Telephone-Based Coaching on Shared Decision making, Behavioral Change, and Health System Navigation Reduces Utilization and Cost
This article describes how Health Dialog Services Corporation (a part of BUPA) developed a telephone-based care management programme that enables patients to participate in their treatment decisions with the support of telephone–based health coaches who help at-risk individuals learn to participate in decisions with their doctors, improve self-management skills, and more effectively navigate the health system.
The programme demonstrated its feasibility with a range of patient populations stratified by health status and risk and reduced hospital admissions and medical costs when offered to a larger portion of the population.
The article is intended to provide information to enable others develop similar innovations.
It describes the key elements of the programme including:
- Identification of at-risk individuals: Predictive models identify individuals likely to need health care services in the near future who thus might benefit from coaching.
- Outreach to gauge interest: Individuals identified by the model receive an outreach call directly from a health coach or from an interactive voice recognition system, or are contacted by mail, e-mail, or text message to determine their interest. Once connected to the patient, the health coach assesses the patient's health care needs, readiness to change health-related behaviors, and receptivity to working with the coach.
Periodic, telephone-based coaching: An assigned health coach periodically calls the patient to offer support through conversational (rather than scripted) interactions, with the length and frequency of such conversations being based on each patient's needs and receptivity to coaching.
Feedback to physician: After each interaction, coaches send the patient's regular physician a letter indicating the patient has received coaching services.
The article also sets out the key steps in the planning and development process, the resources used and skills needed, and things to consider when adopting this approach.