Continuous Coaching with Twine

Twine is a patient application and coaching platform

Both versions can be accessed by smartphone, tablet, or, by computer through an approved web browser. Even if your patient decides not to use technology, Twine maintains its abilities as a patient population management tool. This gives coaches visibility into all of their patients Health Action Plans (we recommend you download the article at the bottom of this page to learn more), progress toward goals, check ins, and conversation history

Twine aims to create patients as self-care experts over time.

When patients begin using Twine, you create a scaffold, or support system, to develop self-care expertise by programming a Health Action Plan. Interacting regularly through the patient messenger, coaches guide practice, feedback, and reflection just-in-time. Twine makes it easy to evolves Health Action Plans to reflect change as patients learn. For some, pairing episodic (face to face or over the phone) interactions with the Twine coaching workflow is a new experience. Both formats are powerful in different ways. As you decide how to pair the two coaching formats together in your practice, here are some points to consider so that you can make the most of both coaching formats

  1. The Proximity (and Influence) of Coaching on Target Behavior
    • Episodic Coaching: This form of coaching helps patients reflect on behaviors out of context in the coach's office or by phone in a location (by space or time) far away from where target behaviors occur. Since patients are often relying on their memory, this method is less reliable for behavioral assessment. However, the open space that these types of visits create can work to uncover general thoughts, feelings, and attitudes about change. This is called reflection-on-action. Face-to-Face or telephonic visits may be preferred when for working through "fuzzy" problems or ones that don't have clear solutions in the patients mind. 
    • Coaching with Twine: This form of coaching helps patients reflect on behaviors in context very soon after or while they occur by logging health actions and using the messenger. This more reliably documents actual behavior and often produces change in an ongoing iterative process as coaches deliver feedback just-in-time. This is called reflection-in-action. Use coaching with Twine as your default interaction, and allow episodic coaching to review progress, problem solve, and identify new change areas.
  2. The Work of Learning Transfer
    • Episodic Coaching: makes learning transfer more difficult. Patient must recall, apply, and maintain what they learn in coaching sessions on their own. If they get lost or miss an opportunity to maximize their changes, they have to wait for an appointment to "reroute" and further develop their goals.
    • Coaching with Twine: makes learning transfer easier. If patients have trouble recalling or applying lessons learned from coaching, they can reference the coach at any time through the messenger. Because patients are not experts when they first start making change, they often don't know when they are off course until its too late. Coaches have an additional opportunity to step in to offer support in this case early relapses in change are observed through the History tab visualizations. 
  3. Non-Verbal Communication
    • Episodic Coaching: Coaches may be able to more quickly identify and work through ambivalence using non-verbal cues such as facial expression, body language, tone of voice, and, cadence of speech.
    • Coaching with Twine: Coaches must rely on interpretation of written words. Though, with tracking, discrepancies are easier to identify and discuss with real-time data. Losing non-verbal communication may sometimes pose a benefit: patients who are unwilling to say things in person may offer up information and insights more freely online. Additionally, you can begin to elicit and validate your patients' attitudes over time vs. generalizing them through one or two interactions.

Has this article got you thinking how you'll manage your face-to-face sessions in Twine? 



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