TeleMOVE® Program: New Ideas in Nutritional Outpatient Counseling

Guest Post By Joyce L. Hornick, Dietetic Intern, Dept of Nutrition and Food Science, University of Maryland, College Park

During a clinical rotation, I spent time with RDs working in a cardiac rehabilitation outpatient center, an outpatient diabetes center, and at the Veterans Affairs (VA) Health Care System to obtain an overview of the TeleMOVE Program, which is an offshoot of the VA telehealth program.

The vast size and scope of the VA health system makes it difficult for patients to see a health care provider on a regular basis. Several innovative health care initiatives were developed using current technologies to overcome these issues. The VA telehealth program enrolls VA members with various health issues, including diabetes and hypertension (high blood pressure). This program helps keep members on top of their illness through regular contact with a nurse in the VA hospital system. Patients use an electronic home-messaging device to relay their blood glucose, blood pressure, and other current health information to a nurse, who contacts them if their values are in an unhealthy range or if additional information is needed.

The TeleMOVE Program uses the same messaging system to allow overweight and obese patients to transmit their weight data and physical activity information. In return, the patients get guidance about healthy lifestyle changes, help with self-management skills, information about how to identify barriers to achieving a healthy weight, and ongoing support, all just a phone call away. The telemonitor gives users daily nutrition and exercise tips in a question-and-answer format. This allows the RD to gauge how patients understand their eating and exercise plans in a measurable format. The RDs working in the program call patients on a regular basis, especially if they are not meeting their goals. The patients can call the RDs any time they need extra help.

It is strongly believed that the best way to lose weight or exercise more frequently is to have a buddy to provide moral support and encouragement. The RDs I met in outpatient counseling are like those buddies. Through their nutritional expertise, they offer accurate healthy eating information, moral support, encouragement, and sometimes a shoulder to cry on when patients are having trouble meeting their goals. I was skeptical that an RD could help someone with these issues via telephone, but it is working. Patients meet their RD in person when registering and getting set up for the program. They get to establish that personal rapport with each other. The rapport between patient and RD is important, just as it is with any working or personal relationship.

The TeleMOVE Program shows that technology is useful in helping counsel patients, as RDs have done for decades. It represents an innovative way to reach patients who are geographically distant, have transportation issues (eg, no car), and are homebound.  Follow this innovative program to see how it evolves and watch for other programs that spring up that are modeled after it.