How telehealth coaching can improve patients’ health outlook and outcomes, while saving on care-delivery costs
By Peter Rasmussen, MD
The days of “one-off” telehealth consultations are rapidly morphing into an era that will be characterized by mainstream integration of remote care as an optimal option for many use cases. As telehealth makes this shift, virtual condition-specific health coaching is poised to become telehealth’s next big value proposition, in a market potentially worth $7 billion.
This is unsurprising as the benefits of virtual coaching—where patients connect with condition-specific experts from around the world to inform chronic disease management—are seemingly endless. Employers are slowly catching on, and as one 2020 survey noted, they are turning to third-party virtual coaching solutions for mental and behavioral health (51%), metabolic syndrome and diabetes (37%), maternity care (29%), and other conditions.
However, while 60% of health plan members want condition coaching, eight in 10 have never had it offered to them, according to another study.
With chronic conditions accounting for seven of the top 10 causes of death worldwide and 90% of $3.8 trillion in U.S. annual healthcare costs, employers are wise to pay attention to this opportunity and look for ways to incorporate coaching into benefits packages.
Virtual health coaching 101
Today, an estimated 128,000 health coaches and educators work with clients to manage chronic conditions, modify lifestyle choices, and achieve challenging health goals. And while virtual coaching can take many forms, from bimonthly telephone calls to weekly video-based consultations, even the most basic telehealth coaching program can make a big impact.
In 2017, a 12-week digital health program for patients with rheumatoid arthritis (RA)—which paired patients with virtual coaches for weekly telephone calls focused on lifestyle changes—led to measurable improvements in medication adherence, sleep, and activity levels. A similar 2016 study of telephone-based health coaching that incorporated motivational interviewing, shared decision-making, and collaborative goal setting led to reduced hospital admissions for heart failure patients.
Given that these coaching interventions were relatively low tech, the results and return on investment speak for themselves. Consequently, it is safe to reason that coaching strategies could be significantly leveled up through use of state-of-the-art virtual care platforms, remote monitoring tools, and other resources.
Think of it this way: If a team is aiming to win the World Cup, would it rely on just any decent coach? Or would it work with an elite coach who utilizes best-in-class techniques, technology, and experience to achieve that goal?
In the long game of healthcare, patients who have access to top coaches to engage and collaborate with them, as part of a comprehensive virtual care program, have the best shot at improving outcomes and avoiding adverse events linked with chronic diseases.
Incorporating coaching into your virtual health program
While numerous case studies highlight the value of condition-specific virtual health coaching, they also raise several questions for employers, benefits managers, and even health plans. For example: What coaching programs should take priority, given limited resources? And which patients stand to benefit the most?
Consider the following three best practices when rolling out a successful condition-specific virtual coaching program:
- Align patients with the right coaching experience. Virtual condition-specific coaching is an ongoing commitment, and a client’s first few sessions with a clinical coach are critical in establishing the cadence of a relationship that supports the client’s progress and goals. Individuals who participate in a coaching program should have access to experienced professionals who not only can relate to their struggles and needs, but also are digitally savvy and experienced in communicating over web-based video interfaces.
- Incorporate tools and apps into the coaching program. Building the right remote monitoring apps or digital tools into the coaching experience can improve compliance and help an individual’s care team track progress and spot negative trends (e.g., weight gain of five pounds within 48 hours) before they escalate and lead to high-cost emergency care. For example: a lifestyle coaching program for individuals with diabetes would benefit from the use of digital apps or connected remote monitoring devices to track blood sugar levels, log meals, and issue alerts if something requires clinical intervention.
- Offer unlimited access to medical expertise. While a health coach can address ongoing lifestyle maintenance needs, patients at risk for disease who have one or more chronic conditions, such as diabetes or hypertension, are at higher risk for more complex, problematic diagnoses (e.g., heart disease, cancer). An employer’s virtual care program should be comprehensive and include access to virtual second opinion programs (which facilitate access to leading medical experts), so that patients can receive the best and most accurate diagnosis and care when they need it.
Going forward, employers and health plans have an enormous opportunity to serve individual beneficiaries through virtual, condition-specific health coaching. Organizations that take into account the real-life needs of their particular workforce (e.g., healthcare professionals, train operators) in developing their programs will be well positioned for 2021 and beyond to make a significant impact in the lives of individuals with chronic care management needs.
Peter Rasmussen, MD, is chief clinical officer at The Clinic by Cleveland Clinic, and professor of neurosurgery in the Department of Neurosurgery, Cleveland Clinic and Cleveland Clinic Lerner College of Medicine, Case Western Reserve University. Dr. Rasmussen is a past-president of the Society of Neurointerventional Surgery, where he played a leading role on the national stage in continuing societal initiatives to train and support veteran and new practitioners in an area of medicine that is transforming treatment approaches to neurovascular conditions.