Health Coach Welcome to the Wild West Nancey Trevanian Tsai, M.D.
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Transcript of Health Coach Welcome to the Wild West Nancey Trevanian Tsai, M.D.
Disclosures
Board of Directors for American Council on Exercise (non-remunerated position)
Certified Personal Trainer
Advance Health and Fitness Professional
Health Coach
Patent-holder, Institute of Applied Neurosciences, Medical University of South Carolina
Overview
Definition?
“Health Coach”
“Clinical Coach”
“Wellness Coach”
Accreditation?
NCCA
Others
Integrative care
Practice improvement?
PQRS
Practice enhancement?
Cash flow beyond E&M
Definition?
“Health Coach”
Nutrition
Fitness
Behavioral change
“Clinical Health Coach”
Same as above, but seeks to claim more medical education
“Wellness Coach”
“Lifestyle coach”
Welcome to the Wild West!
Historically, health coach probably evolved out of nutritional sciences and professional certifications.
However, health is more than ‘packets of nutrients’
Integrate fitness, nutrition, and address emotional health to optimize long-term behavioral change
NCCA: National Commission for Certifying Agencies
Created in 1987
Has accredited over 300 programs from over 120 organizations to include many from healthcare (nursing, dental, EMTs, etc.)
Ensure health, welfare, safety of the public through accreditation of professional programs
Consistent with The Standards for Education and Psychological Testing
Standards require demonstrate of a valid and reliable process for implementing, maintaining, and governing certifications
Peer-reviewed
NCCA: National Commission for Certifying Agencies
Has proven experience as a certification organization
The process of becoming accredited is educational and will create an even better product
Join other professional groups that have long history of providing peer-reviewed courses of
study
Health Coach
Why?
Epidemic of chronic lifestyle related diseases
Evidence demonstrates coaching is effective
Move toward value-based care
Provides integrative education, including nutrition, fitness, and behavioral change through motivational interviewing
Improve outcomes of health benchmarks
Everyone can use techniques; designated health coaches offer quality at lower present-value cost
Practice Improvement?
PQRS: Physicians Quality Reporting Service
CMS requirement
Avoid penalty
Incentive pay
PQRS offers incentives for care providers to promote health through preventative measures or discussion of behaviors through motivational interviews
Health Coach can assist in gathering and providing health promoting information
BMI and f/u
Unhealthy alcohol use
Tobacco cessation
Weight and physical activity assessment in children/adolescents
Practice Enhancement?
Traditional Model
Provider as expert
Patient told what to do
One size fits all solutions
Extrinsic motivators
Patient assessed on “compliance”
Ignores barriers to change
Leads
Health Coaching
Patient as expert in own life
Patient chooses viable solutions
Individualized solutions
Intrinsic motivators
Collaborative and facilitated change
Addresses barriers to change
Guides
Practice Enhancement?
Motivational interviewing
Engaging, Evoking, Focusing, Planning
Open-ended questions, Affirming, Reflective listening, Summarizing
Cognitive behavioral coaching
Change irrational beliefs into rational ones
SMART goal setting
Specific, Measurable, Attainable, Relevant, Time-based
Summary
Health coach as a partner to physiatric practice
Definition is still being refined
Recommend course providers to obtain NCCA accreditation
Health Coaches can be another provider to offer information meeting PQRS requirements (EHR, registry, etc.)
Possibility of health-promoting opportunity to patients