Health coaching

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Health coaching is the act of aiding an individual to achieve their health goals. Health coaches serve as guides that help individuals set and achieve goals, identify and overcome barriers and provide tools to promote healthy living.

Health Coaching Origins

Health coaching originally became popular in the 1990's due to the successful behavior change seen in Alcohol cessation programs using motivational interviewing skills. While equally effective to other approaches (such as Alcoholics Anonymous, motivational interviewing cost considerably less. Since then, similar techniques have been shown to be successful and cost effective to promote change for many other negative health behaviors.

The Health Coach's Role in Patient Care

While not generally considered a part of the care team, health coaches serve as low-cost motivational interviewers that have been shown to help patients meet predetermined goals. While it is necessary for coaches to possess some clinical understanding, the health coach model has been proposed as one way in which low-cost personnel could help to increase the quality of care, improve health outcomes and reduce costs. A great deal of research also exists to support this claim [1][2][3][4].

Health Coaching in Informatics

Limited research exists at the intersection of the health coaching care model and informatics. Jimison describes a scenario in which remote health coaches use video-conferencing software in conjunction with “smart-home” sensor data to provide health coaching services to at-home seniors. Others have taken a different approach, instead offering a “virtual health coach” instead of a person to promote health behavior change[6]. The result is an adaptive set of informational materials that can help individuals with weight loss/management, smoking cessation, control over substance abuse and stress management [7][8].

Incorporating Health Coaching Data into the Electronic Medical Record

While currently not practiced, a case can be made for a future in which the interactions between a health coach and a patient were incorporated into the Electronic Health Record system. It is thought that this practice would provide a closed-loop system in which physicians would have access to observations made and goals set by health coaches. This would allow for increased collaboration between primary care providers and coaches, resulting in further improvements of health outcomes and efficiency.

References

1: Margarite J. Vale; Michael V. Jelinek; James D. Best; Anthony M. Dart; Leeanne E. Grigg; David L. Hare; Betty P. Ho; Robert W. Newman; John J. McNeil

2. Coaching patients On Achieving Cardiovascular Health (COACH): A Multicenter Randomized Trial in Patients With Coronary Heart Disease. Arch Intern Med. 2003;163(22):2775-2783.

3. Young D, Furler J, Vale M, Walker C, Segal L, Dunning P, Best J, Blackberry I, Audehm R, Sulaiman N, Dunbar J, Chondros P. Patient Engagement and Coaching for Health: The PEACH study--a cluster randomised controlled trial using the telephone to coach people with type 2 diabetes to engage with their GPs to improve diabetes care: a study protocol. BMC Fam Pract. 2007 Apr 11;8:20. PubMed PMID: 17428318; PubMed Central PMCID: PMC1854904.

4. Lessons Learned from Practice-Based Network Innovators: Alan M. Adelman and Marie Graybill. Integrating a Health Coach into Primary Care: Reflections From the Penn State Ambulatory Research Network. Ann Fam Med 2005 3:S33-S35; doi:10.1370/afm.317

5. Jimison HB, Pavel M. Integrating computerbased health coaching into elder home care. In: Mihailidis A, Boger J, Kautz H, Normie L, editors. Technology and Aging. IOS Press; Amsterdam, The Netherlands: 2008.

6. Grolleman, J. and van Dijk, E.M.A.G. and Nijholt, A. and van Emst, A. (2006) Break the habit! Designing an e-therapy intervention using a virtual coach in aid of smoking cessation. In: Proceedings Persuasive 2006. First International Conference on Persuasive Technology for Human Well-being, 18-19 May 2006, Eindhoven.

7. http://www.virtualhealthcoach.com/

8. http://www.healthwise.org/products/virtualcoaching.aspx

Submitted by Steve Williamson