K. Randall Burt, who is President and CEO of the company, HealthEmonitoring.com and was a former senior executive at Alere Medical, Inc., responds to the questions:

1. Do you think increased contact or opportunities for increased contact about nutrition or weight loss can help obese home care patients manage their weight?
2. What sorts of communications tools do you think could be useful for this purpose (telephone, Internet, specialized or customized alerting or a range of educational tools)?

.... and in doing so, he of course provides perspective on what's really needed to make this contact work in the long term.

Undeniably, increased contact coupled with handholding and support helps individuals lose weight. Commercial weight loss programs like Weight Watchers, Jenny Craig and Lindora have adhered to this philosophy. The challenge, and therefore the problem with these programs, is the high attrition rate. This attrition rate is primarily due to the individual reaching their weight loss goal (only to gain back the weight they lost in a few months), or the program becomes too inconvenient because it requires travel to a facility several times a week to "weigh-in" and speak with their dietician or nurse.

A tremendous opportunity exists to create the same type of environment by utilizing Tele Technology or Remote Patient Monitoring (RPM). The advantages are numerous but foremost is convenience. An individual no longer needs to travel to a facility but can simply "check in" from the privacy of their own home. Collecting objective data from an individual is effective compliance as it establishes a sense of accountability in a friendly, supportive manner.

Tele-Technology or PRM has proven to be cost effective in managing other diseases such as CHF and Diabetes. Within these patient populations, data suggests individuals like being "watched over" and compliance is very high. The same concept should be applied to individuals who are overweight or obese. To succeed, the program must be perceived as helpful and user friendly and clinically based.

Furthermore, utilizing Tele-Technology or RPM in an overweight and obese population is the best opportunity for Disease Prevention versus Disease Management. Certain tools used in Tele-Technology or RPM include Web-based interactive sessions and reminders, Inbound and Outbound telephonic IVR messaging, and objective data collection. The critical success factor is to create an environment which enables all users to maintain compliance vis-a-vis varying levels of technology.

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