Bariatric weight-loss surgery is becoming more acceptable to physicians and patients alike as a way to treat obesity and the chronic conditions it may cause such as diabetes and heart disease.
Between 2011 and 2017, the total number of bariatric surgeries performed in the U.S. jumped from 158,000 to 228,000, according to the American Society for Metabolic and Bariatric Surgery, and these numbers are likely to increase even faster, thanks to telemedicine.
Bariatric weight-loss surgery is a perfect example of how telehealth can improve outcomes for a variety of reasons. Nearly every American owns some kind of device – computer, tablet or smartphone – allowing them to connect with a health care provider from a location that is convenient for them. By completing pre- and postoperative visits through a video connection with the bariatric surgery center, patients can reduce their travel time to receive pre-surgical care, and are more likely to complete their pre-surgical workup and eventually undergo bariatric surgery.
According to The Advisory Board, a health care best practices consulting firm, many hospitals are investing in telebariatric programs and applying the principles of telehealth “to better retain patients within the bariatric surgery care pathway.” The hope is that as more organizations adopt telebariatric services, patients will benefit from improved experiences and better outcomes like resolving diabetes issues and weight loss, among others.
The planning process for bariatric patients lays the perfect foundation for telemedicine to be effective. To prepare for surgery, patients are required to go through a long preoperative workup – sometimes as long as six months or more – for lab work, nutritional and exercise consultations, behavioral health assessments and monthly counseling sessions. For patients who live far from the hospital, the travel to and from these appointments can be so burdensome that they stop the process entirely. This can be done virtually, avoiding travel time and time off from work or school.
Postoperatively, telehealth allows the patient frequent and intensive interactions with qualified health care providers, supporting them as they adjust to the lifestyle changes, like diet and exercise, that are required to make weight loss successful. By preventing patients from failing to maintain their program due to poor follow-up, practices will improve their success rates thus increasing the number of patients that may consider bariatric surgery.
All weight loss, whether or not it is treated surgically, requires a high amount of physical activity and calorie burning, but many factors can get in the way of patient success in both of these areas, including a lack of time, money and knowledge. By staying connected to their doctors and other health care providers virtually, patients are more likely to adhere to the regimes required for success, rather than reverting to their old ways of eating and poor exercise habits.
A 2017 study in the Journal of Telemedicine and Telecare found that a telehealth program that combines video coaching and self-monitoring led to a “significant weight loss” for almost 70% of the participants. By contrast, only 8% in the control group lost a significant amount of weight. The telehealth coaching platform, which allowed the subjects to access a health coach in real time to review the patient’s data and keep the patient informed and motivated, was the primary factor for success.
As important as these successes are, perhaps an even greater reason to invest in telehealth services for bariatric care is the cost savings that can be realized because telemedicine visits are much less expensive than face-to-face consultation and training. In some cases, patients not covered by health insurance have paid up to $100 to meet with a registered dietician for one 40 to 60 minute consultation and those with insurance still need to meet a deductible or copay fee. A personal trainer typically costs between $60 and $150 per session. A video conference can cost less than $10.
Providers also benefit by opening up the lines of communications with their patients through virtual visits, helping to ensure the path from surgery to retention is positive. The result is that accessing health care becomes less of a burden for patients, and they become more engaged in their treatment plans, which is beneficial to their long-term health.
Dr. Samant Virk is the CEO of MediSprout and can be reached at firstname.lastname@example.org.