Telemedicine and Nutrition Education for Worksite Wellness

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Telemedicine and Nutrition Education for Worksite
Wellness
Health Management Corporation, Inc.
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Agenda
Denine Rogers - RD, LD HMC Nutritional
Consultant

• Describe telemedicine nutrition education
  techniques
• Discover telemedicine nutrition education
  techniques currently utilized with
  participants
• Describe the impact of telemedicine in worksite
  wellness projects

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Background on HMC
Our Mission Improve the lives of the members we
serve

• Established in 1983, HMC has been providing
  disease / condition / health management programs
  for over 25 years
• Headquartered in Richmond, VA, with employer care
  centers in Richmond, Nashville, Atlanta,
  Denver, Indianapolis and Minneapolis
• Wholly-owned subsidiary of WellPoint serving
  employers, health plans, and government entities
• Major investments in 2006 supported the
  development of a single source health management
  solution through enhanced product, technology and
  talent

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Total Population Management
HMC offers solutions to target members not matter
where they are on the health continuum
Members in Need of Targeted Care Management
Members in Peak Condition
and everyone moving in between
Disease Management
Health Improvement
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Health Management Programs

• An integrated health improvement package that
  delivers unprecedented value
• Proactive member identification, outreach and
  engagement
• Clinical measures based on national guidelines
• Service and member satisfaction surveys
• Financial savings for employers

Solutions for the Total Population

• Disease Management
• Asthma
• Diabetes
• CAD
• COPD
• HF
• Musculoskeletal
• Oncology
• Vascular At-Risk
• Complex Care

• On-line programs and information
• Health Risk Assessment
• Lifestyle Management
• Work site Wellness
• Gaps-in-care/Signals

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Telehealth and Telemedicine Definitions

• Telemedicine
• The use of electronic communication and
  information technologies to provide or support
  clinical care at a distance. Included in this
  definition are patient counseling, case
  management, and supervision/preceptorship of
  rural medical residents and health professional
  students when such supervising/precepting
  involves direct patient care.
• Telehealth
• The use of electronic information and
  telecommunications technologies to support and
  promote long-distance clinical health care,
  patient and professional health-related
  education, public health, and health
  administration.

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Responsibilities of RDs and Nurses in Telemedicine

• Registered Dietitian
• Provide nutrition/dietary consultations to
  participants in the health management programs.
  RDs identify areas requiring improvement and
  consult with patients via telephone to initiate
  behavior change related to dietary intake and
  management.

• Primary Nurse Coach
• Performs care management within the scope of
  licensure for members with complex and chronic
  care needs by assessing, developing,
  implementing, coordinating, monitoring, and
  evaluating care plans designed to optimize member
  health care across the care continuum and
  ensuring member access to services appropriate
  to their health needs.

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Nutrition Educational Services

• HMC Registered Dietitians help the medical team
  to improve the nutritional health of members.
  RDs ensure that the patient understands various
  nutrition goals and objectives by providing
• Nutrition Counseling
• Patient Education
• Positive impact outcomes for individuals
  diagnosed with chronic conditions

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Common Conditions for Dietitian Involvement via
Telehealth

• Anemia
• Cardiovascular Disease
• Diabetes
• Gastrointestinal Disease
• Food Allergies
• Gout

• Renal Disease
• Oncology
• Vegetarian
• Pediatrics
• Pregnancy

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Nutrition Education Techniques

• Using virtual education documentation information
  on a variety of subjects in the areas of
  nutrition and healthcare.
• Nutrition education is done via live chat
  session.
• Nutrition information is sent via mail only.
• Nutrition education information
• American Dietetic Association Manual -
  www.nutritioncaremanual.org/
• Healthwise - http//www.healthwise.org/p_hwkb.aspx
  
• During consultations, the RDs refer members to
  registered sites that are approved by HMC e.g.,
  www.dlife.com, www.webmd.com, www.diabetes.org
  and others.

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American Dietetic Association (ADA) Nutrition
Care Manual

• Member nutrition education material.
• The ADA Nutrition Care Manual is a valuable
  resource providing disease-specific information
  and evaluation, printable member handouts,
  calculators that compute BMI/weight range,
  customization tools and much more.
• Research- and evidence-based nutrition care
  information for more than 80 diseases and
  conditions.
• The ADA Manual is used approximately 80 of the
  time and this depends on the member's
  diagnosis.

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Virtual ADA Nutrition Care Manual
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ADA Nutrition Care Manual Client Materials

• Virtual ADA Nutrition Care Manual

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Healthwise

• HMC RDs and Nurse Care Managers utilize
  Healthwise knowledge database for patient
  education

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Registered Dietitian Call Summary

• Use a computerized phone system. RDs are assigned
  to a specific caseload on a daily basis.
• RDs refer to individualized intervention plans
  created by Nurse Care Managers (NCM)
• Education that the NCM provided to the client.
• Changes the client has already made and their
  willingness to change.
• What the member wishes to discuss further with
  the RD
• In 2008, the RD Team completed a total of
• 85,000 outbound calls
• 5,400 inbound calls
• Average daily outbound calls 300-500
• Average daily inbound calls 20-30

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RD Coaching Objectives

• Must do HIPPA Verification for each call.
• Work with the member to complete their goals.
• Consult the member the same way as if the member
  was in person.

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Telemedicine Impact with Worksite Wellness
Program

• Incentives
• Companies offer incentives to Members by
  participating in the program and
  reaching their goals such as
• Monetary Awards
• Health Club Memberships
• Discounts
• Appreciation Awards
• Member benefits
• Guidance and support to adopt healthier behaviors
• Holistic health management to meet total health
  needs
• Greater understanding and control of health risks
  and conditions
• 24/7 access to a primary nurse and access to
  multi-disciplinary team of health professionals
• Employer benefits
• More appropriate health care utilization which
  can help lower costs
• Better health management for prevalent and costly
  conditions
• Improved productivity satisfaction reduced
  absenteeism
• Integration with health plan for seamless program
  delivery

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References

• American Telemedicine Association
  www.americantelemed.org
• Telemedicine Report to Congress
  http//www.ntia.doc.gov/reports/telemed/in
  tro.htm
• The use and influence of employee incentives on
  participation and throughout in a telephonic
  disease management program. Wilhide C, Hayes
  JR, Farah JR Popular Health Management, 2008
  Aug11(4)197-202.
• Overview Telehealth Promise or Peril?
  Thede, Linda Q. The Online Journal of Issues in
  Nursing Vol. 6, No. 3 September 2001
• The Office for Health Information Technology -
  http//www.hrsa.gov/healtit/frn091906.htm
• The Office for the Advancement of Telehealth -
  http//www.hrsa.gov/telehealth/
• HIPAA -
• http//www.hrsa.gov/telehealth/publications.htm