2020-12-15 OMA Agenda - Board of Trustees

Table 1. “ADAPT” Telehealth Obesity Management model (Adapted from the Obesity Medicine Association Obesity Algorithm). (6)

A SSESSMENT Platform

Video conferencing via internet cloud-based platforms best for patient and provider, secure, and compliant with the Health Insurance Portability and Accountability Act Concurrent illnesses, body weight pattern, medications, social history, review of systems (e.g., sleep), nutrition and physical activity May include home device weight, pulse, blood pressure, waist circumference, body composition, temperature. Some vital sign metrics can be derived from wearable technologies (pulse, blood pressure, cardiac rhythm strips, temperature). Home device and/or wearable technologies may be able to transmit vital sign data to the clinician for remote monitoring. Skin, cognition, breathing (shortness of breath, wheezing), gait, speech & communication, mobility, eye exam, mental status, mood, behavior Determine which coding is required or applicable for telemedicine payer reimbursement. Proper informed consent process and agreement between patient and provider for virtual visits, explaining potential limitations in some diagnostic abilities with virtual telehealth visits. General nutrition advice (e.g., ultra-processed foods, fiber, fruits, vegetables, fluids), food labels, portions, food energy density, glycemic index/load, and specific nutritional counseling based upon patient food diaries

History

Vital signs

Physical exam

D IAGNOSIS Coding

Transparency

A DVICE Nutrition

Physical activity prescription (FITTE)

F requency I ntensity T ime spent T ype E njoyment level

Motivational interviewing and behavior modification (e.g., OARS, SMART)

O pen Ended questions

● S pecific ● M easurable ● A ssignable ● R ealistic ● T ime-related

A ffirmation R eflection S ummary

Review additional treatment options

Potential alterations in management of non-obesity concomitant diseases, review anti-obesity medication options, review bariatric surgery options

P ROGNOSIS Understanding

Educate patient that obesity: is a disease with “sick fat disease” and “fat mass” disease adverse outcomes,

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