Julie Ebeling interviews Amy Lemmons
| Julie: | Hi Amy, can you tell us a little bit about yourself, where your work and your role. |
| Amy: | My name is Amy Lemmons. I work with Integrated Health Partners. We are a physician owned organization, a large group of independent providers that hold a membership. We’re NCQA certified membership and adhere to quality standards that are required by the health plans.
We also provide health coaching through our population health department, which is where I work. I’m a clinical health coach, coaching for one of the employers in the community. We’ve actually contracted with one of the employers, and they are a nation-wide company, so we do health coaching for their employees, a benefit that they offer to their employees nation-wide. |
| Julie: | Oh great, and where are you located? |
| Amy: | We’re located in Battle Creek, Michigan. |
| Julie: | How did you decide to become a coach? |
| Amy: | Well, there was an opening here at Integrated Health Partners. I was actually an administrative assistant with the company for two years. When the opportunity opened, they were offering the training through the Clinical Health Coach, so I applied for the position, went through the training and became a clinical health coach. |
| Julie: | Do you have a clinical background? |
| Amy: | No, I don’t. I have worked in doctors’ offices, and things like that in the past, but no I didn’t have a focus in the clinical area. |
| Julie: | Can you tell us how your training went? |
| Amy: | I feel that the training with Clinical Health Coach really provided all of the background to be able to be an effective health coach. We have registered nurses on staff as well. So, when we’re coaching the participants, if a question arises about a medication or a procedure that we don’t have the clinical background to answer, we will pass that person along to one of the nurses in our office so that they can address clinical questions. |
| Julie: | How often do you see your patients, and how many would you say that you have? |
| Amy: | We actually do most of our health coaching telephonically. There’s only maybe one or two that have come to the office for a face-to-face visit. Many of our participants are spread across the United States, we do a lot of telephonic coaching. |
| Julie: | Is it required by their employer, or is it something that they elect to do? |
| Amy: | It’s definitely elective, but if they choose to participate, their employer provides them with value-based insurance design benefit for diabetes, that covers 100% of the costs for all of their prescriptions, and their diabetic supplies and tests. |
| Julie: | What is the one thing that most excited you regarding the value of the clinical health coaching? |
| Amy: | I think the opportunity to help people make a change in their life, a lifelong change so they have a greater value, quality of life. |
| Julie: | What skills from the training do you utilize as you coach? |
| Amy: | The motivational interviewing. I am a strong believer in motivational interviewing, both in my coaching world and my personal world as well. It’s really made a difference in communicating with people, and being able to build rapport and relationships.
I stick strongly to the tools of motivational interviewing, and by doing so, I’m able to build that relationship with somebody over the phone, and find out what’s really important to them, so that we can consistently go back to that, when they’re struggling or they encounter a barrier. |
| Julie: | What impact have you created with your patients through your coaching? |
| Amy: | Well, I’ve had one successful smoking cessation. I had a patient who had recently lost her husband to lung cancer, and her goal was to quit smoking. We were able to use the tools that I learned through the coaching, to get her to a place where she is now, over a year cigarette free.
She had a pretty tough time going the through the grieving stages, so wanting to quit smoking on top of grieving was a challenge. But, we just really stuck with the motivational interviewing, and with that relationship, we were speaking to each other on a weekly basis, and were able to build that relationship to where she was able to overcome the smoking. I have also had several coached patients with diabetes who have reported because of diet and exercise lifestyle changes, their doctor has removed them from diabetic medications. Their A1Cs are at a level where it’s considered normal, and they no longer required such medications. |
| Julie: | What other skills have you utilized help your patients be successful? |
| Amy: | The listening skill. It’s helped me to be a better listener, so I know what to listen for, and what’s important to them. Pairing that with the motivational interviewing, knowing what to listen for and what questions to ask, has really helped. |
| Julie: | Sounds like you work in the population health arena? How did this training equip you or help you, to become a player now, in this population health? |
| Amy: | Not having that clinical background, I really wasn’t sure what population health was all about. The training really prepared me for that. It helped me understand population health as a process. It broke it down and taught me how to group people into a population, then to target that population.
Since we’re a physician organization, I’ve really been talking with our director about the opportunity for us to start coaching for some of the provider offices that are members. They’re utilizing care managers right now, but I can also see where health coaches could come alongside the care managers, very similar to the way that we’re working in the office, taking patients that may need to work on their health goals, but not necessarily need a lot of that one to one nurse care. It would take a load off the care managers, while reaching a larger impact in the patient population. |
| Julie: | Do they seem open to that? |
| Amy: | It’s something that they’ve definitely taken to leadership and are discussing. We would have to target select offices, and say, “Is this something that you would be willing to pay for, as a service?” |
| Julie: | How do you measure your patient outcomes? |
| Amy: | For the employer now using our coaching, we report to them outcomes that are a part of our contract. One of those is seeing a decrease, in the cost of insurance claims. Through health coaching, we’re able to provide that, because our diabetics are no longer taking medications for that, so they are seeing that impact.
We’re also measuring outcomes according to HEDIS measures, eye exams for those with diabetes, etc. We’ve employed the PHQ-2 and 9, for all of our patients, because their employer also has a HelpNet benefit. Employees are able to speak with a behavioral health counselor over the phone, or access inpatient or outpatient treatment, if they need that for behavioral health. We are gauging, measuring all of that and reporting that back to the employer. |
| Julie: | Do you have any particular breakthrough patients or success stories, that you could share with us? |
| Amy: | The one with the smoking cessation individual who had lost her husband. Her motivation for change was to live a longer life. There are at least 15 individuals with diabetes with whom I have coached that have been removed from their diabetic medications for six months to a year. |
| Julie: | Is there anything else that you want to share that I haven’t mentioned? |
| Amy: | I feel that health coaching is really a proven method that can change the lives of patients, and healthcare overall. I would just love to see more providers utilize health coaches in their offices. I feel that in doing so, we’d see a greater improvement in health outcomes and population health. |
| Julie: | It sounds like you’re doing a wonderful job helping patients meet their goals. |
| Amy: | I have had good feedback from my participants that they value the program. We do a lot of different things for them. Not only the health coaching, but if they’re on restricted diets for diabetes, we provide them with recipes and help them build better diets. We really try to partner with them, walk beside them and let them know we are on their team to help them meet their health goals by doing whatever we can do. |
| Julie: | That sounds like a wonderful program and truly satisfying work, Amy! Thank you! |
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