In-office vascular and autonomic testing

Measura for physicians

Measura for physicians is in-office vascular, autonomic and metabolic testing: small-fiber and autonomic studies that pick up change before the diagnosis, structured cognitive screening paired with vestibular and balance testing, and reports filed to the chart as structured documents for MIPS and HEDIS reporting.

You are already managing the consequences of vascular, autonomic and metabolic dysfunction. Measura measures it, so the management stops being inferential.

The argument for adding this testing to a practice is a clinical one. It finds disease earlier in patients you already see, it pairs cognitive screening with objective fall-risk assessment in the population most likely to fall, and the data it produces maps onto the quality measures you are already reporting.

What does in-office testing add to a practice?

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How does the testing fit a clinic workflow?

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How common is poor metabolic health?

In the general adult population, under 12.2% of American adults met a full definition of optimal metabolic health in the National Health and Nutrition Examination Survey for 2009 to 2016, a share that fell below 7% on the tighter criteria applied after 2021 — so roughly 88% of US adults did not. In the Padda Institute patient population the picture is starker still: fewer than 3% of patients overall, and fewer than 1% of chronic pain patients, meet the same definition of metabolic health. Those are practice-reported figures from our own population, not trial outcomes, and individual results vary. A screening protocol built on the assumption that abnormality is the exception will under-detect in almost any adult panel.

How the argument differs by specialty — pain management, orthopedics, primary care, psychiatry and cardiology each have a distinct reason to measure.

Common questions

Does a physician have to be present during testing?

Supervision requirements depend on the study and the setting, and are addressed directly in supervision and staffing for in-office testing.

How do results get into our EMR?

Reports are delivered as structured documents that can be filed to the chart. Getting results into the chart.

What training does the person performing the studies need?

Consistency of technique matters more than credentials for most of these studies. What makes a good tester.

How does this affect quality scores?

Several of the measures are things you are already required to document. Quality measures this testing supports.

What type of doctor does autonomic testing?

Any practice already managing the consequences of vascular, autonomic and metabolic dysfunction. Pain management, orthopedics, primary care, psychiatry and cardiology each have a distinct reason to measure. The studies run in your own office, supervision requirements depend on the study and the setting, and consistency of technique matters more than credentials for most of them.

How do you tell if you have autonomic dysfunction?

You measure it. Small-fiber and autonomic changes come before the diagnoses they belong to, so a history and an exam leave management inferential. Measura’s in-office autonomic studies record the change directly, and the report goes to the chart as a structured document you can act on.

Is metabolic testing worth it for a practice?

The case is clinical. The testing finds disease earlier in patients you already see, pairs structured cognitive screening with objective fall-risk assessment in the population most likely to fall, and produces data that maps onto the MIPS and HEDIS measures you already report. With under 12.2% of US adults metabolically healthy in NHANES 2009 to 2016, a protocol that treats abnormality as the exception will under-detect.

References

• Araújo J, Cai J, Stevens J. Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016. Metabolic Syndrome and Related Disorders. 2019;17(1):46–52. doi:10.1089/met.2018.0105

Medically reviewed by Dr. Gurpreet Singh Padda, MD, MBA, MHP, medical director of Measura. Last reviewed August 20, 2026.