In July, I had the opportunity to deliver a webinar for MedFit Network on data analytics and population health for the medical fitness profession. I believe the MFN is spot on in their interest in data, and here’s why.
Over the past decade medicine has ushered in the era of population health and “big data”. I have been following this trend through my employer health plan Optum (in Minnesota). Optum has been sending white papers about big data, and how artificial intelligence and machine learning will solve many problems associated with medicine.
The main issue they see as a problem is patient retention. It seems that in many physician groups in the US, patients are not happy with their health care (doctor visits, procedures, complicated bills, lack of follow up, high price of prescription drugs, too many prescriptions, etc.), so they jump ship. A.I. has made it easier for physician groups to identify potential patients who are not satisfied, or how have already left their plan, and incentivize them to return. If they can regain 3% – it’s a win.
Data for the Heath and Fitness Profession
This is NOT what the health and fitness movement is all about. Most people who pay for a health club membership do so because they want to be there. If they have a medical condition – they have an extra incentive, but want to know they are in good hands as they go through their wellness program. The MFN, and other associations are working hard to make this happen. Therefore – what do we need big data for, anyway?
We live in a world of information. Our dishwashers, computers, and phones are interconnected in some ways. Wellness should be too. We already collect data. From the time I entered into the wellness and fitness profession in the mid-1980s, we collected data. Mostly biometrics – on body fat, strength, VO2, range of motion, etc. Then came psychometric data on quality of life, pain management, and behavioral change. Now we are looking at medical information – such as blood and salivary testing online, and the results of other types of tests – such as home-based blood pressure, blood sugar, stress management, and anti-aging. We also are looking at sophisticated methods of analyzing vitamin and mineral absorption, and lastly – the rise of precision wellness methods such as Nu-Calm mitochondrial health units, Resp-E-Rate biofeedback monitors, hyper and hypobaric chambers, EECP compression sleeves for cardiovascular health, and cryotherapy for enhanced recovery.
All of these issues need data. Not just the kind you record on a piece of paper and place in a folder in the fitness room. The kind of data that can look at the results of a 20-week wellness program for cancer survivors, and see that they improved their fitness 200%, and their quality of life by 40%. Those are big numbers – and they happen all the time in fitness programs. Especially for the growing number of persons with diagnosed medical conditions who NEED the services of groups from the MedFit Network, or Medical Fitness Association, or Exercise Physiology Society, or Cancer Exercise Specialist network, or others.
Is Fitness Outcomes BETTER than Healthcare Data?
It is data that will allow for the integration into healthcare. Why? Because the current system is broken on every level. Let’s look at home healthcare. Most workers are minimum wage, and can perform basic ADL activities for clients. They cannot, however – take a client from one level of health, and improve it 100%. Medical fitness practitioners can. From prescription drug and opioid crises to the vaccine debacle to unnecessary surgeries to Medicare fraud to political lobbying to hospital mergers – the quality of care for people of all ages has declined. In fact, recent reports state that white American men are actually declining in age. These statistics look at emotional health, weight, suicide, and drug and alcohol abuse, which is causing a decline in both white and black populations since the late 1990s.
Regarding the precision wellness mentioned above – I feel it will be a huge part of our current wellness and fitness profession – as it will allow persons who cannot partake in fitness programs at their early stage of fitness to improve on their cellular health, cardiovascular fitness, and pain levels before lifting a single dumbbell. Precision wellness programming will add another dimension to medically-based fitness, as well as huge profit margins for many types of programs. The issue of reimbursement and health care contracting is becoming another level of discussion regarding many of these types of programs, as well.
The recent report from Marshall and Groves looking at post-rehab fitness for medical conditions such as cancer, diabetes, hypertension, back pain, and Alzheimer’s shows us that data can be used effectively to look at large population groups in a variety of health club settings. Groves and colleagues standardized exercise protocols – but I believe that if outcomes are standardized – persons who teach Pilates and yoga, or other movement therapy could attain similar results over time.
Wellness data will also allow for more direct negotiations with health plans for contracts pertaining to wellness and fitness services. In the current system, few programs are receiving reimbursement because so few ask for it. Silver Sneakers wellness programs — for senior citizens over 65 years — negotiate for contracts from Medicare and other health plans for their network of 13,000 wellness providers nation-wide. Dr. Jay Groves from Wellness and Fitness Associates has used the data from his 2018 report to work with regional plans in New Jersey to reimburse the costs of supervised exercise programs for all of the facilities in their network.
So the industry finds itself in a position of wanting to look at data for their clinical programs – but most don’t understand that processes such as Technogym, Fitbit, and Apple watch may be able to log in personal information on heart rate, blood pressure, time on treadmill, speed, and weight – they are individual, and don’t reflect the elements of population health. It is the next generation of where the industry should be. I believe that data on existing programs can detail tremendous information without violating existing HIPPA or CLIA regulations, and allow for clubs to share their benefits with those in medicine, allied health, public health, and the media.
Eric Durak is the President of Medical Health and Fitness, and Director of the Cancer Wellness CEU Program in Santa Barbara, CA. He is also the author of The Reimbursement Book for Health and Fitness Instructors . Contact him at edurak@medhealthfit.com / 805-451-8072. www.medhealthfit.com
References
- How a synchronized approach address key drivers to change the healthcare industry. Optum Health Plans white paper, 2017. Found at optum.com
- Interactive health outcomes-based wellness program lowers medical costs and increases productivity. Interactive Health white paper. Found at interactivehealthinc.com
- Ararwal, A, Baechle, C, Behara, RS, Rao, V. Multi-method approach to wellness predictive modeling. Journal of Big Data. 2016:3:`5
- Case, A, Deaton, A. Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st 2015, Proc. Nat. Acad. Sci. Found at: www.pnas.org/cgk/doi/10.1073/pnas.1518393112.
- Marshall, TF, Groves, JR, Holan, GP, et all. Feasibility of Community-based Supervised Exercise Programsto Engage and Monitor Patients in the Post Rehabilitative Setting. J. Lifestyle Medicine. Jan. 2018. https://doi.org/10.1177/1559827617750385
