for Family Medicine, the Internal Medicine Clinic, Mountain View Family Medicine in Greer and Cypress Internal Medicine in Greer. Approximately 70 patients have already been referred into the program, with expansion to other GHS practices planned.
“As a physician who practices Lifestyle and Sports Medicine, the Exercise is Medicine Greenville program has been one of the best programs I have had patients participate in,” said GHS’ Bobby Masocol, MD, who has referred patients into both a pilot program and the just-launched program. “I always tell patients that exercise is better than any medication that I can prescribe. To have a program that is sustainable, helps patients long-term and supports physicians is something that health care needs. The patients that I have sent through the program have improved their depression, lost weight and were able to get off some of their medications. I’m grateful to have a resource like this.”
The 12-week group intervention includes twice-weekly exercise routines targeted to each patient’s chronic disease or lack of physical activity as well as face-to-face and technology engagement to progressively build positive lifestyle behavioral changes that will help the patient accomplish, maintain and sustain their chronic disease self-management. The program is available at the GHS Life Center, Caine Halter Family YMCA Downtown, Eastside Family YMCA in Taylors, GHS Family YMCA in Simpsonville and George I. Theisen Family YMCA in Travelers Rest. Specially-trained fitness professionals, who’ve received training beyond the standard level now found in the industry, work closely with the referred patients to provide individualized exercise plans and on-going behavioral and emotional support. The exercise program is targeted to unique issues faced by the patient with chronic disease – for example, patients with hypertension may receive a cardio-metabolic routine that focuses on aerobic exercise while a patient with chronic back pain or osteoporosis may receive a musculoskeletal routine that focuses on strength/mobility issues.
The cost of the program is $199, but the YMCA offers scholarships to those with demonstrated financial need that are referred into the program. Upon completion of the program, participants are encouraged to continue exercising to help ensure that the new practices become ingrained habits.
“Due to the rising epidemic of obesity and related diseases within our community, the YMCA and its partners have adopted Exercise Is Medicine Greenville as a key way of offering solutions to those patients ready to take control of their health,” said Scot Baddley, president of the YMCA of Greenville. “We see firsthand the life-changing transformation that these patients have made and are continuing to make – and it is incredible. We are grateful to have the opportunity to work with our partners to establish physical activity intervention as a new standard in health care.”
“As part of a national, charitable, non-profit association that’s focused on youth development, healthy living and social responsibility, we are also proud to help remove economic barriers to participation so that no one is denied access due to ability to pay,” said Baddley.
The American College of Sports Medicine launched the Exercise is Medicine Solution and the professional credential, which med school researchers then augmented for Greenville by providing in-depth training ranging from behavioral health support to detailed analyses on the cumulative effect of these diseases on the body.
“Exercise is Medicine is committed to the belief that physical activity is integral to patient health and improved treatment outcomes,” said Adrian Hutber, Ph.D., vice president for Exercise is Medicine. “Greenville Health System is a real pioneer in health care by implementing the EIM Solution. We applaud the commitments of the system and the community to improving the health of residents.”
“Creating accountability, motivation and appropriate follow-up for lifestyle interventions is the key to making Exercise is Medicine a cornerstone of preventive medicine and chronic disease management,” said Hutber. “The combined efforts of our partnership will enable us to provide better outcomes, reduce healthcare costs and enhance the quality of life for all.”
About Greenville Health System
Greenville Health System (GHS) — an academic health system that is the largest not-for-profit healthcare delivery system in South Carolina — is committed to medical excellence through research, patient care and education. Prisma Health offers patients an innovative network of clinical integration, expertise and technologies through its eight medical campuses, tertiary medical center, research and education facilities, community hospitals, physician practices and numerous specialty services throughout the Upstate. The 1,358-bed system is home to 15 medical residency and fellowship programs. Visit ghs.org for more information.
About University of South Carolina School of Medicine Greenville
The University of South Carolina School of Medicine Greenville is a partnership between the state’s largest university, the University of South Carolina (USC), and one of the largest health systems in the Southeast, the Greenville Health System (GHS). Located near GHS’ flagship tertiary hospital Greenville Memorial Hospital, the medical school graduated its first physician class in spring 2016. This “different school of thought” is dedicated to providing exceptional training for new physicians in transforming healthcare delivery. Learn more at www.greenvillemed.sc.edu.
About the YMCA of Greenville
The YMCA of Greenville is, and always will be, dedicated to building healthy, confident, connected and secure children, adults, families and communities. With a focus on youth development, healthy living and social responsibility, the Y nurtures the potential of every youth and teen, improves Greenville’s health and well-being and provides opportunities to give back and support neighbors. Begun in 1876, the YMCA of Greenville serves more than 70,000 people annually through programs that include Afterschool, Resident Camp and Day Camp, Aquatics, Youth and Adult Sports, and Health and Wellness. Programs are offered through four family branches, as well as the Verdae YMCA, Y Camp Greenville, Judson Community Center, the Program Center – GHS and the Hollingsworth Outdoor Center. The Y is also home to Y Teen Services and the SC Youth in Government program. For more information about the YMCA of Greenville, visit ymcagreenville.org, or call (864) 412-0288.
About The American College of Sports Medicine
The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 50,000 international, national and regional members and certified professionals are dedicated to advancing and integrating scientific research to provide educational and practical applications of exercise science and sports medicine. For more information, visit acsm.org.