Health coaching is a systematic approach to help patients attain knowledge, proficiency, tools and self-reliance in order to actively engage themselves in self-care and attain self-recognized health goals.

Health coaching aims to coach patients suffering from chronic conditions by supplying relevant information, and facilitating proficiency and confidence to take care of themselves. However, in patients with acute conditions patients are advised to take medication or go for surgery.

A health coach teaches the patient about the necessary action(s) to be taken by the patient to prevent any serious complications arising from the chronic health condition. For instance, a health coach can train the patient in reading blood glucose levels with the help of a glucometer. This can help the patient take relevant corrective measures to avoid worsening or complications of the condition.

Who is a Health Coach?

A health coach is an individual who is designated to ensure the personalized mentoring of the patient. A health coach can be any member of the multidisciplinary team of nurses, social workers, medical assistants (MAs), community, health workers, and health educators. Sometimes the health coach may even be another patient who has attained the appropriate training to deal with a health condition.

Registered nurses (RNs) and social workers are considered to be good health coaches. A RN is well trained to pass on skills and knowledge necessary for self-care. Social workers are also well trained to introduce a behavioral change in patients. However, considering the fact that both RNs and social workers are rarely found in primary care units, medical assistants are generally best fitted to serve as health coaches. A competent health coach is never directional and tries to shift the treatment methodology from rescuing to coaching the patient. The health coach slowly develops a bond with the patient and the treating clinicians during the health coaching process.

Principles of Health Coaching

Health coaching is a specific patient-centric process that has five basic principles as highlighted below:

Offering Self-Management Support

This is the most important aspect of health coaching program as it entails health care outside the hospital settings. Basically, a health coach aims to train patients in seven areas of self - management support as enlisted below:

• Educating the patient through relevant information
• Educating with disease-specific expertise
• Encouraging healthy habits
• Communicating problem-solving proficiencies
• Helping in dealing with the emotional turmoil of a chronic disease on the patient
• Assuring regular follow up
• Encouraging patients to be dynamic in self care

Studies have revealed that self- management support results in an overall improvement in health status.

Link Between Physician and Patient

On various occasions there may be a loss of the expected close connection between the physician and patient  due to a lack of proper communication. For instance, the physician may prescribe medications; however, the patient might miss one or more doses, which can affect the overall prognosis. A health coach acts as a link in such situation and closely monitors and operates within the challenges faced by the patients.

Facilitating the Patient to Steer Through the Health Care System

Many patients require a facilitator to consult and connect with in various health care services. A health coach can assist the patient during the whole process.

Emotional Support

Dealing with chronic conditions can be overwhelming for the patients. A health coach develops a bond with the patients and provides much-needed emotional support to the patients.

Seeing patients on a regular basis

A health coach regularly visits the patients and addresses their concerns. This time that is devoted to patients is typically more than most physicians can achieve in their regular clinical practice.

Models of Health Coaching

There are many ways in which a health coaching program can be employed in medical practice. However, there are two models of health coaching that have been considered successful in coaching patients to health.

• The Teamlet model - Here the health coach aims to visit the patient for 15 minutes or more (depending upon the need of the patient) to coach the patient. This model aims to combine the attendance of an MA or health worker with a physician. This small team addresses the patient in his/her language. The health coach conducts pre-visits for understanding the medication requirement and to set a schedule. After this, a visit is made with a physician. During further visits a health coach ensures that the patient understands and agrees to the designed treatment plan.
• The hospital-to-home model- Post-discharge after a prolonged hospital stay, patients are usually unclear about medications and disease management at home. The Care Transitions Intervention is the most accepted coaching method which teaches expertise in such personal health management, and trains patients and caregivers as to the right treatment approach to be followed at home. This model operates on the four following methodologies:
• A consistent medication management approach
• Eliminating hurdles for follow-up appointments
• Understanding and responding to deteriorating signs and symptoms
• Utilizing a personal health record to check 30-day health goals, health information and important queries to be cleared by the physician during upcoming health visits.

The Care Transitions coach (a nurse or social worker) initially meets the patient in the hospital followed by a subsequent visit to the home. Post meeting, the care transitions coach ensures that the patient is called three times by phone, to ensure the right treatment modality is being followed.