Advancing the EAP Field by Applying Innovations in Technology and Predictive Analytics

Transcription

1 Advancing the EAP Field by Applying Innovations in Technology and Predictive Analytics Presented at Employee Assistance Society of North America 2013 Annual Institute Chicago, IL May 2, 2013 Presented by Tom Amaral, Ph.D., President & CEO EAP Technology Systems Inc. Dave Sharar, Ph.D., Managing Director Chestnut Global Partners Mark Attridge, Ph.D., President Attridge Consulting, Inc. About the Presenters Dr. Tom Amaral is President & CEO of EAP Technology Systems. He is a research psychologist who has been researching and evaluating EAPs for more than 30 years, and a recognized expert on ROI, workplace outcomes, benchmarking, and demonstrating business value. He has implemented these types of projects for many Fortune 500 corporations and other organizations. Tom is also chief architect of the company's computer software systems, and he conducts training seminars on a variety of advanced topics, including how to make the business case for EAPs, how to calculate ROI, and how to conduct benchmarking. He has authored and presented many papers and articles on research, evaluation, cost-benefits, performance metrics, and software topics. He is also on the editorial board of the Journal of Workplace Behavioral Health. Dr. Dave Sharar is Managing Director of Chestnut Global Partners, a provider of international employee assistance, expatriate support, and crisis intervention abroad. Dave is also a Research Scientist with Chestnut's Division of Commercial Science where he deploys scientific methodologies to help EAP firms and other workplace health programs evaluate their effectiveness. Dave has published over 70 articles in peer reviewed journals and trade magazines. In partnership with Dr. Richard Lennox, he co-developed the Workplace Outcome Suite, a tool being used by over 400 EAPs to measure effectiveness. He is on the editorial board of the Journal of Workplace Behavioral Health and on the Board of Directors of the Employee Assistance Research Foundation.

2 Dr. Mark Attridge is a social psychologist and research consultant in independent practice as President of Attridge Consulting. He has experience with a range of employee health management services but has been most active in the field of workplace mental health and with EAPs in particular. He was the co-recipient of the "2009 EASNA Member of the Year" award for writing and editing the EASNA report "Selecting and Strengthening Employee Assistance Programs: A Purchasers Guide." Mark is a prolific writer, scholar and teacher. He has authored more than 100 articles and conference papers on topics in health care, psychology and communication. Previously, Mark was a National Director at Watson Wyatt Worldwide and a Principal at Optum. All three speakers are active members of EASNA s Knowledge Transfer and Research Committee KTR.

3 Advancing the EAP Field by Applying Innovations in Technology and Predictive Analytics Tom Amaral, Ph.D., President & CEO EAP Technology Systems Inc. Dave Sharar, Ph.D., Managing Director Chestnut Global Partners Mark Attridge, Ph.D., President Attridge Consulting, Inc EASNA 25th Annual Institute Chicago, IL May 2, 2013 Top Six Needs of the EAP Industry Higher utilization rates Actionable and measurable outcomes Better coordination among partners Greater perceived value among purchasers Innovative services for future generations Continuous succession of EAP professionals

4 High Prevalence of Behavioral Health Problems in the Workplace 11% 9% 8% 9% Alcohol Drugs Depression Anxiety Percent of All Employees Low Utilization of Benefits for Mental Health and Addictions Those Who Need Help 30% Those Who Receive Help 10% Unmet Need 0% 10% 20% 30% Percent of All Employees

5 EAP Utilization Rates from the EAP Data Warehouse Employee Cases Utilization Rate 3.0% Alcohol Cases Opened 1.4/1000 Drug Cases Opened 0.7/1000 Cases Opened with Depression 6.5/1000 Cases Opened with Anxiety 8.1/1000 Technology Solutions Easy access to the EAP for employees through mobile devices Easy access to self-directed help-seeking information through apps Easy access to the EAP for managers and HR professionals through direct portals Next generation counseling solutions, such as e-counseling, v-counseling, gaming apps

6 EAP Data Warehouse EAP Data EAP Data EAP Data EAP Data EAP Data EAP Data Warehouse EAP Benchmarks Buckets of EAP Outcomes

7 Gathering Consistent Data The role of portals and mobile devices in standardized data collection processes Integration of standardized data collection tools, such as the WOS Automated gathering of workplace outcomes Standardized performance metrics

8 Open Audience Dialogue On: Higher utilization rates Actionable and measureable outcomes What is Coordinated Care? (No Agreed Upon Definition) Linkage Coordination Integration Right care, Right place, Right time Ensuring info sharing across people, functions, sites Smooth transitions from one service to another

9 4 Key Functions of Care Coordination 1. Communication & info sharing 2. Education & motivation 3. Self-management support 4. Monitoring of adherence Symptom severity Why Monitoring is Critical? Hypothetical but Common Example During Pre-tx During During During Post-tx Stage of intervention

10 Care Coordination in EAP is More Than: Handing a referred client a provider phone # A warm phone transfer to a service partner Co-location of EAP, WL, & Wellness Sending the client a web-link or PDF EAP Referral Out vs. Resolved Referred Resolved 82% 85% 18% 15% NBC Study (2013) Sharar (2008)

11 Coordinating Care in EAP: How Are We Doing (In General)? About 25% of EAP vendors incorporate validated screening or SBIRT as a part of intake* Most vendors rely on a 3-10 minute intake call* Of the 18% referred on, how many do you think received post-referral follow-up? Less coordination with workplace as management referrals decline * Mahieu & Taranowski (2013). A study of RFI data from Aon Hewitt. EASNA Research Notes. Barriers to Care Coordination in EAP Mainly viewed by purchasers/consultants as free (pre-benefit) counseling (not care coordination)* Care coordination seen more as a Managed Behavioral Health or Disease Management than EAP role Affiliates are more therapists than care coordinators Are we being paid to provide care coordination? We are largely separated from primary care * National Business Group on Health (2008) Employer s Guide to EAP

12 Use of Technology Can Connect Every EAP Constituent EAP Affiliates Treatment or Community Resources WorkLife and Wellness Partners Management Referral Liaisons Primary Care EAP Provider Common EAP Value Propositions Total well-being Integration with allied products Easy access, Highly responsive Readily available resources Engaging communications Preferential relationships Low price Savings via problem resolution Claims of impact & outcomes

13 Historical Indices of EAP Value 1. High utilization 2. User satisfaction 3. Positive testimonials 4. References to studies/reports 5. Perceived responsiveness 6. Some effort to quantify impact National Behavioral Consortium Benchmark Survey (2012) On your follow-up surveys, did you incorporate items from a standardized and research-validated tool to measure outcomes after use of the EAP? Less than half of EAPs used validated survey tools Yes, 42% No, 58% (n=62)

14 Validated Survey Measurement Tools Of the 25 companies that used Validated Tools: 36% Internally developed tools 28% Workplace Outcome Suite (WOS) 20% Stanford Presenteeism Scale 20% Health and Productivity Questionnaire (HPQ) 16% Work Limitations Questionnaire 4% Employer Measures of Productivity, Absence and Quality or EMPAQ Product Expansion of EAP Work-Life Online Resources Lifestyle Coaching Legal/ Financial Critical Incident Response Short-term Counseling Assess/ Refer 1988 Last 25 Years 2013

15 PEPY Past 20 Years N=29 Convenience Sample of EAPs PEPY RATE $30 $25 $20 $15 $10 $25 $22 $5 Free $5 $ Fee-based (not embedded) full-service, 5 visit EAP and WorkLife AVERAGE book-of-business PEPY. Free (embedded) sleeping EAPs Cross-cutting Themes Product load / Price Turnover / Vendor loyalty Commodity-based purchasing / Value-based Wide variation in quality Little correlation between price and quality

16 Potential Technology Solutions Produce and use improved analytics Align price and performance/outcomes See the future as obtaining rigorous evidence re: effectiveness Use technology to capture relevant, transparent, reliable metrics The Holy Grail IF we use technology to enhance access, build stronger connections, and make data more transparent, WILL this result in fair rates based on quality and effectiveness?

17 Open Audience Dialogue On: Better coordination among service partners Greater perceived value among purchasers Innovative Services for Future Generations Who are the Future Generations? Generation Y Also known as the Millennials Born in late 1970s to 2000 range Teenagers to young adults now in 2013 Generation Z Youngest cohort Born since 2000 Children today

18 Innovative Services for Future Generations: Tools Technology-enabled tools create more opportunities for access to traditional EAP services and to develop new services: Internet webpages Internet therapy ( & video) Internet social media Smartphone text messaging Mobile applications (ipad ) mhealth Review article Attridge 2011 Journal of Employee Assistance Innovative Services for Future Generations: Examples New EAP Tech-Tools: FirstChat Shepell-fgi (Canada) e-ap Homewood Human Solutions (Canada) Beating the Blues from the UK and adapted by Employee & Family Assistance Program (BC, Canada) MoodHacker ORCAS (USA) ExecuPrev OWLS (USA)

19 FirstChat Users Study: Age FirstChat Company EAP Norm % 14% % 33% 33% 41% 50 + years 10% 22% See EASNA Notes by Veder et al. (2012) Innovative Services for Future Generations Need Skills Training for Existing and Future EAP Counselors in Tech-Therapy e-tools to Deliver: Clinical and Risk Assessments Primary Clinical Services Recovery and Monitoring Support Self-Care Educational Resources Prevention and Culture Change

20 Aging of the EAP Field This Annual Institute celebrates 25 Years of EASNA. This is very good; but it also means As EAPA enters its fifth decade, many of its original proponents, innovators and practitioners have retired, moved on or passed away. Could their legacy be lost and forgotten? Dr. Daniel Hughes, Journal of Employee Assistance, Spring, 2013 (p. 26). AGE of EAP Professionals % 3% KEY FACT: 77% are 50 or older % % 60 + years 32% Future Trends Research Study - Attridge & Burke (2011)

21 AGE of EAP Professionals % 14% KEY FACT: 64% are 50 or older % % 60 + years 27% EASNA s COHP Marketing Survey Study March 2013 Continuous Succession of EAP Professionals THE CHALLENGES EAP professionals are aging Few university-based programs focus on EAP No government funding dedicated to EAP Global growth of the field = more demand Is level of pay enough to attract new people?

22 Continuous Succession of EAP Professionals THE ANSWERS Mentoring opportunities/business succession Encourage industry and corporate sources of sponsorship for training (CEU/PHD/certifications) Cross-training of EAP partners and network affiliates Advanced online training (websites & webinars) Technology tools can connect EAP staff globally e-therapy channels attract new people to EAP work e-business entrepreneurs as new partners for EAP Open Audience Dialogue On: Innovative services for future generations Continuous succession of EAP professionals Open Q&A Period

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24 References Amaral, T. M., & Attridge, M. (2003, November). Making the business case for EAPs: A review of research and methods. Workshop presented at the National Conference of the Employee Assistance Professionals Association, New Orleans, LA. Anthony, K., Nagel, D.M., & Goss, S. (Eds.). (2010). The Use of Technology in Mental Health: Applications, Ethics and Practice. Springfield, IL: Charles C Thomas. Attridge, M. (2012). Employee Assistance Programs: Evidence and Current Trends. In R.J. Gatchel & I.Z. Schultz (Eds.), The Handbook of Occupational Health and Wellness (pp ). New York: Springer. Available from: Attridge, M. (2011). The Emerging Role of E-therapy: Online Services Proving to be Effective. Journal of Employee Assistance, 41(4), Attridge, M., & Burke, J. (2011, November). Trends in EAP Services and Strategies: An Industry Survey. EASNA Research Notes, Vol. 2, No. 3. Available from: Attridge, M., Cahill, T., Granberry, S. W., & Herlihy, P. A. (in-press). The National Behavioral Consortium Industry Profile of External EAP Vendors. Journal of Workplace Behavioral Health: Employee Assistance Practice and Research. Blum, T., & Roman, P. (1995). Cost-effectiveness and preventive implications of employee assistance programs. Rockville, MD: U.S. Department of Health and Human Services. Conlin, P., Amaral, T. M., & Harlow, K. (1996). The value of EAP case management. (Health care claims cost-offset study conducted at Southern California Edison Co.). EAP Association Exchange, 26(3), Dainas, C., & Marks, D. (2000). Evidence of an EAP cost offset. Behavioral Health Management, 20(4), Dentzer, S. (2009). Mental health care in America: Not yet good enough. Health Affairs, 28(3), Frone, M. R. (2006a). Prevalence and distribution of alcohol use and impairment in the workplace: A U.S. national survey. Journal of Studies on Alcohol, 67, Frone, M. R. (2006b). Prevalence and distribution of illicit drug use in the workforce and in the workplace: Findings and implications from a U.S. national survey. Journal of Applied Psychology, 91, Hughes, D. (2013). Professional Memory Loss. Journal of Employee Assistance, 2 nd Qtr., Kessler, R. C., Chiu, W. T., Demler, O., Merikangas, K. R., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62,

25 National Institute of Mental Health. (2008). The numbers count: Mental disorders in America. Available from publications/the-numbers-count-mental-disorders-in-america/index.shtml. Smith, D. C., & Mahoney, J. J. (1990). McDonnell Douglas Corporation employee assistance program financial offset study Westport, CT: Alexander & Alexander Consulting Group. U. S. Department of Health and Human Services. (1999). Mental health: A report of the Surgeon General. Rockville, MD: Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health. Available from library/mentalhealth/home.html. Veder, Torino, Beaudoin & Zhoa (2012). Attracting New EAP Users Through Online text-based Chat Services. EASNA Research Notes, Vol. 3, No. 2. Available from: Yandrick, R. M. (1992, July). Taking inventory: Process and outcome studies. EAP Association Exchange, 22(7),