This article was written in collaboration with Bettr Health Group
The Combined Lifestyle Intervention (GLI) is receiving increasing attention in the healthcare landscape. Primary care physicians are referring more people who want to work on their health and lifestyle. At the same time, implementation in practice remains complex. This is because an effective program requires not only good guidance, but also organization, documentation, monitoring, and collaboration.
Lifestyle coach Michael Gerritse sees this every day. He is the owner of Fitwize Lifestyle Practice and works as a regional coordinator for the GLI in North Brabant. His practice is part of the ZoHealthy network, which has been using Bettr Health GLI’s digital support since February.
“The GLI has now gained a fairly solid foothold in general practice, but there is still a great deal of room for improvement.”
Prevention often comes too late
According to Gerritse, the GLI is particularly at odds with the concept of prevention. “The GLI is viewed as a preventive program, while health insurers set a fairly high BMI as a prerequisite for it. If you’re really talking about prevention, it would be great if we could take steps toward that together at an earlier stage.”
In practice, he often doesn’t see many participants until problems have been going on for some time. “We’re now seeing a lot of participants with a BMI over 35. It would be great if we’d seen those people months or years earlier.”
The referral process could also be improved. Family doctors don’t always know exactly who the GLI is suitable for. As a result, the program sometimes becomes a catch-all for a wide range of problems. “These can range from alcohol addiction to drug addiction or eating disorders. At its core, the GLI is about a healthy lifestyle. Specific problems require different solutions.”
See also: “Lifestyle should be part of the basic health insurance package”
From intake to follow-up in a single application
In addition to providing substantive guidance, administrative tasks play a major role. Lifestyle coaches must monitor participants, record attendance, maintain files, document progress, and process claims correctly. Without proper record-keeping, reimbursement can also be jeopardized.
To this end, Gerritse uses Bettr Health GLI. The application was developed as an extension of the Bettr Health Finance platform and focuses specifically on supporting GLI programs. The system digitizes the process from intake to planning, reporting, and financial processing.
According to Laura van Ekris, a product consultant at Bettr Health Group, this is necessary because the GLI is growing and, as a result, becoming more complex. “We provide both substantive and administrative support,” she says. “This includes processing claims and payments, as well as giving lifestyle coaches insight into the status of GLI programs.”
Less paperwork and a better overview
For Gerritse, the transition to a new system was nerve-wracking. New applications often promise to save time, but in practice they can also create extra work. “You never know for sure whether it will work or whether it will actually create more work or hassle than it’s supposed to save.”
According to him, that efficiency has now proven itself. “With the push of a button, we can process reports or record participants’ attendance. That data is also forwarded to the health insurer.”
Seeing who is falling behind
Digital support doesn’t just help with administrative tasks. Equally important is having an up-to-date view of ongoing programs. This is especially necessary in a larger practice. “My practice is so large that I no longer know everyone personally. Digital support ensures that I can still monitor participants at the practice level.”
This is important because GLI participants sometimes drop out. Not always because they no longer want to participate, but because they feel ashamed or become insecure. “Sometimes people miss a few sessions and think they’re no longer allowed to come. Or they’re afraid we’ll get angry because they didn’t do something right.”
An app that provides insight into attendance, progress, and the status of programs helps establish contact more quickly. “Then you can explain that it’s perfectly normal to miss a session once in a while, to be sick, or to just not feel like it. With that insight, you can respond more quickly to those kinds of situations.”
See also: How digital healthcare helps healthcare providers refer patients to the right lifestyle initiatives
The system must adapt to real-world practice
Van Ekris emphasizes that digital support should never take the lead. “There are many systems out there, and you can build great things. But the connection to real-world practice is essential. A system must support the process, not lead it.”
According to Gerritse, it is precisely this connection that is important for keeping the GLI viable—especially since lifestyle practices also need to remain financially sound. “With few participants, it’s hard to avoid losing money with the GLI. A bit of economies of scale is important for a practice to stay afloat. But the essence remains: you want to help people.”
From a disjointed process to appropriate care
Still, more needs to be done to truly integrate the GLI into appropriate care. According to him, it’s still too often a standalone program. The primary care physician refers the patient, the participant follows the program, and then it ends—or someone drops out along the way.
“There’s still room for improvement when it comes to providing a safety net for participants who drop out or need to transition to existing exercise programs or specialized care.”
According to Gerritse, this requires better collaboration between primary care physicians, lifestyle coaches, municipalities, health insurers, and sports and exercise providers. Digital support doesn’t immediately eliminate all obstacles to collaboration, but it does help maintain an overview.
