Engaging Employees in Wellness Using Wireless Technology Kevin Schulman, MD, MBA Peter Tippett, MD, PhD DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.
Conflict of Interest Disclosure Kevin Schulman, MD, MBA Peter Tippett, MD, PhD 2012 HIMSS
Learning Objectives Identify health care cost drivers for self-insured employers Describe the role and value of current health risk appraisals and wellness programs Correlate consumer engagement in wellness to improved health outcomes Outline the role of technology to empower consumer engagement in wellness programs and improve employee health
Health Care for Self-Insured Employers WHAT DOES IT COST?
2008 2009 2010 Cost Climb of Goods & Services Employees now generate an average cost of $7,507 per day for inpatient hospital services and carry an average cost of $10,679 for perinatal services and new dependent care. Source: BCBSNC 2007-2010 claims data; http://facts.kff.org/ http://online.wsj.com/article/sb10001424052748704735304576058281272741332.html?keywords=consumer+purchases#printmode
Utilization and Cost Comparisons 2007-2010 Change Change in Utilization 1 Increase in Cost 2 Individual -2.3% 14.4% Group -3.8% 39.5% 1. Utilization based on inpatient admission per 1000 members 2. Cost based on allowed cost per admission Source: BCBSNC 2007-2010 claims data; http://facts.kff.org/ http://online.wsj.com/article/sb10001424052748704735304576058281272741332.html?keywords=consumer+purchases#printmode
Health Care Costs Image Source: P. Sama; Data: CMS
Scale Economic Frameworks For IT Solutions Network Economics Productivity Non-Value Added Costs (Overhead) Disruptive Innovation Emerging: Substitution (deskilling)
Fiscal Impact Annual Health Spending (Billions of Dollars) Effect of 1.5% Annual Productivity Improvement (Retail Industry Increase) National Health Spending Projection Effect of 4.0% Annual Productivity Improvement (50% of Telecom Industry Increase) Source: Adapted from Hillestad et al. Health Affairs, Vol 24, Issue 5, 1103-1117. Calculations by K. Dossary, S Reed, & K Schulman from CMS data (NHE Historical and Projected, January 2008).
Health Risk Appraisals and Wellness Programs ROLE AND VALUE
The Case for the Wellness Program Health risk appraisals are a static snapshot of a consumer s current health status; they are not dynamic and responsive. Health risk appraisals typically assess risk but not a patient s readiness for change and/or predisposition toward lifestyle modification. A wellness program should move the consumer from risk to engagement.
Wellness Programs Snapshot On average, self-insured companies like Caterpillar, AT&T, John Deere, and Verizon spend over $4000 per employee, dependent, and pensioner on healthcare. Wellness programs are being widely and aggressively adopted by companies seeking to reduce this cost. Return on investment is slow and difficult to measure but worth the investment if they work. Currently, companies spend only $220 per employee on wellness programs per year. Source: Business Brief, February 2011, http://www.businessbrief.com/how-much-is-too-much-to-spend-on-wellness/:
Wellness is Disease Prevention Engaging patients in behaviors that reduce or eliminate the risk for disease. Smoking cessation Weight loss Diet Exercise The Wellness Definition Stress management
Disease Management Disease Management is Lifestyle Management Engaging patients in lifestyle modification measures that help keep chronic disease out of an acute state. Diabetes High cholesterol Hypertension Heart disease Pulmonary disease
Consumer Engagement in Wellness CAN IT IMPROVE HEALTH OUTCOMES?
Health engagement is so important because the more patients actively manage their health, the more these health citizens engage in prevention, healthy behaviors, self-management of diagnosed diseases, and health information seeking. AARP has learned, too, that activated patients achieve outcomes, such as reduced readmissions to hospitals, medical errors, and better care coordination between providers. Health Populi May 2011 Source: Health Populi. 03 May 2011. http://healthpopuli.com/2011/05/03/patients-health-activation-leads-to-better-outcomes-but-providers-arent-as-engaging-as-they-should-be/
Engagement through Technology DEPLOYING TECHNOLOGY TO IMPACT WELLNESS
Leveraging the Cloud Access: The benefit of a nationwide network. Connectivity: The consistency of a secure, reliable connection. Ubiquity: The convenience of an always on, everywhere connection. Capacity: The power of 5 MB bandwidth and a 4G Network.
The Right Proposition The optimal wellness platform will: 1. Deliver a dynamic health risk appraisal that not only confirms risk but predicts patient readiness for lifestyle modification. 2. Offer recommendations for targeted lifestyle modification programs and/or resources based on risk and readiness assessment. 3. Leverage the cloud and mobile technology to connect patients to those resources (mobile apps, media resources, videos, etc.) in an integrated way.
One Model: Technology Enabled HRA Wellness Platform Track user actions/utilization Collect clinical data (outcomes) Evaluate Interventions Intervention Recommendations
The Development Approach Problem definition Clinical Economic Technology application System application (approach and scale) Business model Implementation, analysis, refinement
Integrated Wellness Solution Compliance Behavior modification Resources and programs Outcome monitoring Environmental exposure Goal: Technology-enabled behavior change Images: http://mobihealthnews.com/4435/the-real-top-medical-iphone-apps-money-making-edition/
The Long-Term Potential: Integrating Wellness into Health Care Wellness platform PHR EHR Patient Level Data Collection Patient Reported Outcomes Passive Data Collection (exercise, geo-location) Imaging transmission Text/email clinician messaging Smart monitoring devices (radio chips, pumps, monitors, wheelchairs) Images: http://www.eetimes.com/electronics-blogs/other/4212283/grandma-s-vital-signs-on-your-phone http://www.gizmag.com/health-monitoring-system-japan/14047/
Integrating Wellness into Health Care Reality Disparate systems architecture Disparate state of mobile readiness Business model Regulatory constraints It s a political issue, not a technical issue Images: http://www.eetimes.com/electronics-blogs/other/4212283/grandma-s-vital-signs-on-your-phone http://www.gizmag.com/health-monitoring-system-japan/14047/
Questions?