'Health-E' Encounters

Online wellness tools are giving HR a new way to spread the health message.

Thursday, October 2, 2008
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On April 1, Craig Fletcher was among hundreds of employees at Arcadis, a global engineering and scientific-services-consulting firm, to sign up for a 14,554-mile race from his company's U.S. headquarters in Highlands Ranch, Colo., to its global headquarters in Arnhem, Netherlands.

Despite its launch date, the race was no April Fools' joke. Instead, it was a new initiative launched by his employer to motivate its workforce to get into shape.

Called "The CEO Challenge," the race is virtual, scheduled to end on the last day of 2008. Employees form teams of no more than six, or enter by themselves. Each time they exercise -- anything from walking to strength training -- they log on to CoreXL, a Web site designed by Kelowna, British Columbia-based CoreHealth Technologies Inc., select the activity they just completed from a drop-down menu and enter the amount of time they exercised.

They're then assigned a specific number of points based on the type and amount of exercise they've just completed. The more points they earn, the greater distance they travel: For example, 100 points is equal to one mile.

The Web-based program displays each team on a map that shows how far they've traveled. However, the teams never travel along a straight route. Instead, they zigzag across the United States on their way to Arnhem, stopping at each of the company's various U.S. offices. Employees can click on each office's icon to learn more about its employees, the city it's located in and the projects its staff is working on -- a feature that's designed to build camaraderie.

Although Fletcher's team -- named, appropriately enough, Geek to Peak -- has already earned 950,000 points, it's still in 28th place so far, near Savannah, Ga.

"The Web site is essential to the race," says Fletcher. "Without it, you wouldn't be able to keep track of where you are and where everybody else is."

Employers are all too familiar with the high cost of poor health. Dozens of studies have shown the link between poor health, low job productivity and soaring health claims.

Cornell University's Institute for Health and Productivity Studies researched insurance and disability claims for about 375,000 employees over a three-year period. It recently found that, per employee per year, hypertension costs employers $392, heart disease $368, mental health problems $348, arthritis $327 and allergies $271. Even with mild conditions -- such as headaches and allergies -- productivity losses can account for more than 80 percent of an employer's total illness costs.

As HR leaders struggle with how to encourage their organizations' employees to lose weight and get in shape, many have turned to interactive online services that offer state-of-the-art ways to make fitness a bit more fun while providing additional information on health and nutrition.

These services can also provide HR with a clearer picture of their workforce's health status via status reports. Though hardly a cure-all, many HR leaders say these tools are proving quite useful for their health-promotion efforts.

Boost Participation

At Arcadis, the company's major health challenge was getting employees to be more proactive about their health. Prior to its launch of The CEO Challenge, only 750 of the company's 4,000 U.S. employees participated in its wellness programs, says Jim Barrett, senior vice president of HR.

Other than an online health screening, most of Arcadis' wellness efforts were fairly traditional, consisting of workshops that focused on specific health topics such as smoking cessation. Not long ago, the company asked its healthcare provider to conduct employee health-risk assessments to identify the top medical issues facing its workforce.

Its No. 1 health problem? Obesity.

So HR chose the exercise-based virtual race, hoping it would attract more employees and motivate them to lose weight by exercising on a routine basis. Since then, participation in Arcadis' wellness programs has doubled, to 1,500 employees, says Barrett.

Employees, he says, have referred to it as "fun," "cool" and "exciting." The ultimate goal isn't about who gets to Arnhem first, but for everyone to finish the race, says Barrett.

Although the appeal of The CEO Challenge lies partly in its ability to let participants see how they're progressing compared to their peers, this sort of transparency is not always welcome in other wellness areas. When considering online health tools, companies should not underestimate confidentiality concerns among employees.

Consider Ridgeview Medical Center in Waconia, Minn. Earlier this year, the medical center's HR department offered each of its 1,400 employees $75 if they took an online health exam, completed an online health survey and signed up for a new online program that let them create their own personal health profile.

Employees logged on to a Web site designed by Minneapolis-based RedBrick Health Corp., which collected and processed their confidential information. Using a third party such as RedBrick for this task was vital for addressing employees' confidentiality concerns, says Robert Stevens, Ridgeview's president and CEO.

"We wanted our employees to be able to trust us," he says. "We didn't want them to think there was any kind of proposed or future penalty for signing up, like raising their healthcare premiums if they were overweight or had high cholesterol."

Almost half of Ridgeview's workforce -- about 650 employees -- signed up, Roberts says. The online system offers employees information and assistance based on their health assessments and claims histories over the past five years, ranging from health status reports and remote monitoring and tracking of health readings to personalized tips for improvements and social-networking opportunities. It also notifies workers via e-mail if their health profile was updated. When employees hit key milestones, such as quitting smoking for a year, Ridgeview rewards them with up to $300 in cash.

However, one of the system's key features is designed for management. It analyzes the entire workforce so Ridgeview can create wellness initiatives, based on employee needs, to change unhealthy behaviors.

For example, Ridgeview discovered that 62 percent of its employees were either overweight or obese. "We were shocked," Stevens says, adding that it's now exploring a variety of ideas, such as placing nutrition labels on its cafeteria entrees. It also plans on testing a month-long program in which employees pay one and a half times the normal price for unhealthy foods but half the price for healthy items available in the cafeteria. 

The information may also help Ridgeview cut its prescription-drug costs. Stevens says the No. 1 prescription drug used by employees is Lipitor for high cholesterol, costing the organization approximately $39,000 a month. As a result, it may launch a series of new classes focused on nutrition and exercise.

"What was unique for me was to see a profile of our employees and to look at where we could target some of our dollars to improve employee health," he says. "Our goal is to reduce our expenditures in our [self-funded] health plan by 10 percent within three years, or $550,000 a year."

"Vitality Scores"

Like Ridgeview and Arcadis, Aditi Technologies in Bellevue, Wash., also wanted to put the Web to work in improving its employees' health. It recently contracted with Limeade, an online health company also based in Bellevue, to develop a "whole-person wellness approach" for its 375 U.S. employees, says Naomi Lombard, Aditi's senior HR manager. The global product-development firm helps companies create and implement effective research and development strategies.

Lombard says approximately one-third of Aditi's workforce logged on to Limeade's Web site and completed an assessment that goes way beyond exercise, health conditions or eating habits. It asks employees about all areas that can potentially affect one's health, even financial conditions or "self-attitude." Once they've completed the assessment, employees identify three personal goals and create a plan to achieve them.

The online tool also provides chat rooms and blogs so employees can share their thoughts with other users across the Limeade universe. Additionally, Limeade provides users with online journals so they can write about their feelings, as well as links to other Web sites that provide additional information about specific health issues and regular reminders about HR programs at Aditi designed to address their needs.

Still, it's the online dashboard that caught Lombard's attention. It presents employers with a "vitality score," or ratings that compare responses from an organization's workforce to those from employees at other organizations.

"[The dashboard] allows me to look at the company as a whole and at areas where our employees may need some help," she says.

For example, she says, Aditi's employees scored higher than average in "self-acceptance," but ranked about average in forming positive relationships.

The tool can also be used for prevention. After it revealed that many employees suffered from back problems, says Lombard, the company implemented ergonomic workstations.

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"When your life revolves around a computer, a dashboard is absolutely the best way to get to people," says Lombard. "It doesn't push the program at them, but it's a way to passively ensure that there are tools available that will help them overcome any health issue."

A Family Affair

If employers are serious about improving employee health and decreasing health claims, they may want to consider extending access to their online wellness tools to employees' families. After all, according to ongoing research conducted by Hewitt Associates in Lincolnshire, Ill., between 60 percent to 70 percent of employers' healthcare costs are incurred by people who don't work for them -- i.e., by family members, says Tim Stentiford, a principal at the firm.

Last year, the firm introduced the Hewitt Health Care Hub to its clients. Each client or company has a custom URL. Like other online sites, it offers healthcare information, tools and resources. Where it differs is in how people access and navigate the site.

For instance, any family member can log on. No one needs to register or remember a password (unless they're filing a claim or requesting confidential information), which removes key barriers to access, says Stentiford. With some sites, he says, registration alone can take 15 minutes, driving many employees away.

The Web sites also identify health conditions that generate a company's highest healthcare costs, then provides users with information and tools pulled from more than a dozen Web sites focused on those illnesses. That makes navigation easy, says Stentiford, adding that employees only need to remember one URL and surf just one Web site to get the illness-specific information they may need, rather than going to half a dozen or more.

For example, says Stentiford, because many retailers tend to employ younger workers, maternity would be a hot topic on their Web sites. However, manufacturers -- whose workforces tend to skew older -- would be more likely to feature information about heart disease and musculoskeletal injuries on their Web sites.

To identify topics that appeal to workers, he says, Hewitt reviews employee demographics, medical claims and even psychographic information. The latter can help employers understand why workers fail to properly address their health issues, such as failing to adhere to medication regimens.

This year, Hewitt began designing blogs and other features for organizations to encourage their employees to network about important health and benefit topics. Stentiford points to one financial-services firm that established its own global network, connecting employees who are parents of children with special needs, such as autism or cerebral palsy.

Because many health plans don't offer programs that address specific conditions, Hewitt built a Web site for the firm that informs parents about available company resources and various third-party health and benefit providers.

Likewise, when a global logistics-services company recently changed its health plan, Hewitt designed, built and began hosting a blog that connects hundreds of field HR representatives with company leaders across different geographic locations to encourage them to exchange ideas and explore ways to sell the new program.

All too often, HR makes it "too difficult" for employees to access information, says Stentiford. "The world doesn't need another healthcare tool or site, just a better way to deliver what we already have," he says.

"If online health tools or programs are too complicated or frustrating to use, people will quickly quit using them," says Seth Serxner, a principal at Mercer's Los Angeles office.

He says other questions to ask include:

* Do the online health tools or programs help employees change their behavior? For example, are people exercising more, losing weight, eating healthier or even monitoring their blood sugar as required? Ask the vendor for an outcomes report, which reveals how many employees used the tool, started and completed a program or lowered their health risk.

* Are they interactive or do they just provide health-related content? The more interactive, the more motivated employees will be to develop healthy routines or practices.

* How well do they integrate with your total wellness program? If they're isolated or lack a clear connection, he says, they won't be as powerful.

Serxner says online health tools or programs should be viewed as supplements to your company's overall health-management program. Generally, they're good options for people with low health risks who just need a bit of reinforcement. However, they may not be as potent for employees with more serious or complicated health issues who need strong coaching, extra motivation or even face-to-face counseling.

"We really do view online tools as just another modality within an overall approach to helping people [manage] their health," says Serxner. "For some people, it's a really good learning style. The more options people have, the more likely [it is] they'll participate."

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