The New Health Care Environment 

Despite a recent, but short-lived lull in health care spending increases in the U.S.  (due primarily to the economic downturn according to most economists), health care spending rose at the fastest pace in ten years in the first quarter of 2014. While new care models and payment innovations are being introduced, the pressure on payers and providers to engage patients and guide them to better health has never been greater. The outlook is not expected to improve. 

As the leading U.S. authority on health care financing, Emory University's Dr. Ken Thorpe has observed, that U.S. not only spends twice what most other developed countries spend on health care, it faces a higher prevalence of chronic disease due to unhealthier lifestyles. Overweight and obesity are becoming the norm, with rates approximately twice those of Europe.  Even in children and teens, coronary arterial disease and metabolic changes foreshadowing diabetes are becoming more common. It has been estimated that one of two Latino children born today will be diagnosed with diabetes.

These are challenges that many health care practitioners also face. A 2012 study by the University of Maryland’s School of Nursing, for example, found that 55% of the 2,103 nurses that they surveyed were obese. A 2012 Johns Hopkins Bloomberg School of Public Health study found that 47% of physicians studied were overweight. In the case of physicians, weight status can influence whether or not the physician diagnoses a patient as obese or brings up the subject of weight. 

Focusing on the Causes, Not the Consequences, of Poor Health 

While many promising solutions are being introduced in the U.S.--including tying  reimbursement with patient results or rebalancing health care spending by beefing up the primary care system--the main challenge is that many of the solutions focus on the consequences of poor health, rather than the primary causes. When we do address the primary behavioral causes, practitioners and programs usually rely on advice- and patient education-based approaches that rigorous studies have found not only to be ineffective, but can be counterproductive. We need to change. 

The HCQI System Can Help Organizations and Professionals Make a Transition

In the quality improvement field there is a saying: “If you don’t or won’t measure it, you can’t improve it.” While we measure physicians and other providers on their adherence to recommended medical care, we do not measure practitioner adherence to evidence-based health coaching or health promotion. What it clear, is that changing health care will require the use of the same quality improvement approaches that other industries have used to improve product or service quality or value. A new system has been developed to support improvement: the Health Coaching Quality Improvement (HCQI) System. 

The Value of the Health Coaching Quality Improvement (HCQI) System

• Quality assessment and improvement system that can be implemented internally by supervisors, quality personal or mentors.

 

• Standardized process for measuring the quality of programs and the proficiency of staff.

 

• Analytics that allow leaders, staff and purchasers to benchmark or compare and contrast quality ratings between staff or departments or over time.

 

• A validated, tested tool for measuring practitioner proficiency in motivational interviewing-based health coaching approach backed by over 200 rigorous studies and several meta-analyses.

 

• Individual and aggregate reports that can guide program or individual level improvement