PC1153: The WELL Clinic: A Telemedicine-based Childhood Obesity Specialty Clinic Rooted in Primary Care

Background: Childhood obesity is a prevalent chronic disease associated with multiple comorbidities that disproportionately impacts children from minority communities of lower socioeconomic status. Many affected children do not have access to high-quality, evidence-informed treatment programs. The COVID 19 pandemic worsened childhood obesity and transformed the delivery of care at the WELL Clinic at Children's Primary Care Medical Group, which transitioned to a 100% telemedicine-based program, increasing access for patients affected by obesity across San Diego and Riverside Counties.

Methods: The WELL Clinic is a primary-care based specialty clinic serving patients with obesity and related comorbidities at Children's Primary Care Medical Group, a large single-specialty pediatrics group with 28 offices across San Diego and Riverside Counties. When the COVID-19 pandemic began the WELL clinic transitioned to a fully virtual program. The WELL clinic includes 20-minute theme-based telemedicine sessions based on the Wheel of Health which includes nutrition, physical activity, sleep, screen use, and social/emotional wellness. Interested patients with a BMI>95th% are referred to the WELL clinic from their primary care pediatrician. The visits are held with a specially-trained board-certified pediatrician or nurse practitioner and coded as obesity and any related comorbidities and nutrition and/or exercise counseling. The WELL clinic is offered during 5 half days per week. A certified health coach supports patients in scheduling, follow up, and care coordination. Patients receive a satisfaction survey after each visit.

Results: Over 2-years of a telemedicine-only intensive weight management program, pediatricians from all CPCMG sites submitted 4104 referrals, of which 54% of patients had Medicaid coverage. The WELL clinic team completed 970 initial visits and 2554 follow up visits; 98 patients completed at least 6 visits to date, while 31 patients completed the full 12-month program. Of the patients who completed the patient satisfaction survey, 90% reported that the WELL clinic is helping them to achieve their goals and 100% said they would recommend the program to a friend. All visits were covered by insurance.

Conclusion: A primary-care based childhood obesity intervention delivered via telemedicine is a clinically and financially feasible approach to improve access to a high-quality evidence-informed childhood obesity management program for children of diverse backgrounds.