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Virtual Coaching: One Health Plan’s Clever Weight Loss Program

August 27, 2013
by John DeGaspari
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A health plan engages members in year-long Internet-based diabetes-management program

In June of this year, the Government Employee Health Association (GEHA), Independence, Mo., the nation’s second-largest health plan for civilian federal employees and retirees, enrolled 1,500 members in a virtual weight loss management program that it says was successful with nearly 80 percent of participants in 2012. That’s a significant milestone, because it demonstrates that a Web-based technology can be an effective and relatively low-cost way for individuals to lower their health risks.

The program, called Virtual Lifestyle Management (VLM), grew out of the landmark National Institutes of Health-funded Diabetes Prevention Program, a large multi-center study that showed that making lifestyle changes can reduce the risk for developing diabetes. Developed by Los Angeles-based DPS Health, Inc., in partnership with the faculty at the University of Pittsburgh, in partnership with VLM is an online intervention program that provides learning, goal setting, tracking, monitoring and motivation, with limited involvement of a trained coach.

The program, which is supplied as a software-as-a-service (SaaS) agreement, consists of 16 weekly lessons and eight monthly online lessons that are delivered to the participant’s computer via slides and streaming audio narration, together with workbook pages and an action plan. Participants are able to track their diet, and plan and track their physician activity, seeing their results compared to their goals in real time. As of June, 26 organizations have signed on, including provider organizations, health plans, employers and physician groups, according to a DPS spokesperson.

One of the first participating organizations was GEHA. Kathy Ross, director of clinical quality for GEHA, says that in 2008 the insurance plan was looking for a clinically sound, robust “low-touch” way to support its members who were struggling with their weight, were obese, or who had diabetes or cardiac disease. At the time, VLM was the only on-line program it found that was based on the Diabetes Prevention Program, she says.

In the initial pilots of the program took place in 2009. GEHA care management nurses used the program while working with high-risk patients. The intent was that the nurses use this on-line intervention as a tool to open dialog with the members about their weight. In 2011, as GEHA moved from the initial pilot phase and began expanding the program to lower risk members, it shifted to having the DPS Health team of trained clinicians provide coaching and support to VLM participants. This allowed GEHA nurses to focus on other clinical issues with these patients, Ross says, adding that the DPS coaches brought a new level of expertise in weight management coaching.

According to Ross, because the Diabetes Prevention Program was an evidence-based model that had demonstrated very good results, GEHA was confident that the on-line program was clinically solid and tailored to the adult diabetic and cardiac population. By the end of 2012, the health plan enrolled more than 1,000 members in the on-line program. Participants had an average of 54 and an average body mass index of 35. Of those participants, 65 percent tracked their weight; they lost an average of 10.3 lbs or 4.7 percent of initial body weight. The biggest losers lost an average of 28 pounds or 12.9 percent of initial body weight.

Based on the initial results, GEHA decided to expand the program. “We saw that the on-line program was engaging our members and those who participated were losing weight. We got good satisfaction reports from members through surveys and reports from VLM coaches,” she says.

Ross explains that GEHA is able to use data mining claims data to identify members with diabetes and heart disease and those who are likely to be obese. “We reach out to that population by mail and email.  From there, it is up to the member to go to the GEHA-VLM recruitment Web site and apply for the program,” she says.

The program criteria are noted on the Web site and program candidates can also get an early explanation of how the program works before they make their final decision to participate. “We want to make sure the program participants have more than 30 pounds to lose and have been diagnosed with a disease that is impacted by their weight, like type-2 diabetes, pre-diabetes, high blood pressure, coronary artery disease, high cholesterol, sleep apnea or metabolic syndrome,” she says.