Telehealth News

Maine’s TeleWOW Program Uses Telehealth to Take On Childhood Obesity

A Bangor-based telehealth program is helping more than 50 children and young adults scattered across northern Maine connect with care providers and specialists to talk about health, wellness and weight management.

Source: ThinkStock

By Eric Wicklund

- Healthcare providers in rural Maine are using telehealth to tackle a sensitive topic – children and young adults who have life-threatening issues with weight.

Developed at Eastern Maine Medical Center in Bangor, the TeleWOW (Way to Optimal Weight) program creates a connected health platform for children and adolescents (ages 4-19) with a BMI at or above the 85th percentile. In operation for several years, the program connects care providers and specialists with more than 50 patients through an iPad or similar mHealth device, allowing them to collaborate on care management and health and wellness.

“This is a difficult conversation to have sometimes,” says Valerie O’Hara, M, DO, a pediatrician at the nearby University of Maine in Orono and the program’s director. “There is a lot of stigma involved” that often gets in the way of effective care management.

In the northern two-thirds of Maine, the challenge lies in creating a pathway to care that bridges small, sometimes insular communities, limited healthcare resources, long distances, nasty weather, troublesome roads and the occasional moose that wanders out in front of traffic. In this region, access to specialists – physical therapists, mental health experts and nutritionists – is even more problematic; Bangor is four to six hours away, Portland another two to three hours distant, and Boston a full day away.

In this area, as in any rural part of the country, health and wellness aren’t emphasized and weight issues – and chronic conditions caused by them – are common. Diabetes rates are high, as is heart disease and high blood pressure. And in places like Maine, where roughly 12 percent of the juvenile population meets federal guidelines for obesity, the future is tricky.

READ MORE: Telehealth, mHealth Help Pediatric Hospitals Connect With Kids

That’s where telehealth comes into play.

Partnering with the Aroostook Pediatrics Clinic in Presque Isle, Northern Maine Medical Center in Fort Kent and a clinic in Ellsworth, the TeleWOW program enables patients and their families to meet virtually with O’Hara and a team of care providers. After an initial in-person session to collect biometrics and allow everyone to meet face to face, the video visits take place weekly for about two months, after which the frequency is determined by the care plan.

O’Hara and Starr Johnston, RN, the program’s clinical coordinator, say the telehealth program makes their patients – and the patients’ families – feel more at ease. In more comfortable surroundings, they tend to open up about the challenges of maintaining a healthy weight.

“They get to see the same people each time” even on a video screen, says Johnston. “That familiarity is important. It helps them open up.”

And the results are rewarding. O’Hara starts with often-overlooked benchmarks – attendance at scheduled appointments, and an interest not only from patients but their families in continuing with these video visits. That means the lessons and the advice are taking hold. After that, they start looking at a level BMI, reduced risk of comorbidities, and other clinical factors.

READ MORE: Nemours Uses an mHealth Chatbot to Help Kids Manage Their Weight

“There are a lot of different ways to measure this,” she says.

O’Hara says she and her staff had to do a lot of work to get the program up and running. It’s not easy, she says, taking something that’s traditionally offered in a clinic or doctor’s office and translating it to a video screen.

“We needed to make this the same as if we were walking into the room with them,” she says. “We talked a lot about workflows and presentation before we got started,” as well as redesigning educational materials and handouts so that they could be shared online. “There were everyday things that we take for granted that we had to think about.”

O’Hara also sees the program as an important resource for family practitioners and clinics who don’t have the resources at their disposal but want to keep care local. A program like TeleWOW, she says, works with these doctors and nurses, making them part of a multidisciplinary care team.

“We want to be a resource for them as well,” she says. “When we first ran it by them, many of them said, ‘Oh, yes, let’s go.’ They want this.”

READ MORE: mHealth Programs For Adolescents Need to Focus on Patient Engagement

Both O’Hara and Johnston see a bright future for the program, which has been covered by Maine’s Medicaid provider since 2016 and is gaining traction in the private payer market. O’Hara wants more partnerships with rural clinics and doctors, a better telehealth platform (they’re transitioning now from WebEx to Zoom) and even some group counseling programs. Johnston wants to push the program into other parts of the state, where the need is just as acute.

“We need to be able to bring care to these patients rather than having them come to us,” says O’Hara, who recently talked about her program at a national meeting of pediatric weight loss programs. “There’s a need for this everywhere.”

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