Physicians Practice/CMWL eBook by William Ellis

OBESITY CARE

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HOW TECHNOLOGY TOOLS CAN INCREASE PATIENT ENGAGEMENT, REDUCE OBESITY

Address the obesity issue with patients

ast week, a middle aged woman came to the office for routine follow up of her thyroid nodules. As is my usual practice, I reviewed her vital signs and saw that she had lost weight from her previous visit. I praised her for the weight loss and asked her the specifics of her successful approach. Her initial response surprised me when she looked at me, and said, "Doctor, of all of the physicians that I see, you are the only one that talks with me about my weight."

MANAGE PATIENT OBESITY AND MEET PAY-FOR-PERFORMANCE GOALS

dence-based treatments, not get the appropriate attention from the physicians of this country? My speculation is that many physicians still think their obese patients do not really want to talk about their weight. If only they would eat less, they would lose weight. If the drugs for obesity and nutritional therapy would be covered by insurance, they would lose weight. If the surgery did not have complications, more people would accept this option and lose weight. In my experience, I don't think my patient's complaint is particularly unique. Patients want to talk to their doctors about all of their medical problems, including obesity. As a country, we can't afford to wait around for all of the treatment- and insurance-related problems with obesity to be fixed. My challenge to my colleagues in all areas of medicine is ask your patients about their weight, then provide education regarding lifestyle changes, medications, and surgery according to the guidelines. We have a public health crisis in obesity, but as a physicians, we can attack it one patient at a time.

OCTOBER 2018

OBESITY: AN AMERICAN EPIDEMIC

INTRODUCTION

WEIGHT LOSS COUNSELING AND MAXIMIZING REIMBURSEMENT

SUCCESSFULLY INTEGRATING MEDICAL WEIGHT LOSS INTO A FAMILY MEDICINE PRACTICE

MANAGE PATIENT OBESITY AND MEET PAY-FOR-PERFORMANCE GOALS

HOW TECHNOLOGY TOOLS CAN INCREASE PATIENT ENGAGEMENT, REDUCE OBESITY

Obesity:

An American epidemic

BY LAWRENCE HERMAN, PA-C, MPA, DFAAPA

t strikes me that there are many Are we really facing an epidemic? The people today whose diseases — answer is yes. Data from the Centers for obesity and overweight — makes Disease Control and Prevention's Behavioral them feel they are taking the "walk Risk Factor Surveillance System reveal that of shame" each day. Their disease obesity rates increased by 37 percent be— and society's frequent tween 1998 and 2006. judgment of its symptoms And with no signs of this Data from the Centers and manifestations — makes slowing, many estimate them feel that they are victhat more than one-half for Disease Control and tims, even if no one is physiof Americans will be afPrevention’s Behavioral cally hurling objects or insults. fected by obesity by the Risk Factor Surveillance Obesity is a medical probyear 2030. That's more lem that we have been System reveal that obesity than 180 million people in reluctant to address, even the United States alone rates increased by 37 though it is becoming more — a staggering number. and more common as twoObesity is a gateway percent between 1998 thirds of Americans are disease that almost aland 2006. either overweight or obese. ways leads to conditions It is such a stigmatized issue most of us recognize as that, as I sat to write this, I was challenged life-threatening, including diabetes and heart by how I could address obesity as a clinidisease. It can be linked to increased risk of cian and as a compassionate human being. stroke, liver disease, depression, and even The best way to accomplish this is to explain cancers. The rapid rise in obesity is startling, obesity as a disease and to bring awareness especially when we recognize the potential to how important it is to help patients who for a corresponding increase in these other suffer from it. devastating diseases.

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OCTOBER 2018

OBESITY: AN AMERICAN EPIDEMIC

INTRODUCTION

WEIGHT LOSS COUNSELING AND MAXIMIZING REIMBURSEMENT

SUCCESSFULLY INTEGRATING MEDICAL WEIGHT LOSS INTO A FAMILY MEDICINE PRACTICE

MANAGE PATIENT OBESITY AND MEET PAY-FOR-PERFORMANCE GOALS

HOW TECHNOLOGY TOOLS CAN INCREASE PATIENT ENGAGEMENT, REDUCE OBESITY

How significant are the repercussions? the people who suffer from its devastating Recent estimates show that the annual effects to the healthcare system managing direct medical burden of obesity alone is it — is enormous and truly underappreciated approaching 10 percent of all medical spendby most. The reality is that this disease caning and likely amounted to $147 billion per not be marginalized or ignored. year in 2008. One study found that obesity What have we done about similar diswas responsible for 27 percent of the rise in eases? We declared war. That is what we inflation-adjusted health spending between did with cancer. In addition to stepping up 1987 and 2001. But you cannot calculate the research efforts to fight the disease, we full cost of obesity just in terms of dollars. focused on increasing awareness and educaDespite what many people think, obesity tion about cancer and its impact. Today, while is not a disease that people can stop by we continue to struggle to eradicate it in all themselves. Nobody wants forms, the most comto be obese. The problem is mon form of pediatric Recent estimates show that losing weight is not as leukemia approaches a simple as just pushing one100 percent cure rate. that the annual direct self away from the table or How can we not do the medical burden of obesity same for obesity? exercising more. There are a multitude of genetic, bioalone is approaching The second week chemical, and environmental in October is National 10 percent of all medical factors that cause obesity, Obesity Care Week. spending and likely much the same way these During this week, sciexact same factors cause entists and healthcare amounted to $147 diseases such as depression providers will focus on billion per year in 2008. or heart disease. the basic science, cliniAdditionally, when a percal application, surgical son does lose weight, there are incredibly intervention, and prevention of obesity. By powerful bio-hormonal factors that immedramatically reducing and eventually eradicatdiately make him feel like he is starving to ing obesity, we will eliminate the collective death and prompt him to eat more. We, or burdens this disease is placing on our socipeople we know, have repeatedly tried to ety. Now is the time to declare war on obelose weight only to regain it. This is not a sity in this country. weakness but a series of powerful driving Lawrence Herman, PA-C, MPA, DFAAPA, is forces that result in a devastating disease. dean and full professor in the College of Health Individuals affected by obesity are comSciences, Physician Assistant Studies, Gardnermonly shunned, and many feel they travel Webb University in Boiling Springs, N.C. Herthat walk of shame each day. What comman practiced in emergency medicine for nearly pounds the problem is society's propensity a decade and most recently was the administrato categorize obesity as something within the control of the individual that is managetive medical director for a large multispecialty able, thereby minimizing the complexities practice. He served on the Board of Directors of the disease and its hold on the individual. for the American Academy of Physician AssisObesity's toll on our community — from tants as president and chair of the board.

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OCTOBER 2018

WEIGHT LOSS COUNSELING AND MAXIMIZING REIMBURSEMENT

SUCCESSFULLY INTEGRATING MEDICAL WEIGHT LOSS INTO A FAMILY MEDICINE PRACTICE

HOW TECHNOLOGY TOOLS CAN INCREASE PATIENT ENGAGEMENT, REDUCE OBESITY

OBESITY MEDICINE: THE FUTURE OF HEALTHCARE OBESITY: AN AMERICAN EPIDEMIC

INTRODUCTION

The Systemic Problem

OBESITY 39.8% (~93 million) of US adults suffer from obesity Obesity accounts for $46 Billion in direct medical costs #2 cause of preventable deaths in the US Linked to 50+ chronic conditions

Join the largest network of non-surgical obesity medicine providers in the US.

MANAGE PATIENT OBESITY AND MEET PAY-FOR-PERFORMANCE GOALS

The Proven Solution

CMWL

Proven proprietary program Initial and ongoing training (with CME credits) Technology platform to facilitate workflow for providers and patients Documentation to maximize insurance reimbursement Business model and financial incentives for practice profitability Unparalleled clinical outcomes and strong longterm patient relationships

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OCTOBER 2018

OBESITY: AN AMERICAN EPIDEMIC

INTRODUCTION

WEIGHT LOSS COUNSELING AND MAXIMIZING REIMBURSEMENT

SUCCESSFULLY INTEGRATING MEDICAL WEIGHT LOSS INTO A FAMILY MEDICINE PRACTICE

MANAGE PATIENT OBESITY AND MEET PAY-FOR-PERFORMANCE GOALS

HOW TECHNOLOGY TOOLS CAN INCREASE PATIENT ENGAGEMENT, REDUCE OBESITY

Weight loss counseling and maximizing reimbursement BY ANN K. KUENKER, DO

ith more than 70 percent of Americans overweight or obese, we are in the throes of a serious population health challenge. It has been well established that obesity can contribute to many serious health conditions, including Type 2 diabetes, cardiovascular disease, stroke, certain cancers, osteoarthritis, sleep apnea, and more. We see this with our patients every day. There is a high fiscal cost as well. According to the 2013 American Heart Association and American College of Cardiology issued Guideline for the Management of Overweight and Obesity in Adults, compared to normal weight patients, obese patients incur 46 percent higher inpatient costs, 27 percent more physician visits and outpatient costs, and 80 percent higher prescription drug spending. The cost of obesity care in the United States is enormous: As of 2008, these healthcare costs came in at about $147 billion.

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In addition to chronic disease, excess weight impacts health in many other ways. Sometimes surgery will have to be postponed if the patient is obese, and additional weight can increase the likelihood of complications, especially for procedures such as joint replacement surgeries. Also, individuals who are overweight are more likely to have workplace injuries. And recently, a leading expert from the American Cancer Society announced that obesity is catching up to smoking as a risk factor for cancer. All these sobering facts remind us that interventions are badly needed. In 2011, The Affordable Care Act included provisions to provide preventative care services. Under these provisions, health plans would be required to cover the U.S. Preventive Services Task Force (USPSTF) recommendations, which include obesity counseling. USPSTF guidelines state that all adults be screened for obesity, and physicians should initiate a conversation about weight loss if the patient has a body mass index (BMI) over 30.

OCTOBER 2018

OBESITY: AN AMERICAN EPIDEMIC

INTRODUCTION

WEIGHT LOSS COUNSELING AND MAXIMIZING REIMBURSEMENT

SUCCESSFULLY INTEGRATING MEDICAL WEIGHT LOSS INTO A FAMILY MEDICINE PRACTICE

As critical as it is, having the conversation about weight loss can be difficult for some physicians, even for those who have been in practice for many years. Broaching the topic of weight with patients might seem like more of a personal affront than discussions about other medical conditions, such as high blood pressure, glaucoma, or other health issues that may be out of their immediate control. In fact, a 2016 Nielsen survey sponsored by the Council of Accountable Physician Practices found that while 52 percent of physicians report that they advise their patients to start a weight loss program, only 5 percent of those patients polled say they heard this advice. Weight loss counseling should be incorporated into physicians’ practices for several reasons. First and foremost, physicians enter medicine with the primary goal to help people, and excess weight adversely impacts overall health. Second, pay for performance measures make screening for BMI and weight management counseling a standard for reimbursement, and these actions must be documented in patients’ medical records. Third, physicians make a difference. Studies show that when physicians talk to patients about weight, patients are more likely to make the behavioral changes necessary to be successful. Many different types of providers, from family practitioners to OB-GYNs can offer weight loss counseling to their patients. According to CMS guidelines, behavioral therapy for obesity should include screening and measurement of BMI, dietary assessment and intensive behavioral counseling, and high-intensity interventions and resources to promote sustained weight loss. These interventions could include weight management protocols to promote permanent lifestyle change and behavior modification.

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MANAGE PATIENT OBESITY AND MEET PAY-FOR-PERFORMANCE GOALS

HOW TECHNOLOGY TOOLS CAN INCREASE PATIENT ENGAGEMENT, REDUCE OBESITY

CMS guidelines state that obese patients qualify for up to six months of covered obesity counseling. After six months of regular visits, a reassessment determining weight loss must be performed and documented. At this juncture, patients must have achieved a weight loss of at least 6.6 pounds to qualify for an additional six months of visits. If they have not reached that benchmark, a reassessment of willingness and readiness is appropriate. Additionally, records should include a comprehensive description of the intervention and measures taken. Medicare suggests documenting the 5-A approach as recommended by the USPSTF (Assess, Advise, Agree, Assist, and Arrange). Obesity screening and counseling are time-based codes and documentation of services should also include the amount of time spent with the patient. Physicians can have the weight loss conversation and not only maximize reimbursement, but they can also augment revenue by making medically designed and developed weight loss protocols available right in their practice instead of referring patients elsewhere for these services. Many patients would be happy to pay out of pocket for a viable weight management solution, especially if suggested by a trusted provider. Reimbursement for obesity counseling gives physicians some “skin in the game” and can be an incentive to help solve a serious public health crisis. Proactive weight loss counseling and interventions are a way to help keep patients and the practice healthy — all while making a meaningful impact in the fight against obesity. Ann K. Kuenker, DO, is a family practitioner in private practice in Traverse City, Mich. She has offered a medically designed and developed weight loss protocol to her patients since 2009. Kuenker sits on the Ideal Protein Medical Advisory Board.

OCTOBER 2018

OBESITY: AN AMERICAN EPIDEMIC

INTRODUCTION

WEIGHT LOSS COUNSELING AND MAXIMIZING REIMBURSEMENT

SUCCESSFULLY INTEGRATING MEDICAL WEIGHT LOSS INTO A FAMILY MEDICINE PRACTICE

MANAGE PATIENT OBESITY AND MEET PAY-FOR-PERFORMANCE GOALS

HOW TECHNOLOGY TOOLS CAN INCREASE PATIENT ENGAGEMENT, REDUCE OBESITY

S P ONS OR ’ S C ONTE NT

Successfully integrating medical weight loss into a family medicine practice

BY PALMA POSILLICO, MANAGEMENT CONSULTANT FOR THE WEIGHT LOSS INDUSTRY

n recent years, more physicians and medical weight loss into his practice in a largely middle- to low-income demographic clinicians have realized the critical area. In addition to seeing significant returns role they play in the identification and within a short period of time, he saw an treatment of obese and overweight increased personal satisfaction in helping papatients. The shift toward clinical care tients achieve better health through physician of obesity is gaining support at a rapid rate. directed, long-term Obesity has been identified weight loss. as the root cause contributing Despite this obesity to more than 59 health condiHOW EZEIGBO tions, including cardiovascular trend, some doctors feel STARTED OUT disease, osteoarthritis, sleep completed ill-equipped to effectively Ezeigbo apnea, and cancer. According his medical degree to the CDC, more than onetreat obesity as a disease and residency training third (36.5 percent) of U.S. in family medicine at and are often uncomfort- Eastern Virginia Mediadults are obese. Despite this obesity trend, some doctors able having meaningful cal School and then feel ill-equipped to effectively a fellowship in sports discussions about the treat obesity as a disease and medicine at Wake Forare often uncomfortable havest University Baptist health risks associated ing meaningful discussions Medical Center. Upon with obesity.1 about the health risks associfinishing his fellowship ated with obesity.1 For family in 1998, he went to practice physicians, obesity can represent a work for Wake Forest University Baptist Medisignificant factor in the health of their patients. cal Center Community Physicians. Walter Ezeigbo, MD, is a family medicine While practicing family and sports mediand sports medicine physician in Winstoncine for several years, he became increasSalem, N.C. Ezeigbo successfully integrated ingly aware of the impact being overweight

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OCTOBER 2018

OBESITY: AN AMERICAN EPIDEMIC

INTRODUCTION

WEIGHT LOSS COUNSELING AND MAXIMIZING REIMBURSEMENT

SUCCESSFULLY INTEGRATING MEDICAL WEIGHT LOSS INTO A FAMILY MEDICINE PRACTICE

MANAGE PATIENT OBESITY AND MEET PAY-FOR-PERFORMANCE GOALS

HOW TECHNOLOGY TOOLS CAN INCREASE PATIENT ENGAGEMENT, REDUCE OBESITY

or obese had on the health of his patients. that weight reduction has a direct positive impact on health. Even a modest 5 percent Ezeigbo was always a big believer in the role weight loss has been proven to reduce the of increased physical activity in promoting health risks associated with obesity. health but, over time, he realized the need Ezeigbo began an in-depth research profor a formalized weight loss and lifestyle cess. He knew that he lacked the complete modification component for many of his knowledge required to patients. He was becomprovide effective weight ing frustrated by medicine After researching and loss tailored for each of that seemed to be all ruling out franchise programs his patients. Lifestyle about the numbers: treatmodification is a difficult ing 25 to 35 patients a day that were too much of a cost thing for most people to and the increasing number burden or would require achieve. of prescriptions to tackle him to invest in stand-alone He sought an authentic chronic and acute medical solution based on sciproblems. build-outs, he found The ence and medical knowlHis goal was to achieve Center for Medical Weight edge that would provide effective preventative care Loss (CMWL). The program him with the training and for his patients. Because tools that would increase seemed to provide the same of the link between obehis confidence in deliversity and many of the offerings as the weight loss ing obesity care. medical issues faced by franchises but with more After researching and his patients, Ezeigbo deruling out franchise flexibility and at significantly veloped a natural profesprograms that were too sional interest in effective reduced costs while filling much of a cost burden weight management. His in any gaps in education or would require him experiences on the chalto invest in stand-alone and providing the digital lenges and frustrations of build-outs, he found keeping his patients at a tools to succeed clinically The Center for Medical healthy weight inspired and financially. Weight Loss (CMWL). him to look for a solution. The program seemed to provide the same offerings as the weight HIS PATH TO PROVIDING EFFECTIVE PREVENTATIVE CARE loss franchises but with more flexibility and WITH A WEIGHT LOSS COMPONENT at significantly reduced costs while filling in Ezeigbo decided to go out on his own to any gaps in education and providing the digiprovide a family and sports medicine practice tal tools to succeed clinically and financially. that also offered a proven medical weight In 2010, he opened Advance Family & Sports loss solution. He was hungry for an answer Medicine Center integrated with a CMWL that would address his patients’ challenges weight loss program in Winston-Salem, N.C. in managing their weight in order to improve their health outcomes. It was clear that many GROWING HIS WEIGHT LOSS PRACTICE of his patients needed help losing weight, and Ezeigbo discovered that integrating medical it was also clear from decades of research weight loss into his family practice offered

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OCTOBER 2018

OBESITY: AN AMERICAN EPIDEMIC

INTRODUCTION

WEIGHT LOSS COUNSELING AND MAXIMIZING REIMBURSEMENT

SUCCESSFULLY INTEGRATING MEDICAL WEIGHT LOSS INTO A FAMILY MEDICINE PRACTICE

MANAGE PATIENT OBESITY AND MEET PAY-FOR-PERFORMANCE GOALS

HOW TECHNOLOGY TOOLS CAN INCREASE PATIENT ENGAGEMENT, REDUCE OBESITY

great flexibility for expanding the overall • lose 100 pounds, practice. Having a turnkey program with a • lower her A1C to 5.3, focus on the intensive behavioral interven• come off all her medications, and tion allowed Eziegbo to address his high-risk • control her blood pressure. obese patient population. His nurse refers any existing patient with a body mass index Ezeigbo’s patients have lost an average of greater than 30 to his weight loss program. 24.1 pounds. Perhaps more importantly, he The other 20-25 percent of his weight loss estimates that approximately 80 to 85 perpatients come from word-of-mouth referrals cent of his weight loss patients have been from existing patients and from online searchable to reduce or eliminate their medications. es. Currently, Ezeigbo reserves two half days 2. Improved revenues: “Financially, this just a week solely for weight loss patients and makes sense,” Ezeigbo says. Since weight integrates weight loss patients the rest of loss screening and counseling is covered the week. Ezeibgo says by most insurance plans, finding a weight loss “I am enjoying medicine again!” the practice benefits as template to tailor to a well as the patients’ health doctor’s practice, along Ezeigbo says. “When people outcomes. Offering mediwith ongoing education cal weight loss attracts new start feeling good, looking and guidance, is key patients to the practice. It is better, and coming off to building a successestimated that the integraful medical weight loss their medications, I feel tion of the weight loss pracprogram. tice with his family medicine

tremendously rewarded.”

THE BENEFITS OF INTEGRATING WEIGHT LOSS INTO A FAMILY AND SPORTS MEDICINE PRACTICE

–Walter Ezeigbo, MD, family medicine and sports medicine physician

Ezeigbo says integrating a weight loss program into his practice has yielded three primary benefits: 1. Overall improved health outcomes: Every overweight and obese person naturally benefits from weight loss. Ezeigbo now routinely sees his weight loss patients lower their A1C, discontinue diabetes and other medications, lower their blood pressure, reduce their cholesterol, and avoid the need for knee replacements. One of his greatest achievements is helping a 78-year-old diabetic patient who weighed 272 pounds. She had been on dialysis for 20 years and was in end-stage renal disease. With the program, Ezeigbo helped her to:

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practice represents approximately 35 to 40 percent incremental revenue.

3. Greater personal satisfaction: “I am enjoying medicine again!” Ezeigbo says. “When people start feeling good, looking better, and coming off their medications, I feel tremendously rewarded.” Ezeigbo’s success is reflected in the quality measures of his practice. His practice has earned a Patient-Centered Medical Home Level 3 recognition. “Every day, I look forward to and am excited about going to work. I am seeing results instead of only chronic medical problems.” REFERENCES 1. Beich, Sara N., et al. “National survey of US primary care physicians’ perspectives about causes of obesity and solutions to improve care.” BMJ open 2.6 (2012).

OCTOBER 2018

OBESITY: AN AMERICAN EPIDEMIC

INTRODUCTION

WEIGHT LOSS COUNSELING AND MAXIMIZING REIMBURSEMENT

SUCCESSFULLY INTEGRATING MEDICAL WEIGHT LOSS INTO A FAMILY MEDICINE PRACTICE

MANAGE PATIENT OBESITY AND MEET PAY-FOR-PERFORMANCE GOALS

HOW TECHNOLOGY TOOLS CAN INCREASE PATIENT ENGAGEMENT, REDUCE OBESITY

Join the Largest Non-surgical Obesity Medicine Network in the US THE CENTER FOR MEDICAL WEIGHT LOSS A proven turnkey, end-to-end obesity medicine program for medical providers • Achieve an average 11% weight loss per patient within the first 3 months. • Earn ~$15K-$20K per month in incremental revenue on a part-time basis. • Comply with USPSTF and CMS guidelines for obesity care. • Strengthen relationships with happier, healthier patients. • Increase your competitive advantage. • Avoid professional burnout. • Launch in under 30 days.

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OCTOBER 2018

OBESITY: AN AMERICAN EPIDEMIC

INTRODUCTION

WEIGHT LOSS COUNSELING AND MAXIMIZING REIMBURSEMENT

SUCCESSFULLY INTEGRATING MEDICAL WEIGHT LOSS INTO A FAMILY MEDICINE PRACTICE

MANAGE PATIENT OBESITY AND MEET PAY-FOR-PERFORMANCE GOALS

HOW TECHNOLOGY TOOLS CAN INCREASE PATIENT ENGAGEMENT, REDUCE OBESITY

Manage patient obesity and meet pay-forperformance goals BY DOUGLAS ROTHROCK, MD

ouston — or should I say Primary care physicians and practitioners are America — we have a also on the frontlines in the struggle against problem. Although Texas’ obesity. However, it’s clear the tried — and most poputried again — diet and lous city exercise prescription has long held a reputation Primary care physicians is not working. as home to the most obese It’s critical that physiand practitioners are population per capita, when cians and specialists we look at the bigger picture, lead the fight against also on the frontlines we see that the Lone Star obesity. Yes, it’s difin the struggle against State is, in fact, not alone. ficult. Traditionally we The nationwide statistics are have not had the time, obesity. However, it’s staggering: in 2013, 69 perskill set, or resources clear the tried — and cent of US adults over the to support our patients age of 20 were overweight or on their challenging tried again — diet and obese, according to the CDC. journey. However, exercise prescription The same year, the AMA there are some simple officially labeled obesity steps you can take to is not working. as a disease. better engage your As a cardiologist, I’m overweight patients, committed to helping my improve patient wellness, measurably impatients avoid the long-term and often fatal prove population health, and — at the same consequences of obesity, including hypertime — positively impact the bottom line of tension, diabetes, heart disease, and stroke. your practice.

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OCTOBER 2018

OBESITY: AN AMERICAN EPIDEMIC

INTRODUCTION

WEIGHT LOSS COUNSELING AND MAXIMIZING REIMBURSEMENT

SUCCESSFULLY INTEGRATING MEDICAL WEIGHT LOSS INTO A FAMILY MEDICINE PRACTICE

1. CONVERSATION

If you have patients who would benefit from losing weight, talk to them about it. Although this may seem like a no-brainer, one-third of patients who are obese report that they have not been told that they are overweight by their physician, according to a Journal of Community Health report. Reimbursement is now available for initiating obesity dialogue with the introduction of obesity screening and counseling for Medicare patients with a body mass index (BMI) of If you have 30 or more.

MANAGE PATIENT OBESITY AND MEET PAY-FOR-PERFORMANCE GOALS

HOW TECHNOLOGY TOOLS CAN INCREASE PATIENT ENGAGEMENT, REDUCE OBESITY

that provide tools to help doctors recommend weight loss as well as motivate and manage the patient to meet their weight loss goals are needed for successful, long-term weight loss. 4. EVALUATION

Aside from being repeatable and sustainable, structured weight loss programs are measurable. We can document the success and objectively evaluate the quality of these programs through patients’ lab results. Positive lab results help improve population health management and patients who better prepare your would benefit from losing practice to respond 2. EDUCATION A study in The Lanweight, talk to them about to pay-for-performance initiatives. cet found that physiit. Although this may seem If physicians can cians do not emphasize overweight nutrition counseling of like a no-brainer, one-third support and obese patients obese patients and an with the tools they of patients who are obese increased emphasis on need — conversaexercise despite the fact report that they have tion, education, that nutrition is actually structure, and evalumore effective for weight not been told that they ation — through loss. Additionally, paare overweight by their repeatable and sustients should be educattainable weight loss ed in the chemical comphysician, according to programs, we can position of their diets and truly help patients to a Journal of Community the roles that insulin and achieve long-term, pancreatic dysfunction Health report. positive effects on play in obesity-related their health and wellissues. They should also being and help our be supported with tools to help them evaluate practices thrive in the pay-for-performance and address their diet. environment as well. 3. STRUCTURE

Simply telling patients that they need to lose weight is not enough. I am a formerly obese patient: I tried dieting and exercise, but it’s not that simple. Losing weight — and more importantly keeping the weight off — is difficult. Repeatable and sustainable weight loss programs

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Douglas Rothrock, MD, is a board certified cardiologist practicing in Prescott, Ariz., and the senior medical adviser for Ideal Protein®, a physician-developed weight loss method. He can be contacted at dougandnancyrothrock@gmail.com.

OCTOBER 2018

OBESITY: AN AMERICAN EPIDEMIC

INTRODUCTION

WEIGHT LOSS COUNSELING AND MAXIMIZING REIMBURSEMENT

SUCCESSFULLY INTEGRATING MEDICAL WEIGHT LOSS INTO A FAMILY MEDICINE PRACTICE

MANAGE PATIENT OBESITY AND MEET PAY-FOR-PERFORMANCE GOALS

HOW TECHNOLOGY TOOLS CAN INCREASE PATIENT ENGAGEMENT, REDUCE OBESITY

How technology tools can increase patient engagement, reduce obesity BY MARISA TORRIERI

hen it comes to obesity, Unhealthy Habits Result in a Growing Probmany physicians believe lem for Americans. The report, conducted by there's only so much TeleVox, a provider of patient engagement interventechnology tools, and tion can do Kelton Research, is “You can load for patients. But new research based on a survey of somebody up with shows that increasing patient more than 1,130 Ameriengagement through technolcans ages 18 and older as much information ogy — in other words, involving and 463 healthcare as you want, but patients in their own weight loss providers. efforts between visits by giving "You can load someuntil they’re actually body them tools such as text-based up with as much exercise reminders — may committed to making information as you want, allow physicians to help those but until they're actually that change, they’re patients in need of weight-mancommitted to making agement assistance. not going to do it.” that change, they're not More than 35 percent of going to do it," Allison –Allison Hart, director of marketing those who don’t follow exact Hart, director of marketcommunications at TeleVox treatment plans said they ing communications at would be more likely to follow TeleVox, told Physicians Practice. "Behavior directions if they received reminders from change is incredibly hard." their doctors via email, voicemail, or text, acTypically, what happens is overweight cording to the report The Obesity Epidemic: patients go to the doctor. The doctor says,

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OCTOBER 2018

OBESITY: AN AMERICAN EPIDEMIC

INTRODUCTION

WEIGHT LOSS COUNSELING AND MAXIMIZING REIMBURSEMENT

SUCCESSFULLY INTEGRATING MEDICAL WEIGHT LOSS INTO A FAMILY MEDICINE PRACTICE

MANAGE PATIENT OBESITY AND MEET PAY-FOR-PERFORMANCE GOALS

HOW TECHNOLOGY TOOLS CAN INCREASE PATIENT ENGAGEMENT, REDUCE OBESITY

"'you need to lose weight' and 'come back in six months or whatever,' but there's no support given on a daily basis," Hart says. "That's where engagement communications plays a part [in] … delivering that encouragement, engagement, and support between visits." Results of the survey support this premise:

or send text messages to patients reminding them to exercise, Hart says. "Our research shows about 46 percent of providers said they use email, voicemail, and text messaging for patient care between visits," Hart says. "I think that what you'll find is that most of them are using [these means of communication] for appointment reminders, • 30 percent of U.S. consumers asserted that lab test results, things like that. We've really receiving text messages, voicemails, or just started talking emails that provide about this idea of patient care between [using] technology “Our research shows about visits would increase beyond the basics." 46 percent of providers said feelings of trust in The good news their provider; for physicians is they use e-mail, voice mail, that these types of • Of the 66 percent of text messaging for patient services are bepatients who have ing offered by an care between visits. I think received a voicemail, increasing number text messages, or that what you’ll find is that of vendors. Howevemail from a healthmost of them are using [these er, physicians and care provider, 51 other healthcare percent reported feelmeans of communication] for providers should ing more valued as a appointment reminders, lab test proceed with patient; caution and ask results, things like that. We’ve • 61 percent of Amerivendors they are really just started talking about cans said they would considering working with questions be interested in and/ this idea of [using] technology such as: What is or happy to receive beyond the basics.” your privacy policy? communications from How do you protect their doctor with tips –Allison Hart, director of marketing communications at TeleVox the data you store on how to manage against perceived their weight; and threats? What • 24 percent of Americans said communications HIPAA guidelines do you have in place? Do from their doctor between office visits such you have external audits? as email, text messages, or phone calls would Physicians should also ask to see a copy of help them better manage their overall health. their latest audit report, Hart suggests. And while about half of physicians surveyed "There's always going to be some level said they already use technology to engage of concern with patient privacy and compliance," Hart says. "The most important thing with patients, the reality is that such engageto do is to choose a vendor that's trustworment is limited. In fact, few physicians actuthy in this area." ally do things such as email healthy recipes

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OCTOBER 2018