1. Exercise & Wellness Program Matt Jacobs, MA, RD/LD, NSCA-CPT February 8th, 2008

2. Goal Bring an exercise component to the already comprehensive OWLO program Employee Wellness Program (EWP) Online Personal Training Program (OPT) Fitness Facility for Patients and Employees (2009)

3. Literature Review McCullough et al., Chest 2006 109 patients prior to lap Roux-en-Y Measured complication rate (death, angina, stroke) compared to VO2 max 16% (6 of 37 patients) with VO2 < 15.8 mL/kg/min 2.8%(2 of 72 patients) with VO2 > 15.8 mL/kg/min

4. Literature Review Kerrigan et al, Medicine & Science in Sports & Exercise, 2005 rate of weight loss after (3 and 6 months) bariatric surgery for 3 groups: 1) clinic based, supervised exercise program 2) self-reported regular exercise 3) self-reported no regular exercise Supervised group lost greater absolute weight than the other two groups at both 3 and 6 months There was no difference in weight lost between groups 2 & 3

5. Who will this program benefit? Patients Less risk of complications after surgery Improved weight loss after surgery Employees Decreased absenteeism due to illness, depression, stress Increased job satisfaction, morale, productivity Decreased weight, blood pressure, stress OWLO Increased revenue stream Increased patient satisfaction Decreased work site stress Employee buy in to OWLO program

6. Divisions of Program Employee Wellness Program (EWP) Online Personal Training (OPT) OWLO Fitness Facility (2009)

7. Components of the Employee Wellness Program (EWP) Provide access to cardiovascular and resistance exercise equipment at the workplace Provide education related to nutrition Basic and advanced exercise instruction Topics related to health and wellness Employee set goals (weight loss, blood pressure, percent body fat, etc) Nutrition supplement use

8. How EWP works... Employees enroll in wellness program as part of a benefit package from OWLO 30 minute confidential RD consultation Medical evaluation from a RN Exercise evaluation from a CPT Employees will meet weekly in a group setting during non-business hours (before or after work, noon) Incentives offered for employees that meet goals

9. Goals and Incentives of EWP Employees set a 12 week goal Employees that meet goals would be eligible for incentives as long as they continue with the program Discounted health insurance premiums - OR - Reimbursement for copays Reimbursement for gym memberships Monetary rewards Paid time off

10. Costs of EWP Employee costs $5 per month for initial evaluations and weekly group meetings $1 per 15 minute session of exercise $25 individualized exercise plan Monthly supplements OWLO Costs Equipment (cardio, pedometers, mats, education materials, stability ball) Office Space Incentives Program facilitator time

11. Anticipated revenue from EWP Employee Enrollment 10 employees x $5/month x 1 year = $600/year Time Reservation 15 minute blocks of time x $1/session 10 employees 3 sessions/ week = $1560/year Employee purchased Supplements $120/month or $1440/year Individualized Exercise Program $25 x 10 employees = $250 x 4 = $1000/year Total revenue for 10 employees enrolled = $4600/year

12. On-Line Personal Training Program (OPT) Website devoted to the exercise and fitness needs of OWLO patients and employees Trainerforce.com Online personal training program used by fitness professionals to provide an additional service to their clients Can be linked to existing website

13. How the OPT program works.... Patients log on the the OPT website linked directly to owlo.com Pay monthly fee Gain complete access to site Site monitored by CPT

14. Benefits of OPT program Patient Benefits Customized exercise plan complete with animation All exercises are able to be performed at home with proper equipment Discussion forum, newsletter, emails Support system OWLO Benefits Increased revenue Increased patient satisfaction and care Trainer Benefits Instant clientèle Increased revenue

15. Costs of OPT program Patient costs $30 per month- patients gain complete access to entire website and services OWLO costs Advertisement costs (brochures etc) 30% of subscription costs for website $30 x 30% = $9/month Trainer Costs 70% of subscription costs for website Time and effort of maintaining website

16. Compensation to Trainer Trainer will receive 70% of income from OPT program Trainer is responsible for maintaining all tasks associated with website and any service offered If trainer is also an employee of OWLO, any work performed for the OPT will be on downtime, evenings, weekends etc

17. Anticipated Revenue from OPT program After 3 months: 10 users x $30/month = $300 x 30% = $90 x 3 months = $270 - $27 (website) = $243 After 1 year: $243 x 4 = $972 (before advertising costs)

18. OWLO Fitness Facility Provide a facility in new hospital for staff and patients of OWLO Provide exclusive bariatric specific wellness facility

19. Benefits of Fitness Facility Enhances the already comprehensive OWLO program Provide additional service to patients and staff Increased revenue for OWLO Initial exercise assessments

20. OWLO Fitness Facility Cardio Equipment Free Weights Machine Weights Bariatric specific equipment

21. Costs of Fitness Facility Numerous Factors Size Type of equipment Brand of equipment Staffing Utilities

22. Anticipated Revenue from Fitness Facility Monthly Memberships Personal Training Walk in visits Initial patient assessments

23. Next Steps of Action Space and equipment for EWP & Initial Assesments Development of EWP curriculum (Balance) In service of EWP Begin development of online personal training website Develop promotional materials for OPT Begin plans for Fitness Facility

24. Thank you McCullough PA, Gallagher MJ, deJong AT, et al. Cardiorespiratory fitness and short-term complications after bariatric surgery. Chest. 2006;130:517–525. Kerrigan, DJ; Keteyian, SJ; Thompson, T et al. Post Surgical Weight Loss In Bariatric Patients Who Self-Select Supervised Exercise. Medicine & Science in Sports & Exercise. 37(5) Supplement:S286, May 2005.