Physician-led, team-based health coaches have helped many patients with chronic conditions including Type 2 diabetes and hypertension.
The Union Health Center is one such organization that looks to medical assistants to act as health coaches. The practice, a level three patient-centered medical home based in Manhattan, looks to proximity, flexible scheduling, standardized tracking and evidence-based communications approaches to continue their success.
The first step Union Health Center uses is the proximity of clinicians and health coaches. They use the STEPS Forward practice improvement module on health coaching by setting up every three clinicians with a health coach across the hall in order to immediately see patients. The health coaches introduce their role in medical care. At Union Health Center uses health coaches in areas including endocrinology, pulmonology, cardiology, podiatry and ophthalmology.
The second step is flexible scheduling that includes offering appointments by phone for busy patients. The frequency of appointments is also flexible, depending on the need of the patient and the ability to call their health coach with concerns that don’t necessarily need a physician.
The third step to successful health coaching is consistent and standardized tracking of patient appointments. This allows both coaches and other clinicians to be able to follow the patient without interruption.
Finally, evidence-based communication skills allow patients to speak with their health coaches in their native language and engage in evidence-based communications including ask-tell-ask approaches. The ask-tell-ask approach involves asking patients about their health and knowledge of their diseases then tell the patient actionable information using what the patient said. Then, the coach would ask a follow-up question to make sure the patient understands all that was discussed. Coaches also ask patients to repeat, in their own words, what they were taught which is a technique called teach-back.
Finally, using action planning, health coaches help patients find specific ways to improve their health.
