Health Coaching is Driving Practice Transformation
Health coaching is on the rise as an active healthcare practice transformation strategy. Several forces drive widespread acceptance of this strategy in clinical practice settings. To be sure, robust health coaching supports development and accreditation of Patient Center Medical Homes. However, even more significantly, it adds power to the promise of patient engagement, activation and the potential for improved clinical and cost outcomes. Here is how.
- Practical Path to True Population Health
A growing commitment to implement population health in primary care, and even in specialty care, warrants attention to identifying and intervening with patients at highest risk. Teaching, telling and prescribing high risk patients episodically when they present themselves for treatment has not proven to be a highly effective path to achieving the Triple Aim. Being more proactive, partnering with high risk patients to maintain and advance their health status does work. Proactive care coordination which mixes education for self-management with behavioral and lifestyle modification helps the patient set stage for health while mitigating costly exacerbations.
- Behaviors Core to Maintaining and Improving Patient Health
Many patients who are high risk, and high cost, achieve that designation as a result of diagnoses of diabetes, heart failure, COPD, depression and cancer. While genetics may be a contributing factor for some, these conditions are frequently earned by less than optimal health behaviors of the individual or habits of their cultural setting. Sixty percent of factors leading to premature death are within one’s control according to the New England Journal of Medicine, and 50 to 70 percent of determinants of health are as well, according to the Centers for Disease Control. Engaging patients by coordinating their care, identifying and addressing care gaps and inspiring improved behaviors holds promise for mitigating patient risks and costs, particularly unnecessary hospitalizations and ER visits.
- Value of Partnering and Relationships
Most physicians and healthcare professionals grant value to the power of building a trusting relationship with their patients. The importance of positive patient relationships along with how essential continuity of patients will be for practices in value based reimbursement magnifies their value for every practice. Select healthcare professionals exhibit an amazing capacity to forge such relationships with patients. Less well understood are the active ingredients for achieving such trusting relationships. Evidence from coaching sciences is definitive in this regard – when professionals recognize the patient as capable the stage for positive, productive relationship is set.
The basis of patient centered care is recognition that the patient is the great underutilized resource in healthcare. Most care for those who are high risk and with chronic conditions is self-care. Recognizing patients as capable and developing their self-management skills leverages the knowledge of healthcare professionals into the 98 percent of the time that those patients are not in a medical office or healthcare setting. While the Triple Aim is the end game for healthcare, partnering with patients based upon their interests, collaborating to set care plans and inspiring patient accountability for their own health future is the powerful prize for all.
True practice transformation represents change. Seldom does it come easily or quickly. Success emerges from thoughtful plans around process, teams with both clinical and behavioral change skills, and strategies for a new level of patient engagement. Effective health coaches focus the intent of practice transformation and help in assuring capacity to meet its promise.
William Appelgate, PhD, CPC
Founder of Clinical Health Coach