Assessments of a health-related matter of interest, importance, or worry to a patient, patient’s family, or patient’s healthcare provider that could identify a need, problem, or condition.

Data Element

Physical Activity

Evaluation of a patient's current or usual exercise.

Examples include but are not limited to frequency of muscle-strengthening physical activity, days per week with moderate to strenuous physical activity, and minutes per day of moderate to strenuous physical activity.

Applicable Vocabulary Standard(s)

Applicable Standards
  • Logical Observation Identifiers Names and Codes (LOINC®) version 2.74


The concepts outlined under…

The concepts outlined under Physical Activity (e.g., days/week and hours/day of Physical Activity; and muscle strengthening) in the applicable vocabulary standards identify Logical Observation Identifiers Names and Codes (LOINC®) version 2.73.  However, there are similar concepts that are in SNOMEDCT that may be in use (e.g., SCTID: 639700 - Muscular strength development exercise (regime/therapy)) that should be included. Suggest that the equivalent concepts in SNOMEDCT are supported.

IHRSA Supports Physical Activity Assessment

IHRSA - The Global Health & Fitness Association supports the Physical Activity Alliance submission of the Physical Activity Status data element to standardize the assessment of physical activity (PA) into the U.S. Core Data for Interoperability (USCDI), including all four applicable standards addressing the components of aerobic and muscle strengthening PA. Please find the attached letter of support.

4-17-23 IHRSA Support for Assessment of Physical Activity Status in USCDI v4.pdf

NCPDP Comment

NCPDP supports the use of LOINC codes for assessments and observations for physical activity. NCPDP utilizes LOINC codes in the HL7/NCPDP Pharmacist eCare Plan.

Inclusion of physical activity in core data

I am writing to express my support for the Physical Activity Alliance's application to add Physical Activity Status as a data element to the next iteration of the US Core Data for Interoperability. 

The proposed Physical Activity Status data element is comprised of four standardized measures:

(1) Average frequency of moderate to strenuous exercise each week; 

(2) Average duration of moderate to strenuous exercise;

(3) Total minutes of moderate-vigorous physical activity/week; and

(4) Average frequency of muscle-strengthening exercise each week.

These measures are validated in the peer-reviewed literature1,2 and are aligned with the 2018 U.S. Physical Activity Guidelines for Americans.3

Integrating the Physical Activity Status data element into existing platforms is readily feasible for electronic health record systems. In fact, two of the measures are already included in the voluntary 2015 Certification Companion Guide on Social, Psychological, and Behavioral data (Paragraph (a)(15)(v)); which is currently followed by approximately 150 electronic health record systems in the U.S. Therefore, for the systems that already adhere to the certification criteria, adding the Physical Activity Status data element would simply require the introduction of the muscle-strengthening measure, which should fit into the existing workflow, user- interface, and data exchange codes. Furthermore, the Physical Activity Alliance is developing a HL7 FHIR implementation guide involving the proposed measures, which we expect will be sent to balloting in May 2023 and published in the Fall of 2023.

Being physically active is one of the most important lifestyle behaviors for maintaining physical health, mental health, and well-being.3 As a primary care sports medicine physician practicing musculoskeletal medicine daily, physical activity is a critical part of every conversation whether they are young or old and regardless of their current level of exercise and physical activity. In my two leadership roles, medical director of the Women's Sports Medicine Center and incoming President of the American Medical Society for Sports Medicine, I regularly advocate for many components of physical activity. Physical activity is included in our intake forms for all patients asking details related to the data elements above. Having this as a standard data element would enhance how practitioners across the nation discuss physical activity with their patients which is especially important now since so much is known of the value of physical activity yet we are in an epidemic of sedentary lifestyle. 

Evidence suggests that routine assessment of physical activity by clinicians leads to more referrals for exercise programming, greater weight loss for patients with obesity, and improved hemoglobin A1c levels in patients with diabetes.4 Despite these potential outcomes, however, widespread implementation of physical activity assessment is inhibited by the lack of standardized physical activity measures. Adding Physical Activity Status to the USCDI would further solidify and standardize physical activity measures in the electronic health records in the U.S., which could dramatically improve the health of the public and bring U.S. healthcare costs down.5 Therefore, we urge ONC to maintain Physical Activity Status as a data element within the final USCDI version 4.

Thank you.


Marci Goolsby, MD, FAMSSM

Primary Care Sports Medicine, Hospital for Special Surgery (HSS) New York, NY

Medical Director, Women's Sports Medicine Center at HSS

1st Vice President, American Medical Society for Sports Medicine

1 Coleman KJ, Ngor E, Reynolds K, Quinn VP, Koebnick C, Young DR, Sternfeld B, Sallis RE. Initial validation of an exercise “vital sign” in electronic medical records. Med Sci Sports Exerc. 2012;44:2071–2076. doi:10.1249/MSS.0b013e3182630ec1
2 Harris C, Watson K. A data users guide to the BRFSS physical activity questions: How to assess the 2008 Physical Activity
Guidelines for Americans. Atlanta, GA: CDC; 2011.

3 US Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition. 2018.


CDC's Consolidated Comment for USCDI v4

The Centers for Disease Control and Prevention supports adding physical activity to the USCDI. Physical activity is an important health behavior and like smoking and alcohol consumption should be included in routine clinical assessment. We support the addition of the Physical Activity Status Panel to the next version of the USCDI. In addition to voicing our support, we would like to reinforce the need to include all four data elements for physical activity required to meet/assess/measure compliance with national PA guidelines:

  1. The frequency of aerobic activity in episodes per week,
  2. The average usual duration of aerobic activity episodes,
  3. A calculated value multiplying #1 and #2 to arrive at minutes per week, and
  4. The number of episodes per week of muscle strengthening activity).

To obtain the full health benefits of physical activity, the Physical Activity Guidelines for Americans (2nd edition) (PAG) recommends, for example, that adults perform at least 150 minutes per week of at least moderate-intensity aerobic physical activity (the aerobic guideline) in addition to performing muscle strengthening activity that includes all major muscle groups at least twice weekly (the muscle-strengthening guideline). Other recommendations in the PAG also apply to young people and older adults. The peer-reviewed science that forms the basis of the Guidelines recommends this combination of activities because it is important for optimal health and thus, is important to monitor in the clinical setting. The four physical activity elements proposed to add to the USCDI are necessary to measure whether people are meeting these two guidelines

  •  Comments from NACCHO: NACCHO supports the inclusion of the data element physical activity status. At the local health level, having this data will aid in creating community health assessments (i.e., chronic disease health assessments) and community health improvement plans.

ACLM Letter of Support for Physical Activity Assessment

This field is for general comments on this specific data element. To submit new USCDI data classes and/or data elements, please use the USCDI ONDEC system:

Please see the attached letter of support from the American College of Lifestyle Medicine for the Physical Activity Alliance's application to add to add Physical Activity Status as a data element to the next iteration of the U.S. Core Data for Interoperability (USCDI).

ONC letter of support JT 3.15.23.pdf

Support for Assessment of Physical Activity Status in USCDI v4

Comment submission on behalf of Dr. Michelle Albert, AHA President (2022-2023)

The American Heart Association (AHA) supports the addition of the draft data element to standardize the assessment of physical activity (PA) into the U.S. Core Data for Interoperability (USCDI), including all four applicable standards addressing the components of aerobic and muscle strengthening physical activity. The AHA has been supporting the “It’s Time to Move” initiative by helping to convene experts, work with regulatory agencies, engage in the HL7 process, and manage the HL7 project work group calls for developing the Physical Activity FHIR Implementation Guide. We encourage ONC to include the entire PA data element in the final version 4 of USCDI.

CREP letter of support

Please find attached The Coalition of the Registration of Exercise Professionals’ letter of support for the Physical Activity Alliance’s application to add Physical Activity Status as a data element to the next iteration of the U.S. Core Data for Interoperability (USCDI).

CREP ONC Letter of Support USCDI V4.pdf

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