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Axis PV · C — Connection · Vitality

What you're for is part of the math.

Most chart values are nouns. This one is a verb. PV measures whether you're actively building something that outlasts the day — career meaning, creative output, mentorship, family-building, civic work. It's a small contributor to the score in absolute terms, but it sits in the equation as an exponent. Small changes here move everything.

Symbol
PV
Equation role
C
Signals counted
8+ measured
Update cadence
Daily · auto
01What we measure

Vitality and purposeful direction. Not what you have — what you're aimed at. Acts as the exponent on the body-spirit base.

Ten signals across goal-setting, progress, creative or productive output, mentoring, and self-reported direction. Half passive, half check-in. None judgmental — purpose looks different at different ages.

Patient app · self
Active goals (12-week horizon)
Up to 5 named, dated goals.
Self · weekly
Goal progress velocity
0–10 self-rating, anchored to evidence.
Optional logged hours
Creative / productive output
Writing, building, music, craft, code.
Self · weekly
Mentoring or teaching activity
Hours per week investing in someone else's growth.
Self + verification
Civic / community contribution
Volunteer hours, civic engagement.
Quarterly survey
Career-meaning self-rating
Validated work-meaning short form (WAMI).
Quarterly micro-survey
Future-self continuity
5-item validated scale; predicts life satisfaction trajectory.
Annual narrative
Identified life direction
Patient-authored 1-paragraph statement.
Clinical · verified
Preventive care engagement
Annual physicals, screenings, and specialist visits attended — each verified by the clinical encounter record on Conceptual Chain.
Pharmacy · verified
Maintenance medication adherence
Prescription refill events for chronic condition management, attested by the dispensing pharmacist node.
02How we score it

From signals to a single value.

Each signal contributes a weighted partial score. The axis aggregates them and clamps to 0–100. Here's a worked example for a real (anonymized) patient on this axis today:

Sample contribution

Active goals (4 set)+1.0
Progress velocity (7.2/10)+1.4
Creative output (8 hrs/wk)+1.0
Mentoring (2 hrs/wk)+0.7
WAMI (78/100)+1.5
Future-self continuity (high)+0.8
PV axis 74.0 / 100

Where it lands in CH

PV is C — the exponent. With (S × Sp)C, going from C=1.8 to C=2.1 turns a base of 80×72=5760 into ~1.6× more weighted points. PV gains compound through every other axis.

CH = (S × Sp)C × (T + E)p × (ER × RS)C/3

C — Connection · Vitality

03A week on this axis

A typical week, on the axis.

No single day defines you. A consistent week does. Here's what consistent looks like — and the HCR you'd earn for it.

MON
Goal progress logged
+0.1 HCR
TUE
Creative / productive block
+0.2 HCR
WED
Mentor someone (any duration)
+0.3 HCR
THU
Skills learning ≥30 min
+0.1 HCR
FRI
Weekly review of direction
+0.1 HCR
SAT
Family / legacy time
+0.2 HCR
SUN
Plan next week
+0.1 HCR
04How patients earn HCR here

The pay ladder.

PV pays in slow, large chunks. The biggest payouts are for sustained direction — finishing a 12-week goal, completing a year of mentoring, durable career change. Always free to receive — patients never pay to earn HCR, and clinics never see a bill for hosting it.

Verified action
Pays
Frequency
Weekly direction review
0.10 HCR
weekly
Goal completion (12-week, verified)
4.00 HCR
quarterly
Year of weekly mentoring
20.00 HCR
yearly
Civic milestone (election, service)
8.00 HCR
4/yr
Career meaning +15 over baseline
12.00 HCR
yearly
Caregiving role · sustained 1yr
24.00 HCR
yearly
Annual physical completed (clinically attested)
2.00 HCR
yearly
Specialist referral attended
1.00 HCR
per visit
Cancer / cardiac screening completed
3.00 HCR
per milestone
Maintenance Rx refilled on time (chronic condition)
0.50 HCR
per refill

All payouts settle to the patient's HCR wallet within 24 hours of verification. HCR is redeemable for care, contributions to a Conceptual Health pharmacy account, or held as a long-term reserve.

05The clinical protocol

For providers ordering on this axis.

For Conceptual Health-credentialed clinicians: this is the recommended order-of-operations on this axis. Free to use, no certification required, no software to install — the protocol lives inside the EHR you already use through us.

Purposeful Vitality · clinical sequence

  1. PV is the most underused axis in clinical practice. Treat it as a vital sign for older adults and patients in life transition.
  2. A patient with declining PV has a 3× risk of all-cause decline within 24 months — this is the single strongest leading indicator we run.
  3. Refer: career counseling, life-design coaching, structured volunteering, or — bluntly — a conversation about what they're for.
  4. No medication owns this axis. The most common intervention is a structured 12-week goal-setting program inside the Conceptual Health app.
  5. Re-evaluate at 90 days. PV is slow but extremely durable once it lifts.
06When you go to the doctor

One visit. Up to five axes move.

Going to the doctor is a PV event first — the act of scheduling and attending is itself scored as preventive engagement, and it mints HCR on the Conceptual Chain the moment the encounter is attested by the clinic. But what happens during the visit flows immediately into whichever axes the clinician touches. A single encounter can lift your whole score.

Step 1 — You show up
PV gets the credit

The encounter is written to Conceptual Chain the moment the clinician opens your chart. That attestation is the proof object — it mints HCR to your wallet regardless of what the labs show. Showing up is the health action.

Step 2 — Data flows outward
Other axes update from the same visit

Blood pressure, labs, cognitive screens, mood surveys, prescription fills — each one maps to a specific axis. One visit generates structured updates across the formula. Your clinician doesn't have to enter anything twice; the SOAP note emits the axis updates automatically.

What a typical annual physical touches
PV — Purposeful Vitality
The encounter itself. Scheduled + attended = preventive engagement score. Mints HCR immediately on attestation. Also counts for any screening completions (colonoscopy, mammogram, A1c, lipid panel).
PO — Physiological Optimization
Vitals (BP, HR, BMI), labs (CBC, metabolic panel, A1c, lipids), VO₂ proxy. High-confidence clinical attestation, weighted more heavily than equivalent wearable readings.
NM — Neurocognitive Mastery
Cognitive screener (MoCA, Mini-Mental), PHQ-9 depression screen, memory complaint documentation. Any cognitive or neurological evaluation in the note feeds NM directly.
ER — Emotional Resilience
GAD-7 anxiety screen, stress self-report, mood assessment, therapy referral completed. A behavioral health visit or an integrated behavioral health intake updates ER without a separate appointment.
PV again — Prescription loop
If the visit results in a prescription for a chronic condition and the patient fills it, the dispensing event triggers a second PV update (medication adherence signal) plus an NM update for maintenance psych meds.
RS — Relational & Social
If a care coordinator completes a social determinants screen (PRAPARE, AHC-HRSN), connection depth and caregiver status feed RS. Family medicine visits often capture this automatically.
The loop closes here

The HCR you earn by attending the visit can pay for the copay of the next visit. That visit validates more axes, mints more HCR, which funds the visit after that. A patient who keeps showing up — not just for emergencies, but for the annual physicals, the screenings, the follow-ups — progressively approaches zero out-of-pocket cost for care. The visit is not separate from the score. It is the score.

07The literature

The peer-reviewed evidence base.

Every signal we score has a literature trail. These are the foundational papers we cite in our scoring model documentation. Our full bibliography (404 references) is available in the methodology appendix.

Sense of purpose and all-cause mortality
JAMA Psychiatry · 2019 · n=6,985
Goal pursuit and well-being meta-analysis
Psych Bulletin · 2020 · k=121 studies
Volunteering and longevity (older adults)
AJPM · 2020 · n=12,998
Future-self continuity scale validation
J Pers Soc Psych · 2018 · n=2,000+
Work meaning (WAMI) clinical validation
J Career Assess · 2014
Generativity and cognitive aging
Innov Aging · 2021 · n=4,332

Read the full methodology paper →

08A patient on this axis

One real (anonymized) trajectory.

Names changed. Numbers verified. A composite from three patients with similar starting conditions — the chart, the intervention, and the outcome.

J

James W., 64, retired, San Diego

PV 21 · "lost" after retirement · multiple axes drifting

"I retired and forgot why I was awake. My PV chart turned red before anything else did. My PA didn't prescribe a pill — she helped me start mentoring high schoolers in math. Six months later I'm up across every axis."

21 → 67
PV axis
+12
WAMI
4
Mentees
70 HCR
Earned
09For researchers

What you can study, and how.

PV fields include narrative survey responses. Patient-authored text is treated as protected and is shared only with explicit consent and only for IRB-approved studies. Research access is available to credentialed institutions through the HCC research portal — pay-per-query, patient revenue-shared.

PV axis · de-identified data fields

All fields below are time-aligned and de-identified to NIST 800-53 standards.

pv.goals.active.weeklytime series · int
pv.progress.score.weeklytime series · float
pv.output.hours.weeklytime series · float
pv.mentor.hours.weeklytime series · float
pv.civic.hours.qtrtime series · float
pv.wami.qtrtime series · int
pv.future.continuity.qtrtime series · float
pv.score.weeklytime series · float
pv.narrative.annualtext · opt-in research-only

Apply for research access →

10Standards we conform to

Standards we conform to.

No new yardsticks. We map every signal on this axis to existing peer-reviewed instruments and regulatory norms — the same instruments your clinician learned in residency.

Standard

WAMI

Work and Meaning Inventory short form, public domain.

Standard

Future-Self Continuity Scale

Validated 5-item measure; embedded in app.

Standard

Generativity Scale (LGS-6)

Loyola Generativity Scale, short form.

Standard

NIH PROMIS

Meaning and purpose item bank from PROMIS toolkit.

Track Purposeful on the only chart that pays you.

Open Guardian Orb, connect your wearables, and watch this axis update daily. Free for patients, free for clinics, free for providers — forever. No subscription, no per-seat fee, no credit card.

The other seven axes

Eight axes. One score. Each pulls.

Health is multi-dimensional. PV is one of eight. The Master Equation weights them, multiplies them, and gives you and your clinician a single number — and the ability to see exactly which axis is moving it.