Lifestyle medicine innovations: Physical activity assessment in patient care and implementation of a digital health platform to support healthier movement

OBJECTIVE: To introduce the ExerciseRxTM digital health platform as a scalable approach to support personalized physical activity (PA) and home exercise as part of clinical care. DESIGN: Narrative review of Physical Activity Vital Sign (PAVS) integration within an academic healthcare system as well as description and ongoing research on a digital health platform to support physical activity as part of patient care. SETTING: Outpatient clinics within an academic medical center. PARTICIPANTS: Patients across multiple populations, including individuals with limb loss, multiple sclerosis, and primary care cohorts, as well as participants in pediatric rehabilitation, oncology, and rheumatology clinics. INTERVENTIONS: Integration of two standardized PAVS questions into the electronic health record and development of the ExerciseRx digital health platform incorporating smartphone and wearable step count tracking, personalized activity goals, and AI/ML home exercise sensing innovations. MAIN OUTCOME MEASURES: Self-reported PA levels, associations with demographic and clinical factors, healthcare utilization, and feasibility and usability of the digital health platform. RESULTS: PAVS assessment implementation demonstrated that a majority of patients across multiple clinic populations did not meet PA recommendations and highlighted demographic and clinical differences in activity levels. Higher self-reported PA was associated with lower healthcare utilization while controlling for confounding factors. Preliminary findings involving the ExerciseRx platform showed feasibility, high usability, and increased PA engagement, while enabling providers to monitor patient progress with actionable data. CONCLUSIONS: Routine assessment of PA through PAVS, combined with digital health tools such as the ExerciseRx platform, may help identify insufficiently active patients and support personalized, home-based exercise at scale. This approach aligns with priorities in lifestyle medicine and population health, with further research needed on clinical integration at scale.