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PURPOSEUTILITY AND FEASIBILITY OF DIGITAL HEALTH COACH PORTAL
• Designed to increase communications between nurse coaches and patients outside of clinical interactions
• Provide a snapshot of each patient – including clinical and behavioral information (goals)
• Provide opportunities for patients to engage in skill building beyond interactions with coach by providing series of mini-behavioral interventions
OBJECTIVES
PORTAL COMPONENTSHOW THE PORTAL WORKS
• The health coach sets goal(s) with patient during live sessions and enters goal into portal
• Based on patient profi le and goals set, the portal provides recommendations for specifi c messages and content that the coach can share with the patient
• The health coach then selects and pushes out mini behavioral interventions (i.e., problem solving) via email and text to patient
• The portal provides coaches with a snapshot of each patient, including progress toward goals
STUDY DESIGNDESCRIPTIVE STUDY
• 19 interviews (health coaches, n=15 and administrators, n=4), 40% of which were nurses
• Convenience sample from 5 large hospital systems in NC
• Thematic analysis was conducted of interview content
RESULTS/OUTCOMES • Health coaches and administrators believed the portal would benefi t them by assisting in the standardization of health coaching practice
• Patients felt the portal would facilitate integration of coaches into the clinical setting and acknowledge their value in helping patients achieve clinical goals
• Health coaches and their administrators believe that providing tools and skill-building opportunities to their patients between sessions are critical for improving patient outcomes in the clinical setting
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BACKGROUND/SIGNIFICANCE • 117 million are US adults living with chronic disease
• Patients struggle to meet goals due to a lack of self-management skills
• The burden of care often falls on the patient
• Health coaching is a proven strategy to help patients build these skills beyond limited interactions with healthcare providers
• Health Coaching is:
- A partnership to assist patients in gaining the skills, knowledge, and self-effi cacy (confi dence) to achieve their self-identifi ed health goals
- The patient is the expert in their own health
• Health Coaching has proved effective in reducing health care costs:
• Proven outcomes of Health Coaching include:
• Nurses are continually tasked with taking on a larger role in helping patients meet clinical targets
• Stepping into role of health coach
• Time with patients is already strained
Opportunity for Impact
Opportunity for Impact
Opportunity for Impact
*Systolic blood pressure<140 mm Hg and diastolic blood pressure<90 mm Hg. †Glycemic control de� ned as HbA1c<7.0%. ‡LDL-C<70mg/dL
6 hours a year in the office (including with physician, nurse, dietitian or other specialist)
5,000 waking hours for a patient to manage on their own
Reduces total medical
costs by
per person/per month
$23.27
Lowers costs for facility and professional
services by
per person/per month
$8.48
Health coaches
Administration
Hospital systems in area
Thematic analysis
Interview
Four topics:• Interviews explored health coaching practice
• Needs• Reactions to the proposed portal
• Thoughts about integration of the portal into the process-of-care of the organization
n=25
n=4
”I think the problem is…we are trying to fi t coaching into a system that wasn’t designed for the type of activity that we do.”
– Administrator
“It would be helpful to…let some [patients, PCPs, etc.] know the value of health coaching. I feel like it’s just not something that is really recognized in health care and people really don’t understand the benefi t or the value.”
– Health Coach
REFERENCES[To be determined]
The health coaching portal allows coaches to input clinical and behavioral data about each patient and centers around goal setting.
Based upon the goal the patient sets with the health coach, the portal allows the health coach to browse and select the most relevant tool to share with the patient.
Following the coaching session, the portal facilitates the coach pushing out a problem-solving exercise to the patient via text message.
The patient accesses the problem-solving exercise at home and practices self-management skills in between coaching sessions.
Through the portal, the health coach can see how the patient is progressing with the problem-solving exercise. The portal also recommends some specific ideas that the coach can use for follow-up at the patient’s next coaching session.
Access to Resources
Social Support
“The second biggest challenge is lack of resources for them to complete their
goals. Whether that is money, whether that is time, whether that is physical ability.”
“For the most part, a lot of these folks also have some kind of social need, so to have
someone to talk to them, to reassure them, to encourage them, I think would probably get more of the results we were looking for.”
• Study participants ultimately, perceived it would improve patient outcomes
• From the thematic analysis two study segments were identifi ed:
• Nurses with mulitiple roles, who functioned as coaches, saw the portal as effi cient, organized, and needed a system to connect with patients, keep records, and help patients build-long term skills
DISCUSSION/CONCLUSIONNurse coaches found that it provided value through increased communication and through the evidence-based skill-building opportunities to increase patient self-management skills
Next steps:
• Optimize the portal based on fi ndings and conduct a feasibility study before pilot testing in a real-world clinical setting
IMPLICATIONS [Icons or Graph? Help with image.]
Incorporate a portal into clinical practice that will help nurse coaches:
Most Important Aspects of the Portal
42.1%
Increased patient engagement
31.6%
Access to the health coach
15.9%
Record consolidation
10.6%
Standardization of the practice
Pure Health Coaches
Health CoachesWith Multiple Roles
• Only meet 1 or 2 times • Sessions limited to 15-30 minutes • Also conducting health screenings/ educational courses
“I think it could really help in making long-lasting changes and keeping [patients] connected…”
“I think it just gives you one more way to reach the patient.”
Pure Health Coaches
Pure Health Coaches • Meets weekly or bi-weekly• Patients stay with coaches for up to one year• Load of 60-70 PATIENTS
“This is exactly what we would ask them if they were sitting right in front of us.”
“I think this is good information, but once you’ve done coaching for a while, this is basically [useless].”
“So this right here is a coaching session… This to me is just an IT coach.”
Provide additional value
through increased communication with
patients beyond what is offered in health coaching sessions
Provide a method to
standardize the process of health
coaching and direct patient-health coach interactions to drive to desired clinical
outcomes
Help patients build skills to increase self-management skills outside of health coaching
sessions
9%Average of
fewer preference- sensitive surgeries
89%patients meeting at least one of their identified goals
reduction in hospital
admission rate
10-12%60%increase in patient
engagement levels
Jessica Brueggeman, RN, MPHSVP, Health Behavior GroupMicroMass Communications, Inc.919.256.2403 | [email protected]
Address time constraints
Standardize the Health Coach role
Promote patient optimal self-management behaviors
Attain improved clinical outcomes