How Technology and Telemedicine Are Targeting Obesity

Health care professionals are finding that telemedicine offers yet another way to attack the growing epidemic of childhood obesity.
Health care professionals are finding that telemedicine offers yet another way to attack the growing epidemic of childhood obesity.

For those who doubt that the United States is experiencing an epidemic of childhood obesity, the Centers for Disease Control and Prevention has some statistics that will almost certainly open your eyes to the serious nature of this problem.

According to the CDC, over the last three decades the rate of obesity has more than doubled in children and quadrupled in adolescents. In children between the ages of 6 and 11, roughly 7 percent were obese in 1980, a rate that had jumped to 17 percent by 2012. The incidence of obesity among adolescents between the ages of 12 and 19 grew from 5 percent in 1980 to a whopping 21 percent in 2012.

Telemedicine Can Help

Health professionals looking for new and more effective ways to address this growing problem are turning to the technologies that facilitate telemedicine to give them additional weapons with which to wage the war on childhood obesity.

In late April 2015, the Pediatric Department at the University of Michigan’s C.S. Mott Children’s Hospital launched a telemedicine program that will allow patients to access their evidence-based weight management program remotely. This will cut down sharply on the need to commute to the hospital in Ann Arbor for checkups and counseling, much of which now can be done via video conferencing.

Fruit Street Software Platform

Clinicians at the hospital in Ann Arbor, Michigan, will use Fruit Street Health’s video conferencing platform to interact with both individual patients and groups for the collection of activity and nutrition data between patient visits to the hospital. The Fruit Street Health video platform is compliant with the provisions of the Health Insurance Portability and Accountability Act, which safeguards patient privacy.

To enable Ann Arbor-based clinicians to closely monitor patients’ activity levels and health data, the new telemedicine program integrates a wide array of wearable technologies such as FitBit, iHealth Labs, Jawbone UP, Withings, and even the newly released Apple Watch. These wearable devices allow clinicians and other professionals in the hospital’s weight management program to collect accurate data on blood glucose levels, blood pressure, diet, exercise, sleep, and weight.

Telemedicine brings health care to those in remote areas and also helps rural practitioners to stay abreast of current standards of medical practice.
Telemedicine brings health care to those in remote areas and also helps rural practitioners to stay abreast of current standards of medical practice.

Health professionals involved in the MPOWER (Michigan Pediatric Outpatient Weight Evaluation & Reduction) CONNECT program include not only physicians but also dietitians, exercise physiologists, physician assistants, psychologists, and social workers.

Major Public Health Concern

Noting that childhood obesity is ¨a significant public health concern,¨ Susan Woolford, M.D., director of the weight management program, said that many such children will grow up to be severely obese adults and will suffer from obesity-related illnesses such as diabetes and heart disease.¨

Of her hopes for the MPOWER CONNECT program, Dr. Woolford said, ¨Our goal is to help teens and their families improve their health through lifestyle changes, and we believe that well-designed communications technology can help us connect with our patients and increase the likelihood of our patients achieving success.¨

To accomplish these goals, said Dr. Woolford, the Pediatrics Department selected Fruit Street Health’s software solutions as the best fit for its weight management program. Among FruitStreet.com’s features, in addition to wearable device integration and video conferencing, are a patient dashboard, clinical note-taking capability, interactive chat, a goal-setting tool, visual food diary, and patient scheduling tool.

Demand Outpaces Resources

Helping to fuel the growth of telemedicine applications is the shrinking inventory of health resources available to meet the ever-expanding demand for health care. The telecommunications technologies that provide the infrastructure for telemedicine make it possible for health professionals to deliver diagnostic and treatment services to patients who are located far from hospitals, doctors’ offices, and health clinics.

Telemedicine’s technologies also provide health professionals with a valuable learning tool when it comes to dealing with the multifaceted challenges of childhood obesity. In an article published in the October 29, 2013, issue of ¨American Journal of Medical Quality,¨ researchers recounted their evaluation of a program designed to bring rural doctors up to speed on the latest guidelines for the prevention of childhood obesity.

HEALTH COP Program

Specifically, a research team from the University of California, Davis, studied the experiences of seven primary care clinics in rural California that participated in the virtual HEALTH COP program. HEALTH COP is an acronym for Healthy Eating Active Living TeleHealth Community of Practice. The nine-month HEALTH COP program was designed to help participants learn about the best practice standards for childhood obesity prevention so that they could use them in their own practices and also share them with colleagues.

Cartoons may be cute and clever, but there's very little funny about the problems posed by childhood obesity.
Cartoons may be cute and clever, but there’s very little funny about the problems posed by childhood obesity.

The need for such a program was based on the realization that rural health professionals don’t usually have an intelligence network that they can readily draw on, as is the case for medical personnel in an urban setting. Elaborating, the study’s lead researcher, Ulfat Shaikh, M.D., notes, ¨As an urban pediatrician, if I can’t figure out a problem, all I have to do is find a colleague in the building and get their impressions.¨

As envisioned by Dr. Shaikh, the HEALTH COP program and network will make it easier for rural clinicians to get in touch with far-flung colleagues when faced with such questions.

144 Children in Treatment

The researchers from UC Davis looked specifically at the treatment of 144 children who participated in the study. Each child visited one of the seven rural primary care clinics at least twice during the study period, once before the HEALTH COP initiative was launched, and a second time after the beginning of HEALTH COP.

Clinicians who participated in the HEALTH COP virtual learning program were schooled through videoconferencing and access to a collection of online resources about the facts of childhood obesity and the basics of treatment. Researchers found that clinicians who underwent HEALTH COP training interacted more extensively with the families of the children they were treating. Also noted were statistically significant increases in counseling about the dangers of sugar-laden drinks and too much time spent on video games, as well as increases in guidance on breakfast, family meals, and fruits and vegetables.

Positive Results Noted

Among the children who visited clinicians who took part in HEALTH COP, researchers found significant gains in both nutrition and physical activity after the HEALTH COP training intervention. Another positive development noted in the wake of HEALTH COP intervention was an improvement in peer support among the participating clinics.

In the conclusion to their published report, UC Davis researchers noted that “virtual quality improvement learning networks in geographically-dispersed clinics can significantly increase clinicians’ adherence to guidelines for childhood obesity and improve access to recommended care for rural and underserved children.”

Don Amerman is a freelance author who writes extensively about a wide array of nutrition and health-related topics.

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