I have been interested in the idea of organizing a conference around the issue of whether "telecoaching" -- providing self-care guidance over the web or telephone -- is an educational intervention, and therefore not governed by state licensing regulations that govern health professionals such as doctors and nurses. This is of considerable interest to providers, patients, health plans, and disease management (DM) vendors, among others. One medical director of a DM company told me that in one U.S. state, anything a nurse does in a relationship with a patient is considered by the nursing board to be nursing practice and requires a license in that state, even if they are calling by phone from another state. The patchwork quilt of regulations varying from state to state regarding telehealth licensure is an impediment to the growth of behavioral telehealth applications. It might be useful to have a one-day invitational meeting to address the licensing issues. Key stakeholders to invite would be directors of boards of registration in nursing and medicine from the Northest region, medical directors of health plans and large medical groups, providers, patients, employers, and vendors. What do you think of this issue and the proposed idea for a meeting?

I am a lifestyle fitness coach (and personal trainer) with certifications, and I have had success with national telecoaching of men and women in eating, exercise and self care. I believe that fitness educated coaches that do telecoaching can provide a valuable service to the medical community and would be invaluable to your discussion.

The industry of Health Coaching would gain momentum if there was a national (global) certifying entity that defined the role and qualifications. Currently under Health Coaching fall Health Guides, Health Advocates, Health Navigators, Nurse Coaches and other roles that are defined only by individual producers as no industry standard exits. The standards for licensed professional are defined by state. Health Coaches are not licensed, are not defined by state and cannot diagnose and prescribe. Thus, a nurse can add health coaching skills, as a physician can add health coaching skills, to their medical practice, however, if that nurse practices in the role of Health Coach as a professional Health Coach, then they would need to abide by Health Coaching professions guidelines. The question remains as to who is setting those guidelines. We at World Health and Healing Collaborative produce and offer telphonic health coaching services and training programs. Most of the web based inquiries we receive are individuals inquiring about certification! Their education level ranges from high school through MD and PHD and their health coach training range is likewise from minimal to maximal. It would be tremendously useful to have a one-day invitational meeting to address the licensing and or certification issues.

Thanks Alice and Ryma for your important comments about health coaching. One related and interesting issue was highlighted during a conversation I had recently with a medical director of a disease management organization. He said the Director of the Board of Registration in Nursing in one state told him that any time a nurse talks to a patient about a clinical matter she consideres that to be the practice of nursing and thus requiring a license in her state. If the nurse is located in a call center in another state, and the patient is in her state, the nursing board director considers the care manager or health coach, no matter what she calls herself or her activity, to be engaged in the practice of nursing and would require that the nurse be licensed in her (the director's) state. So this is likely to vary state by state, making it important that the Federal Government, a major stakeholder due to MediCare, weigh in and try to fix this problem.

Hello, I am very happy to be part of this group. I have been very much engaged in the implementation of virtual reality environments for therapies and emergency preparedness. I would like to point to this group our ongoing work in emergency preparedness training in a virtual environment (www.play2train.org). My team is primarily on the technical end of the things, and we have to resources to create virtual environments. I will be very happy to create a virtual 3D meeting place for connected-health.org on one of my virtual islands. This will be a great start and a way to introduce to this group the potential of the next evolutions of the web. We have talked a lot about web2.0 but it seems that web 3.0 is already round the corner.