wellness connect managing obesity in primary care ragan dubose-morris, phd – director, office for...
TRANSCRIPT
Wellness ConnectManaging Obesity in Primary Care
Ragan DuBose-Morris, PhD – Director, Office for Telehealth Education, South Carolina AHEC, MUSC
Josh Brown, PhD – Director of Clinical Services & Training, MUSC Weight Management Center
Access to Obesity Experts
In 2012, the U.S. Preventative Task Force officially recommended “intensive, multicomponent behavioral interventions” for obese adults.
Shift towards population health standards requires better access to services and care coordination among providers.
Maldistribution of nutrition experts, psychologists, and exercise physiologists across the state creates access issues.
Building on Successful Models MUSC Weight Management Center
Ranked as one of the top 15 medical weight management centers in the U.S.
Evidence-based and multidisciplinary team approach
Lovelace Family Medicine
Implemented by Oscar Lovelace, MD
Practice-based and community-focused approach
South Carolina AHEC
Health professions education
Distance delivery network
Wellness Connect Overview Practice-Based Quality Improvement Project
Goal to include 8 practices over 2 years – will have 9
In order to receive small financial incentive to offset provider time and practice disruption, each practice required to facilitate ~20 patients per year (3 cohorts)
Online Provider Education
Every-other-week telehealth classes for patients with multidisciplinary team at MUSC Weight Management
iPad App for real-time, secure data collection and transmission
Recorded sessions for absent/late starting patients
Participating Practices
Clinical, Educational & Technology Support Team MUSC Weight Management Center
Josh Brown, PhD - Psychologist
Tonya Turner, MPH, RD, LD – Registered Dietitian
David Sword, PT, DPT, CCS – Exercise Physiologist
Patrick O’Neil, PhD – Psychologist and Director
Office for Telehealth Education, SC AHEC/MUSC
Ragan DuBose-Morris, PhD - Director
Ali McMenamin, MA - Coordinator
Duncan McDuffie, BS – Program Assistant
Technology Applications Center for Healthful Lifestyles – MUSC CON
Sachin Patel, MSc - Director
Shawntel Parker, BS - Systems Architect
Frank Treiber, PhD - Endowed Chair
Preceptor & Staff Training
MUSC Weight Management – Online Course for Providers
All personnel
Pre-training assessment
Brief video learning modules (100 minutes; ~10 mins/each)
100% practice participation rate
Sample Topic Areas:
Medical Complications of Obesity
Psychosocial Aspects of Obesity
Physical Assessment of Obese Patients
“Bedside Manner” with Obese Patients
Telehealth Technologies
Cisco SX 10 Codec Camera & Monitor
iPad – TACHL App
Weight Scale
BP Cuff (M/L)
Tape Measure
Launching A New Initiative
Practice Identification
Preceptor/Residency Criteria
Identified Area of Need for Nutrition Services
Broadband Assessment
Equipment Purchase and Installation
App Development
Provider Training
Continuous Feedback Loop
App Data Collection & Review
Results - General
Program “Completion”
1. Attending half of possible classes AND
2. Attending at least one class at/beyond 70% mark
No baseline differences in Weight or BMI between eventual completers and non-completers
No difference in completion rate between clinics
Significant difference in Completion Rate between cohorts, c2(1, N = 53) = 7.43, p = .006 Cohort 1 Completion Rate = 88%
Cohort 2 Completion Rate = 53.6%
Results from Cohort 1
•Time: p < 0.001•Clinic: NS•Time*Clinic: NS
Avg Wt Loss: 5.1kg (4.2%)
Expansion for Cohorts 2-3
Revised Data Collection App and Peripherals
Added Additional Geographic Locations
Included Community Health Centers
Spinoff of Physician to New Practice Location
Sustainability Goals - Working Towards Reimbursement from Third-Party Payers
Results from Cohort 2
•Time: p < 0.001•Clinic: NS•Time*Clinic: NS
Avg Wt Loss: 4.6kg (4.5%)
What we’ve learned (so far)
… Patients were satisfied with telehealth weight
management care (93% would recommend to others)
Standard procedures for patient management are important for maintaining patient engagement (e.g., class reminders, PCP check-in)
Minimal technology issues
App development is an ongoing process
Weight loss results comparable to in-person classes
Remaining Challenges
Payer Parity/Reimbursement Medicare
Medicaid
BlueCross/Blue Shield
Patient Engagement for Entire Program
Faculty Provider Time for Expansion
Contact Us for Additional Information
Ragan DuBose-Morris, PhDDirector, Office for Telehealth Education, South Carolina AHEC, MUSC: www.scahec.net/[email protected]
Josh Brown, PhDDirector of Clinical Services, MUSC Weight Management: www.MUSChealth.org/weight [email protected]