Dr. Papanna Ravichandra is a primary care physician with offices in Midtown and East Harlem. Since joining NYC REACH, he has participated in a number of quality improvement programs. He believes primary care providers can play an important role in guiding patients with prediabetes through lifestyle changes to prevent type 2 diabetes. To that end, he became a certified National Diabetes Prevention Program (National DPP) lifestyle coach in 2016. We asked him what it’s like to host National DPP workshops, how he empowers patients, and how technology can improve population health.
Why did you become a lifestyle coach?
[Primary care providers] need to go and mingle with people, and this platform is like a kitchen table. It’s less frightening; people are more welcome to share their feelings. It’s not like an office, it’s not like a molecular biology class. Patients just have to share what they do, talk about their lifestyle, then make some corrections. We need to create a model of healthy living. We need a system to turn “patient” back into “person.” Structured programs like the National DPP do that.
There are many reasons people become lifestyle coaches. Some have worked in healthcare venues that treat patients with chronic disease, while others have personal experience seeing a friend or family member work through the burden of type 2 diabetes.
Whatever the reason, lifestyle coaches have passion for helping people live healthier lives. They possess strong interpersonal and group facilitation skills in order to create an environment where participants thrive and grow.
What’s the key to delivering a successful National DPP?
I believe the key to scaling the program is to make it local, meaning classes have to be held within a 10-minute drive of patients’ homes and led by a coach with local knowledge of neighborhood resources who can foster community-based, peer-to-peer connections.
Compliance is the key. We have reserved Wednesday for wellness every week. It’s easy to remember. Patients consistently show up. They know the importance. They participate even better if you empower them with a microphone. They love to say something.
The technology exists. The reimbursement exists. You can structure the timing, the reimbursement, or what have you, and you can make it work.
How important is preventive care?
The only cure is prevention. It’s the single best way. If you don’t manage medical conditions, the conditions manage you. From a cost perspective, preventive health care is significantly cheaper than treating disease. Payers are actively encouraging their policy holders to take preventive measures and are gladly footing the bill. Addressing social determinants of health as a preventive health care strategy has begun to emerge in recent years.
How does technology help?
Approximately 95% of Americans have a mobile phone of some kind,9 and like any sector, health care has had to transform its processes to connect with people easily and efficiently. Mobile health apps offer greater flexibility to all parties. They’re one of the most inexpensive ways for facilities to provide stronger services to their patients. Through the use of apps and attachments, smartphones also can better inform patients who need to continually monitor their conditions.
For example, in one study, patients with diabetes and uncontrolled hypertension who used a smartphone app were able to significantly reduce their blood pressure within six weeks.10 Some work to create better health awareness while others facilitate communication between patient and care provider.
Sometimes patients come to this table and get their family members on the TV. I help them connect to Google Chrome. I have a family member calling from Seattle calling her grandpa here in NYC. I can say look, your grandfather is sad because you’re far away, he’s back to eating poorly, he hasn’t slept, he’s not taking his medicines. So the granddaughter comes on the TV and talks to him about it.
How do you empower patients?
Changing the waiting room game helps increase the level of participation. I think every office should be a living room, so there’s no waiting room. Patients have internet access, they have USB chargers, TVs. I want them to feel better when they leave, or at least begin to feel better.
Every place should be a healing place. It reduces patient anxiety. Participation is then excellent.
The National DPP is an evidence-based, lifestyle change prevention program that follows a CDC-approved curriculum. Primary care providers can deliver the National DPP by becoming certified lifestyle coaches. National DPP providers can now bill Medicare for services under the expanded Medicare DPP.
Contact firstname.lastname@example.org to learn more about the benefits of the program and how to get involved.
This article was featured in the Fall 2019 NYC REACH Newsletter