Telemedicine and primary care obesity management in rural areas – innovative approach for older adults?

BMC Geriatrics

Debate

Sarah N. Pletcher¹  James E. Stahl²  John A. Batsis³ 

[1] Geisel School of Medicine at Dartmouth, Hanover, NH, USA;Centers for Telehealth, Dartmouth-Hitchcock, Lebanon, NH, USA;Section of General Internal Medicine, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, 03756, Lebanon, NH, USA;Geisel School of Medicine at Dartmouth, Hanover, NH, USA;Section of General Internal Medicine, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, 03756, Lebanon, NH, USA;Geisel School of Medicine at Dartmouth, Hanover, NH, USA;The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA;Dartmouth Centers for Health and Aging, Dartmouth College, Hanover, NH, USA;Health Promotion Research Center at Dartmouth, Lebanon, NH, USA;Dartmouth Weight and Wellness Center, Lebanon, NH, USA;

关键词: Obesity;    Weight loss;    Medicare;    Telemedicine;    Primary care;   

DOI  :  10.1186/s12877-016-0396-x

 received in 2016-03-18, accepted in 2016-12-10,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe growing prevalence of obesity is paralleling a rise in the older adult population creating an increased risk of functional impairment, nursing home placement and early mortality. The Centers for Medicare and Medicaid recognized the importance of treating obesity and instituted a benefit in primary care settings to encourage intensive behavioral therapy in beneficiaries by primary care clinicians. This benefit covers frequent, brief, clinic visits designed to address older adult obesity.DiscussionWe describe the challenges in the implementation and delivery into real-world settings. The challenges in rural settings that have the fastest growing elderly population, high obesity rates, but also workforce shortages and lack of specialized services are emphasized. The use of Telemedicine has successfully been implemented in other specialties and could be a useful modality in delivering much needed intensive behavioral therapy, particularly in distant, under-resourced environments. This review outlines some of the challenges with the current benefit and proposed solutions in overcoming rural primary care barriers to implementation, including changes in staffing models.ConclusionsRecommendations to extend the benefit’s coverage to be more inclusive of non-physician team members is needed but also for improvement in reimbursement for telemedicine services for older adults with obesity.

【 授权许可】

CC BY   
© The Author(s). 2017