Archive for the ‘Wellness/Prevention’ Category

Guest Post: Living Better, Not Just Longer: Worksite Wellness at Any Age

October 27th, 2014 by Tanja Madsen

Population health management

Living healthier, more productive years is the goal of population health management.

Just 20 years ago, about one in 10 workers was over the age of 55; today, it’s one in five. We are aging as a nation. We are living longer than our forebears a century ago, but can effective population health management push back the serious effects from chronic disease so we can live healthier, more productive years?

In the typical lifespan, there is a point at which an individual first becomes chronically ill or disabled, and a further point at which a person dies. On average, the time between those two points is about 20 years, according to healthy aging pioneer James Fries. Fries envisions a world in which we may not add many more years to the end of life, but we can “compress morbidity,” or shorten the number of years we suffer from illness.

The key question is: how can we maximize the healthy years of our lives? It’s not just a question important to individuals; it’s critically important to our economy as well. Population health and a nation’s financial health are inextricably linked. This is the focus of the World Economic Forum’s Healthy Living initiative, which found that more than 60 percent of global deaths are due to diseases associated with preventable lifestyle risk: cardiovascular diseases, diabetes, cancer and chronic respiratory diseases.

Closer to home, CEOs of some of the nation’s largest companies unveiled a new initiative, Building Better Health: Innovative Strategies from America’s Business Leaders, to leverage their market power to identify an evidence-based approach to population health.

As our working-age population grows older, it’s critical that employers seize the opportunity to address the factors that influence health and can enhance productivity in older workers. For those of us who work in health promotion and prevention, that starts with a change in how we define the concept of “health.” Taking a cue from public health research, we must recognize that health is more than the absence of disease and take a whole-person approach to total well-being. Public health literature points to physical, social, economic, environmental and genetic “determinants of health” that combine to affect the health of individuals and populations. Using a more expansive term for this view of health, the Centers for Disease Control and Prevention notes that well-being includes, at a minimum, positive emotions, satisfaction with life, fulfillment and positive [physical] functioning.

This fuller definition of well-being comes into play as employers focus on the value of this aging workforce. Older workers offer tangible benefits for employers to keep them healthy and productive. Researchers found that older workers (over age 65) make fewer serious errors than their younger colleagues (age 20 – 31); they also offer experience, consistently high motivation, a balanced daily routine and stable mood.

The University of Louisville’s program, “Get Healthy Now,” opens health coaching to all interested employees, regardless of whether they are at low-, medium- or high-risk for chronic disease. Care-giving workshops are designed to help everyone from new parents to sandwich-generation Baby Boomers caring for elderly parents; elements include legal, financial and social factors. Mindfulness, yoga and relaxation are among the many classes offered to promote well-being. ROI analysis found the UofL program returned a benefit cost ratio of 7.16 to 1 after four years, and it has become a model for a statewide strategic wellness initiative called “Get Healthy Kentucky.”

Evidence-based workplace health management programs that offer tools to support healthy aging can help older workers maintain active, productive lives. Some interventions, such as in-person health coaching, are particularly effective for those over age 40. In addition to a continued focus on the key behaviors that can help delay the onset of health problems (avoid tobacco, exercise regularly, and maintain a healthy weight), it becomes more important than ever to invest in programs that enhance the emotional, physical, social and financial well-being of all workers—no matter their age.

Tanja Madsen

Tanja Madsen

About the Author: A veteran of health education and health management product development, Tanja Madsen is director of product management for HealthFitness. She is involved in the development of the innovative HealthFitness technology platform, the Persona™ behavior change model, a short, engaging health assessment and a new approach to coaching. A certified health educator, Tanja works with a team that includes registered dietitians, health educators, exercise physiologists and behavior-change experts who are responsible for the development and management of national programs to improve population health.

HIN Disclaimer: The opinions, representations and statements made within this guest article are those of the author and not of the Healthcare Intelligence Network as a whole. Any copyright remains with the author and any liability with regard to infringement of intellectual property rights remain with them. The company accepts no liability for any errors, omissions or representations.

Adventist Population Health Management Incentives Engage Employees, Curb Costs

October 16th, 2014 by Cheryl Miller

If employees are healthier, they’re more effective, engaged in their work, and more present, says Elizabeth Miller, vice president of care management at White Memorial Medical Center (part of Adventist Health). Presenteeism is part of the company’s “Engaged Health Plan,” a patient engagement strategy that is targeted to save as much as $49 million overall.

To engage patients, you can offer incentives. For example, at Adventist Health we outreach to our entire organization, our own employees, and we are on track to save millions of dollars with that. We call it ‘The Engaged Health Plan’ and it’s a reduced monthly cost on their health insurance. It is a bi-weekly reduction of $50, which is significant. They’re saving $100 a month. We engaged by taking their blood pressure, their weight and their blood glucose. We created an exercise plan for them with their consent, talked to them about their physical conditioning and what they wanted to see in their physical. We also talked about the ideal health population, and how we consider a healthy employee a more effective employee.

It’s costing our organization money to put this on; even though it’s our own health plan, it does cost. Why did Adventist Health go in this direction? You can see with the cost and the savings that it will save us $49 million. It is a mission. We are a faith-based organization, but it is a mission of ours to improve the health status. And it is also going to improve us financially. If our employees are healthier, they’re more effective, more engaged in their work, more present. You’ve heard of presenteeism. These are things that we’ve looked at.

dual eligibles care
Elizabeth Miller, RN, MSN, is the vice president of care management, diabetes program at White Memorial Medical Center, Adventist Health. Ms. Miller is accountable for the daily operations of the care management team, nurse care managers, social workers and the diabetes program, ensuring optimal patient flow through the healthcare continuum of care.

Source: Population Health Framework: 27 Strategies to Drive Engagement, Access & Risk Stratification

8 Ebola Emergency Preparedness Measures from CarePoint Health

October 16th, 2014 by Patricia Donovan

Ebola drills, preparation of ‘grab-and-go bags” and targeted screening of callers requesting ambulances are some of the Ebola emergency preparedness measures announced by CarePoint Health this week In response to individual cases in the United States and elsewhere.

CarePoint Health has implemented the measures system-wide at its three New Jersey hospitals and its McCabe Ambulance service.

For example, patients arriving in a CarePoint ED will immediately be screened to determine their risk of exposure to Ebola. If a case is suspected, CarePoint Health has procedures, equipment and technology in place to help limit exposure and to safely care for the patient. “We will continue to refine our plan based upon the latest information available from clinicians treating Ebola patients,” said Dr. Mark Spektor, chief clinical integration officer for CarePoint Health.

Also, McCabe Ambulance’s call screening technology incorporates an Ebola screening tool that prompts dispatchers to ask all callers about recent travel and critical symptoms before an ambulance even arrives at the scene. If dispatchers suspect a patient may be at risk for Ebola, EMTs can safely transfer the patient and notify the receiving hospital.

Some other immediate Ebola-related safety measures CarePoint Health has implemented include the following:

  • Ebola Drills. CarePoint Health hospitals have each begun running unannounced Ebola drills to help prepare staff members for how to deal with a suspected Ebola case. These drills will continue until the recent outbreak has been contained.

  • Creation of Ebola ‘Grab and Go’ bags in emergency departments. Pre-packaged bags containing all necessary personal protective equipment (PPE), instructions for donning/doffing the PPE and a checklist of how to care for patients suspected of being infected with Ebola are available in all CarePoint Health emergency departments.

  • Technology. With the new electronic medical record system, changes have been made to the screening and triage of patients making it mandatory to document travel history at intake.

  • Internal Communications. CarePoint Health is providing updates about our processes, protocols and systems to all staff members via e-mail, town hall meetings, group huddles, text alerts, and other channels. There are also targeted communications for clinical staff, emergency room personnel, security guards, housekeeping staff, communications reps and senior leadership addressing their specific protocols.

  • Regular communications with CDC and state and local health departments. CarePoint Health is in constant communication with the CDC, New Jersey and local health departments so protocols and procedures can be adjusted based upon the latest clinical data.

  • Use of personal protective equipment. CarePoint Health is conducting department specific hands-on training on the proper use of personal protective equipment. This training includes donning and doffing of equipment as well as environmental issues surrounding waste disposal.

  • Multidisciplinary task force. CarePoint Health has convened a working group drawn from its departments of clinical services, environmental services, infection control, admitting, materials management, human resources, security and others to manage its Ebola response plan.

  • Staff education. Staff members will regularly receive written educational material developed by the CDC and compiled by the Departments of Infection Control and organizational education that will address many of the questions surrounding Ebola. Full educational in-services will be provided for those staff members and our affiliated physicians who may potentially have any involvement in either the direct or indirect care of an Ebola patient.

Infographic: Large Employers Lead the Way With Worksite Wellness

September 10th, 2014 by Melanie Matthews

As a growing number of employers realize the impact that employees’ health has on the bottom line, the number of employer-sponsored wellness programs has increased with larger employers leading the way.

An infographic by MBA Healthcare examines the types of wellness programs that employers are offering and the impact the programs have on employee health.

Big Companies Leading the Way in Preventive Care

7 Patient-Centered Strategies to Generate Value-Based ReimbursementHealthcare companies seeking a roadmap to richer reimbursement should begin with the seven value-based healthcare priorities for 2014 identified by the healthcare C-suite: population health management, care coordination, integrated care delivery, e-health and telehealth, access to care, health and wellness, and dual eligibles. 7 Patient-Centered Strategies to Generate Value-Based Reimbursement explores the seven healthcare areas ripest for development in 2014, prioritized by 136 respondents to HIN’s ninth annual Trends & Forecasts survey.

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Guest Post: With Rise of Remote Healthcare, Are Physicians Equipped for Engaged Patients?

August 13th, 2014 by Scott Zimmerman

More engaged patients will expect more responsive healthcare professionals.

Thanks to a proliferation of wireless health monitoring tools, healthcare providers must prepare for a new breed of patient who is more tech-savvy and engaged in the management of their own health, advises guest blogger Scott Zimmerman, president of TeleVox Software.

Is your healthcare organization ready for a new breed of patient? Individuals who want or need to play a more active part in their health, and who expect their physicians to do the same?

If it’s not, it may be time to start prepping. Think about consumers’ growing interest in smart devices, sensors and mobile apps for tracking fitness levels. IHS Technology has predicted that global market revenue for sports, fitness and activity monitors will rise by 46 percent, to $2.8 billion, from 2013 through 2019.

That trend is accompanied by employers’ trying to lower their own healthcare costs, by having employees take on higher deductibles or paying only fixed amounts for certain tests or procedures. That’s creating a consumer class more conscious of securing the best health services at the best prices. Increasing personal responsibility in this area may well have a spillover effect, motivating people to become better overall managers of their own health. We may see the same result, too, as more businesses offer wellness incentives that give employees rebates for engaging in better health practices.

Also taking on greater healthcare accountability are individuals with chronic conditions, especially those using wireless home health monitoring tools to track and even transmit EKG, sugar levels and other health statistics to their providers’ systems. IHS Technology has studied this area, too, finding that worldwide revenue for telehealth devices and services used for monitoring diseases and conditions will grow to $4.5 billion in 2018, up from $440.6 million in 2013.

What Have You Done For Me Lately?

As consumers become more savvy and more engaged participants in their healthcare, they may have increased expectations about how providers will respond to their efforts. As they become better equipped to remotely transmit healthcare data to their doctors, for example, they may naturally assume providers are equally well-equipped to provide feedback on that information in real-time—or at least something close to it.

After all, while it’s nice to have direct feedback from a wireless activity wristband on daily calorie intake, that data may be even more useful if a physician can analyze it in context with other patient data—such as information in the EMR that the individual has Type 2 diabetes and blood glucose levels recorded by a home health monitoring device. The healthcare practitioner may conclude from all these measurements that calorie intake should actually be reduced now that blood glucose control has improved, in order to avoid weight gain. It’s understandable if the patient would like to be informed of that as soon as the conclusion is reached, rather than waiting for the next scheduled appointment.

Just-in-time patient engagement, then, is the direction in which healthcare providers must move. Consider that three in ten U.S. consumers responding to TeleVox’s Healthy World Research Survey said that receiving text messages, voicemails or e-mails that provide patient care between visits would increase feelings of trust in their provider. Of those who have received such communications, 51 percent reported feeling more valued as a patient, and 34 percent reported feeling more certain about visiting that healthcare provider again.

An Eye Toward the Future

Today, tens of thousands of healthcare providers already have started down that road of between-visit engagement, with automated appointment, prescription and treatment notification and reminder systems that use the patient’s medium of choice—e-mail, text or voice. In fact, TeleVox’s survey showed that more than 35 percent of patients who don’t follow exact treatment plans said they would be more likely to adhere to directions if they received reminders from their doctors via these methods. Though the outreach is automated and one-to-many, the systems feel one-to-one, as they are personalized with the patient’s name and other details drawn from providers’ practice management systems.

Ochsner Health System in Louisiana is among healthcare providers who have successfully leveraged this technology. It deployed an automated phone campaign to 3,000-plus patients who had been ordered to have colonoscopies and upper endoscopies, but had not scheduled the exams. The phone messages even offered patients the option to book the appointment by pressing a key while on the line. Of the patients reached, close to 20 percent made the appointment.

This was a win-win for patients and providers. Colon cancer detected and treated early has a nearly 100 percent success rate. These patients told Ochsner that without the automated notification, they never would have completed the test. As for the health system, Ochsner generated more than $600,000 in revenue from conducting the exams.

Today, the industry is just scratching the surface of how it can use communications technology to help healthcare providers better engage with patients between visits. The future holds the promise for more providers to obtain more data from EMRs, sensors, wearable medical devices, and home health monitoring tools; feed this data into patient engagement systems, and use business rules to trigger just-in-time customized patient engagement communications. A worrisome remote ECG reading transmitted from a heart disease patient’s home monitoring device, for example, can drive a follow-up action such as a time-sensitive outbound call to the first available specialist.

While getting to this level might sound a little daunting, it doesn’t have to be. Providers can take on the project in stages, moving from general reminders about preventive tests to follow-up messages aimed at those with chronic conditions, before they tackle real-time or near real-time responses to data submissions generated via remote healthcare devices. For instance, daily text messages could be scheduled to go out to obese patients querying them about whether they have met their daily walking goal. Or, treatment protocol compliance reminders, such as retinal and foot exams for diabetic patients, could be scheduled at regular intervals.

All that said, I suspect most providers are looking to this future less with trepidation than with excitement. They’re in the healthcare business, after all, because they want to help people. Now, the doors are open for them to have more regular and proactive contact with their patients, as well as respond more quickly to potentially dangerous situations.

About the Author: Scott Zimmerman is a regularly published authority on utilizing technology to engage and activate patients. He also spearheads TeleVox’s Healthy World initiative, which leverages ethnographic research to uncover, understand and interpret both patient and provider points of view with the end goal of creating a healthy world, one person at a time. Healthier World promotes the idea that touching the hearts and minds of patients by engaging with them between healthcare appointments will encourage and inspire them to follow and embrace treatment plans, and that activating these positive behaviors leads to healthier lives. Zimmerman possesses 20 years of proven performance in the healthcare industry, and currently serves as the president of TeleVox Software, Inc, a high-tech engagement communications company that provides automated voice, e-mail, SMS and web solutions that activate positive patient behaviors by applying technology to deliver a human touch.

HIN Disclaimer: The opinions, representations and statements made within this guest article are those of the author and not of the Healthcare Intelligence Network as a whole. Any copyright remains with the author and any liability with regard to infringement of intellectual property rights remain with them. The company accepts no liability for any errors, omissions or representations.

J&J and Canyon Ranch Partner on Corporate Wellness Program

July 10th, 2014 by Cheryl Miller

An organization is only as healthy as its leadership.

And that’s one of the key reasons behind a recent corporate wellness venture between Johnson & Johnson’s Human Performance Institute (HPI) and Canyon Ranch. The Human Performance Institute has collaborated with Canyon Ranch by combining the principles of their flagship course, Corporate Athlete® with Canyon Ranch’s integrative wellness offerings. The hybrid course, called The EXCELerate Program — The Power of Energy for Purpose & Performance, offers clients a five-day health and wellness experience that incorporates the full resources and amenities of Canyon Ranch’s flagship property in Tucson, Arizona and HPI’s premier energy management performance training program.

We spoke to Bill Donovan, the General Manager of the Human Performance Institute, Wellness & Prevention, Inc., about this program.

HIN: Can you tell us a little about the program?

(Bill Donovan) The purpose of this program is to expand our reach and impact more lives by working together to create the ultimate wellness experience. The Human Performance Institute’s Corporate Athlete training is based on 30 years of proprietary research and depth of knowledge in training elite performers. We started with professional athletes in the world of sports. We learned very quickly that the strategy of increased performance in sports was easily transferable to any environment. So we moved into other areas, surgery, medical, Special Forces, military; now Fortune 500 executives are the main focus for us. The program combines the sciences of performance psychology, nutrition, and exercise physiology. And the premise is to help train people to expand their energy so they can increase their performance in work and in life.

When you look at Canyon Ranch, they’ve also been around for over 30 years. They have an award-winning integrative approach to wellness. Their world-class facilities create the perfect environment for this wellness experience to come to life. Together we educate, empower, inspire, and help create lasting change in people through the blended experience. Canyon Ranch is very much hands-on, one on one. HPI is more group training. Together, we create customized experiences that cover critical dimensions of health and can truly have impact.

Who is Canyon Ranch and Human Performance Institute targeting for enrollment in their new EXCELerate program?

The program is designed to benefit anyone, but the key targets are senior level executives and leaders that are looking to improve health, performance, and be able to thrive in the face of constant demand and pressures. One thing we see in the world today is that the demands and pressures being put upon us and our leaders in particular continue to increase. How do we rise up in the face of that and not only survive but thrive?

Secondarily, we’re focusing on past graduates of our respective programs; graduates of HPI and Canyon Ranch loyals who want a more in-depth and immersive experience.

What will this program’s impact be on absenteeism, productivity and performance for employees in general?

It’s designed with senior leaders in mind, and built on the premise that the culture of an organization is often a reflection of its leadership. So if you believe that great success and change starts with leadership, then that’s what this program is about. It’s an immersive five day training program designed to help individuals make healthy, sustainable life changes, resulting in optimized well being, improved health, and enhanced performance.

When a senior leader, who is often the busiest person in the organization, can role model the behaviors that people aspire to, whether it is an optimistic outlook, focus, better work/life balance, better fitness, or eating habits, or maybe even overall health across all dimensions: mental, emotional and physical, they give hope and inspire those they lead. That is the critical first ingredient towards creating cultural change within an organization.

How will this program differ from standard wellness or disease management programs?

The immersive experience is a big part of it. I don’t know of any program that brings together the best of both group training around performance with holistic, hands-on, unique, individual experiences to really focus on helping to improve health. Bringing together the best of Canyon Ranch and HPI and our Corporate Athlete Program create something unlike anything in the market, and I think this really sets us apart.

To learn more on the program, with dates scheduled for July 13-18, and October 19-24 in 2014, click here.

What’s Your Motivational Interviewing Communication Style?

May 6th, 2014 by Patricia Donovan

MI is increasingly favored by case managers and health coaches to elicit behavior change.

There are three distinct communication styles in motivational interviewing (MI), a directive, client-centered counseling style designed to invite or elicit behavior change specifically by helping individuals to explore and to resolve ambivalence toward specific behavior change. Today, motivational interviewing is favored not only by health coaches but also by case managers and physicians. Here, the three styles are defined by Dr. Karen Lawson, MD, program director for the health coaching track at the Center for Spirituality and Healing, University of Minnesota.

Directing, which is familiar to any of us who come from a conventional, medical or therapeutic background, is about getting specific information, making informed recommendations — basically telling someone what their next step should be and what they should do. There is an important place and role for that in healthcare, and it should by no means be eliminated.

From a coaching standpoint however, when someone is truly wearing the hat of coach, I do not believe for the most part that directing should play a significant part in what they’re doing. There may be a moment or two in time where delivering concrete information that they happen to have that could be of use to a client, may be appropriate, but that should be a very small percentage of the time that’s spent in a health coaching session.

Looking at the second style, the opposite of directing is following, where you truly are with no agenda, structure, or input, openly listening and following where the client wants to go. There’s definitely a role for that in coaching; however, coaching should be 100 percent following.

The place in the middle is guiding. Health coaching done from this perspective with an MI framework is a guiding relationship.

For example, a teenager who has diabetes may have many complex situations going on. They’re often very resistant, and trying to find a way to both manage their adolescence and their diabetes at the same time. It’s very common for the physician, in a directive way, to say, “How many times are you taking your insulin? How often are you checking your blood sugar? What are your numbers running? This is what you should do to fix the situation.”

By comparison, a coach working with a client like that might be able to say, “How do you feel that you are doing with your sugar management? What do you feel you might be able to do if you would like to take that blood sugar management up to a better level? Would you like to do that, and if so, how would you do that?”

There’s still some guiding in there that occurs. It’s not only listening generically; guiding does occur, but it’s cognizant of not delivering clear, dictated instructions.

Excerpted from Health Coaching for Behavior Change: Motivational Interviewing Methods and Practice.

Infographic: Does Early Breast Cancer Detection Save Lives?

April 14th, 2014 by Jackie Lyons

An extensive study of mammograms found that they do not decrease breast cancer death rates, and they increase over-diagnosis, according to a new infographic from based on a Canadian study.

Consequences to misdiagnosis include unnecessary radiation, surgery and chemotherapy that come with high costs. The average cost of treating early stages of breast cancer is $22,000, according to the infographic. This infographic also includes the history and statistics of mammograms and early detection.

Learn more about assessing health risks in 2013 Healthcare Benchmarks: Health Risk Assessments. This 60-page resource provides metrics on current and planned HRA initiatives as well as lessons learned and results from successful health assessment programs. It is enhanced with guidance from industry thought leaders on the necessity of HRA and stratification prior to launching a population health management program.

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Infographic: U.S. Prescription Drug Costs

April 9th, 2014 by Jackie Lyons

American consumers pay 50 to 100 percent more for prescription drugs than any other country, with the average American paying $983 per year, according to a new infographic from Clarity Way.

This infographic outlines the cost of specific prescription drugs in comparison to other countries and the cost of drug research and development. It also identifies the benefits of access to prescription drugs, such as savings, prevention of death and hospital visits and more.

Drug Benefit Trends and Strategies: 2013 includes insight and expert analysis — from the publishers of Drug Benefit News and Specialty Pharmacy News — to help you understand what pharmacy benefit management trends are on the horizon in regards to: market share, formulary structures, PBM contracting, transparency, copays and Rx drug costs and utilization.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

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Infographic: How the ACA Affects Mental Health

April 7th, 2014 by Jackie Lyons

In terms of medical care, missed days of work, chronic health issues and death, depression is estimated to have cost the United States $112 billion in 2013, according to a new infographic from The Affordable Care Act (ACA) mandates mental health coverage for millions of Americans and requires a free depression screening under all health insurance plans.

This infographic provides an overview of depression in America, including prevalence of depression, the average cost of a hospital stay, cost of medication, as well as how the ACA is expected to impact mental healthcare.

Illness Management and Recovery (IMR): Personalized Skills and Strategies for those with Mental Illness helps people with SMI identify personally meaningful goals and work to achieve these goals by addressing smaller, more manageable segments of those goals.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you’d like featured on our site? Click here for submission guidelines.