Building for Scale: Four Industry Experts on Scaling a Best-in-Class Health Coaching Experience.

Part Two: Building for Scale

One size doesn't fit all when delivering effective virtual care. Each individual brings a unique circumstance, lifestyle, and health history to the conversation, which requires an additional layer of personalization to facilitate patient activation and treatment plan adherence.

National Board Certified Health & Wellness Coaches are trained to partner with individuals and tailor a care plan according to their unique needs, motivators, and environment. Their depth of understanding in the science of habit formation - a combination of motivational interviewing, self-determination theory, the transtheoretical model of change, and positive psychology - enables them to support that person in translating their health goals into real-life positive health outcomes. In short, coaches are expertly trained to deliver personalized behavioral care, with the delivery of each touchpoint adapted to the member’s context and preferences.

In our Primer on Digital Health Coaching and Part One: Meet the Experts, we featured four industry leaders and their views on the evolution of coaching and best practices for recruiting the right coach provider for an effective digital health offering. Now in Part Two, we turn our attention to the art of scaling an effective, personalized experience and lessons learned along the way.

Bree Gorman, MPH, NBC-HWC, Health Coaching Lead @ Wellinks

On creating a best-in-class coaching experience: Coaching in digital health is tricky. Most companies have very specific outcome expectations – these outcomes are, after all, are what payers, health systems, or employers, are buying into. The question is, how do we best support these expectations while maintaining the integrity and spirit of human-centered coaching? How do you coach to these outcomes when they’re defined by someone other than the individual you’re coaching? While it’s really challenging, I think this is where strong coaches become an incredible asset to an organization selling health behavior change.

When building a coaching program as part of an integrated solution in digital health, it’s essential that coaching is well-aligned with the bigger picture goals the company is targeting. In this type of coaching relationship, you’re working toward something pre-defined, but how the member gets there will still happen in their own, unique way.   

On the most critical elements for scale: Building a solid foundation—everything from evidence-based programs and efficient operations through strong teams and amazing culture. You need a strong framework to guide how a coach works with members to ensure each member gets a consistent experience, regardless of the coach they’re partnered with. It's also important (and obvious) to embrace technology, utilize it where appropriate and keep the human touch where it needs to be. One of the biggest things we want to stay mindful of is not dehumanizing healthcare.

On the program side, we also have to embrace the ongoing cycle of experimentation, design, and iterating to push the program's success. 

I’ll state the obvious for digital health: get really friendly with data. Let it inform continual improvements on what you offer and how to communicate with members. Doing that at scale takes a lot of collaboration and innovative thinking (and, of course, some really smart data scientists). At Wellinks, we use data to deliver a personalized experience while also working to move everyone towards the same set of clinical outcomes.

On key lessons learned: As a coach, often shutting your mouth and truly listening is the best thing you can do for a member. Folks that we work with largely do not feel heard by the medical community, and coaching is a refreshing opportunity to feel seen, heard, and validated. It's amazing how coaches can simply listen and reflect, and that's all it sometimes takes to start to move the needle. 

Moving forward, evidence-based lifestyle interventions with integrated coaching support will continue to play an evolving role in the healthcare landscape. As lifestyle-based disease grows exponentially and provider shortages continue, health coaches have a massive opportunity to rise up and work their magic in team-based care.

Adrienne Prentice, JD, Professional Coach, Co-founder & CEO @ Keep Company

On creating a best-in-class coaching experience: Start with clear expectations; that means being clear about what the program entails and how it works. From the get-go, being specific with our goal of finding fulfillment to avoid burnout - which can often be intangible - we set expectations that can inform an outline of specific next steps. We want to design the relationship from the beginning so that members understand what they can expect from the coaching process.

Personalization is essential, which can be difficult at scale. At the core, trusting the member's intuition that they know themselves, with the coach providing the space to reflect on what's best for us. Keep Company wants to provide the tools and support to facilitate that experience. 

On the most critical elements for scale: Achieving scale with any business requires repeatable, consistent, and sustainable growth. Because we are a service business, we want our coaches to feel confident and prepared to deliver a great experience to members. To that end, we've developed proprietary training that's evidence-based and practical so that the coach is given tools that they can implement. They then move forward, but always with the support of the whole organization behind them. 

On key lessons learned: One of Keep Company’s most significant pivots was when we realized employers are attuned to the issues of employee well-being. Progressive employers understand that if their employees are burning out and not feeling well, it impacts their bottom line significantly. So it's a win for Keep Company and a win for the employer to solve this issue.

Also, when you bring people together as a group, the impact is exponential compared to 1:1 personalized coaching. It's fantastic for parents and caregivers to connect with fellow members in what we call "Boards" -- allowing for a member to be inspired by seeing someone else taking steps and being motivated to meet their own goals. 

There's a force multiplier effect that these personalized micro-communities can have on the potential of these individuals. When you get people together who are similar - with the same-aged kids or caregiving responsibilities, the same jobs - they often encounter similar challenges. If you connect people with enough similarities, the value is that they can learn from one another vs. purely relating to one another.

Jennifer Dowdeswell, Professional Coach, Digital Health Product Lead @ HealthQB

On creating a best-in-class coaching experience: It begins with listening skills. A client may off-handedly mention their device didn't sync for the program, or that they had too much going on this week. The ability of the coach to stay curious and really listen to what clients are saying helps them feel heard, and supported and will keep them coming back. Client retention is important in this industry, particularly if the client experience is predominantly with an app. This means that every human interaction must be top-notch and add to the client experience. 

On the most critical elements for scale: When first setting up a coaching program, there needs to be a lot of room for listening and learning to ensure we build a program that is what clients want, not what we think they want. Critical at this time are procedures to document learnings, analytics, and short feedback loops between the coaches and the product owner. The aim is to be able to automate things where feasible and improve the elements that are best done by a coach. 

On key lessons learned: From a company perspective, having coaches as employees is a big expense, so it's important to do research and pilot tests to first measure client success with a coach versus without a coach. As coaches, we know our worth because we see the great success our clients experience, however, it can be hard to capture that value. The more we can measure and present findings on the benefits of working with a health coach (versus not), the stronger our industry will be.

Megan Murk, MA, NBC-HWC, Founding Team Member @ Wave

On creating a best-in-class coaching experience: I think it comes from a balance of seamless operations and Coach presence and attunement. Having the scaffolding and structural support to make it easy to schedule and join a session, and setting clear expectations for what will happen in the session is essential. Equally important is how a Coach prepares for the session. How they review important information ahead of the session and 'get into the zone' really influences their level of presence. When training coaches, I always emphasize that having routines to help prepare, and understanding what distractions to minimize, is important because it allows us to 'hold space' and help clients feel seen and heard.  

On the most critical elements for scale: I think it has a lot to do with the culture you create on the team and within the business. Most people become coaches for a reason, so it isn't hard to find a lot of passionate and mission-aligned coaches to hire. And that passion and talent are not the only things that contribute to a safe, welcoming, and generative culture. 

We know that DEIB and workplace culture has been a very popular topic in recent years, and we know that there's a huge lack of representation in the coaching field to date. This is a rate limiter for many clients feeling safe and open in seeking and receiving care. So when it comes to recruiting and hiring, your company values, culture, and hiring practices intersect with these truths. I believe it is something that can't be ignored. Doing the work to create a culture where people feel safe and welcomed to show up as their whole selves takes time and effort, and it will enrich everyone's experience.  

On key lessons learned: Many people assume that coaching is only action-oriented and is about achieving goals. Goal setting is a tool for Coaches, but it is not all we do. We know that behavior change and truly supporting health and well-being are more than that. Walking with somebody to actualize what's meaningful for them is more nuanced than a binary goal. In all interactions, I believe that it's very important to balance compassion and empathy with desire, vision, and action-taking. Holding the dialectic of acceptance and change is essential.

Kasia Smith, NBC-HWC, Head of Health Coaching @ Pillar

These coaching experts work at venture-backed companies across emotional well-being, chronic pain, parental support, and COPD. While they each have a unique approach, the level of intentionality that went into the design of their programs is evident, beginning with the recruitment of best-fit coaches. From our conversations, the essential coach quality that emerged was empathy—connecting with the client, understanding where they are in their overall journey, and tailoring care to support them for outcomes and empowerment. 

I'm so grateful to know each of these leaders and am thrilled to collaborate to create more awareness of the coach’s role in digital health. At Pillar, we’re on a mission to empower clients with the tools and framework to take control of their health. Coaching is a powerful partnership by which to enable that.

About the Author: Kasia is a National Board Certified Health & Wellness Coach and brings a decade of experience in clinical neuropsychology research, insurance, and coaching expertise. Kasia is the Head of Coaching at Pillar, leading the expansion and management of the coach community and broader provider network.

About Pillar: Pillar powers board-approved health coaching, providing companies with the white-labeled workforce and technology to launch or scale a coaching program in-house with measurable ROI. We’re female-founded and backed by top-tier investors including Y Combinator, Streamlined Ventures, as well as industry-leading founders and operators in the healthcare ecosystem. 

For coaches, join our network here.

For companies interested in launching and scaling coaching in-house, email [email protected].