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Alice Peck Day Introduces Novel Patient Exercise Program



Valley News Staff Writer
Friday, November 09, 2018

Lebanon — There are many reasons people fail to get up and get moving as their doctors recommend, but a new pilot program at Alice Peck Day Memorial Hospital aims to eliminate at least one such obstacle — cost.

The program, called FitScripts, allows APD primary care providers to write referrals for adult patients — for whom cost has been a barrier — to area fitness centers, including the Carter Community Building Association in Lebanon and the Upper Valley Aquatic Center in White River Junction.

Upon receipt, staff members at the fitness centers reach out to the patients and invite them in for an intake visit to see the facility, meet with a staff member and find out what type of fitness plan might work best for them.

The cost of the patients’ memberships is covered by the hospital’s Community Health Department with philanthropic support.

“We have wonderful fitness facilities here and cost is often a barrier for people,” Nancy DuMont, APD’s director of community health, said in a Friday phone interview.

It’s a challenge that has come up in conversations over the years and in surveys related to the hospital’s community health needs assessment that it conducts every three years, DuMont said.

A regular monthly membership for an adult costs $84 at the CCBA and $87 at UVAC.

Starting in July, DuMont decided to devote some money to the cause. So far, APD providers have made 112 referrals, said DuMont, who is in the process of doing an evaluation of the pilot to use in determining the program’s future.

There is no income-eligibility requirement for the initial referral, but APD does discuss the patients’ finances with them as they continue in the program, APD spokesman Peter Glenshaw said in an email on Friday.

So far, staff at the CCBA have seen at least half of the 70 people referred there walk through the door, according to CCBA’s fitness coordinator Rick Dickson.

“We’ve been thinking about this kind of approach for a long time,” Dickson said.

The way the country currently allocates money for health care by setting money aside, waiting for someone to get sick and then paying for treatment doesn’t make sense, Dickson said.

“Nobody is unaware of the fact that prevention, wellness, exercise — all of this stuff — is the first line of defense and the most direct way to address what’s a really catastrophic health care cost situation,” he said. “We know that’s the end goal. (But) how do we get there?”

Prescribing exercise in the way APD is through FitScripts offers a path to prevention and to cost containment, he said.

He predicted that within the next few years, programs such as FitScripts will be “how a lot of places like the CCBA will be operating.”

In fact, other primary care providers already have reached out to Dickson to ask how they might go about setting up a similar program, he said.

The people referred to the CCBA through the program have a wide range of abilities and experiences with exercise, Dickson said. Some simply are looking for a way to get moving, while others are managing specific illnesses or injuries, he said. For example, the CCBA has seen a number of people come in seeking to address their anxiety and depression through exercise, he said.

The initial intake process takes an hour to an hour and a half, Dickson said. During that time, staff members ask about the person’s limitations, goals and diet. From there, it becomes clear who on the staff would be a good match to help the person navigate the fitness center.

The first prescription is for a week and if a patient uses it, APD renews it on a monthly basis, he said.

Though some participants in the program can come in and use the CCBA on their own, others need help and supervision from a personal trainer while they’re there, Dickson said.

He’s been surprised at the number of people who have returned time and again to use the facility, he said.

“They’re very enthusiastic,” Dickson said. “If I were a betting man, I would have lost a lot of money. ... It’s really been eye-opening.”

At UVAC, the program began by offering day passes to participants, John Grainger, UVAC’s fitness and personal training director, said in a Friday phone interview. But that didn’t work, so in recent weeks APD has started offering one-month UVAC memberships to FitScripts participants, Grainger said. Participants also get assistance from a personal trainer, he said.

So far, about a dozen people have come in through this program, Grainger said.

“It’s great for us,” he said. “We’re able to reach more people.”

In particular, it helps bring in people who wouldn’t be able to come in otherwise, he said.

Like at CCBA, UVAC staff start the process by sitting down with a person to understand their health history and point them to appropriate programs and equipment, Grainger said. Some, for example, simply want to come in and use the recumbent bike, while others join group classes, he said.

If participants come in at least six times in that first month, APD will renew the membership, he said.

Like Dickson, Grainger said fitness memberships ought to be considered preventive health care.

“To have a hospital team up with a fitness center makes so much sense,” Grainger said. “It will be great when someday a gym membership is part of your health insurance plan. ... That’s hopefully the goal of where the industry is going.”

Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.