Sunday, September 18, 2011

Health care: a problem to solve or opportunity to integrate?

Whose job is it to keep our nation healthy? In today's climate with economic cutbacks, limited resources and extended work responsibilities within all sectors, it seems that everyone agrees that everyone has a role in improving access, quality, and affordability of health care. In addition, every business, membership organization and government agency has the responsibility to provide resources to allow it's members to understand and manage their health care needs. Based on this agreement, it is surprising how challenging it is to integrate disciplines to resolve these very important issues.

Similar to organizations that are decentralized and work in silos to run their businesses, the various areas of health care have been contained within their own space for some time. From public health to school health to health promotion to health technology to health psychology and others, we have evolved within our disciplines over the years, but done a poor job learning from each other and integrating our best practices to afford greater outcomes.

Perhaps the question is not "Whose job is it to keep our nation healthy?" ,but "Who will take the lead in bridging the gaps between health disciplines to ensure the health of our nation improves?"  thus far, a single leader has not emerged, but some organizations (Robert Wood Johnson Foundation, Health Enhancement Research Organization, Health Advocates) are making significant strides in the arena. I commend the leaders working towards a united voice/approach to improve health care quality, access and affordability - many minds working together have always been better than one working alone.

Thursday, August 18, 2011

Mobile Apps for Health

Would you like to use an app to book a doctors appointment just like you might do on Expedia or Travelocity? Would you like to have your health information accessible in an app so that you could access when needed (ie., blood pressure, cholesterol, BMI) at a doctor's office? Would you use an app to work with a virtual fitness trainer or weight management coach?  If you could, what type of app would you want to use for your health?

As smart phones continue to advance their functionality, consumers are being afforded more and more opportunities to "access" information and automate their traditional in-person services. Although there may be disadvantages to this remote approach, consumers and vendors alike are seeing the benefits of using mobile devices to connect with each other.  With this, what type of health app would you like to better manage aspects of your health care needs? Would it be a scheduling tool, a content tool, a tracking tool, or another type of tool?

If you are currently using one of the health apps on the market, please share your experience with me. I would be very interested in learning about your experience.




Tuesday, July 19, 2011

Incentives - are they the solution or the distraction in EHM?

For many years, we have been asked to demonstrate the ROI of health management programs. Specifically, identify the financial investment in employee health management programs and show the savings reaped from the investment. Recently financial incentives have been at the top of discussions because of their "power" in motivating individuals to participate in programs. Furthering this dialogue is health reform, allowing employers to increase the percent of health benefits that can be offered as incentives from 20% to 30%, and possibly 50% in the future.  Based on the state of the market and our interest in responding to the ROI request, many are asking the question "What is the best incentive to offer to engage participants and afford the best outcome in health programs?"

I would challenge those responding to that question and ask why we are trying to answer this question? In all of my experience over the years, no one program design has fit more than one company, because each company has it's own set of unique program goals, culture, leadership support, resources and policies. So, what would make us think we could identify one incentive amount, type, or design as the "gold standard." 

I think we should be asking different questions entirely: What barriers exist that are preventing people from prioritizing their health? How is the health of an employee woven into an organization's policies, performance reviews, manager evaluations, leadership commitment? What is the organization's opportunity to achieve greater performance, retention, growth, culture, etc.?  Identifying success measures and assigning value to these as a "return" is a worthy conversation. 

Finally, let's not focus all of our attention on an incentive and assume this component is the success or failure of the program. An incentive is only the "coupon" that gets you to walk in the store, let's try to achieve loyal customers and integrate programs so well that prioritizing health is easy, rewarding and an expectation within the organization's culture.

Friday, July 15, 2011

HERO - its strengths & vision to drive EHM

Yesterday I was honored to sit around the table with many thought leaders in the area of employee health management at the annual HERO Think Tank meeting. I am always impressed at the level of commitment and engagement these meetings include, as well as the "brain power" around the table. Credit should be given to the founders of HERO (Bill Witmer and Mark Dundon), as well as Jerry Noyce and his staff for continuing to evolve HERO as an organization and continue its mission. Today it was determined that HERO's research focus is to identify EHM best practices for the industry and it's members and continue to flesh these out to better define gold-standard EHM programming.

As I process our meeting, I have a few observations....

- member organizations are only as good as it's members and their ability to identify their organization's goals, define a strategy to achieve these goals, and take action on this strategy.
- effective leaders bring out the passion in people and their interests, and utilize this energy to shape and springboard the organization's mission.
- organizations should recognize their past successes, but focus on their future success and defining it well. Defining the questions they are trying to answer, determining whether the group has the means to adequately address them, and if the right people are involved to make it happen.

As I sat through research priority discussions today, I felt excited to be a part of a group that has not only identified priorities for our field, but also challenged itself to conduct research with scientific rigor, investigate areas that practitioners are most interested in, and commit to establishing partnerships with other organizations to reach their goals. In addition, it has been an outstanding experience thus far to learn from the many leaders and minds involved in this initiative.

Sunday, July 10, 2011

Health Education - its importance at school

A recent study revealed that sharing BMI results of overweight and obese children with their parents had no affect on whether children lost weight years later http://www.foxnews.com/health/2011/07/08/no-point-in-telling-parents-about-kids-weight/ . Although one might think this is surprising, it coincides with our experience when only presenting individuals with their health status data, and little information on what the data means or resources/programs to work on improving such metrics. Without the latter, it can be assumed that individuals, will at a minimum, understand they have health risks, but certainly not understand the importance of those risks or how to better manage them.

Currently, I am working with a local elementary school to improve their culture of health. The goal of the initiative is to increase awareness of healthy habits throughout the community, and ultimately improve the health of the students, families and staff of the school. This study is timely, as the school has been measuring  BMI and fitness levels for all students. To date, a standard one-page report has gone home to parents letting them know of their child's results. It would be ideal to continue these health measurements, but create communication pieces that emphasize the reason for measuring these stats, the importance of managing them, and how the school is working to provide an environment supportive of healthy activities. Ultimately, the changes in policy and environment would improve student health status.

Although it is not the school's responsibility to manage the health of their students, the school environment teaches ideals. Understanding how many hours children are in school during the year, and the impact the school environment can have on children, improving school policies and environment to support healthy habits is a necessity to afford our children a healthy, prosperous life. It is exciting to see how many schools throughout the country are focusing on health as a key priority of their environment.

Friday, May 20, 2011

Managing Health is a Lifestyle, not an Activity

As a health professional working with organizations to strategically plan their health management programs, one of the greatest challenges faced is to keep their population interested and engaged in their health "programs". After all, the objective is usually to implement the most effective programs to help improve the population's health status, resulting in healthier, more productive employees. Although this objective is a sound one, we may be preventing the outcome we are working so hard to achieve - lifestyle/behavior change. Why? Simply because we are asking participants to join a "program," sign up for a "class," participate in an "event." These invitations are for one-time, temporary enrollment. They begin and end, and certainly imply that there will be another option to choose from soon. Almost like trying the weekly special or buying the latest smart phone that came out this week. These programs are not soliciting lifetime change, they are suggesting a short-term solution by design.

It is for this reason I am questioning the approach and marketing we use for our initiatives today. Perhaps we need to consider adopting an approach that more openly invites permanent change. Published studies show that long-term behavior change results when individuals work with a lifestyle coach to develop a plan to change their behavior, take small steps in the process, and work towards a specific goal over a long period of time. If this is the case, we should be approaching individuals and inviting them to make a long-term change, rather than a sign-up for short-term programs?

Furthermore, I would even suggest that asking individuals to commit to a change, rather than sign up for a program, might have greater impact and better encourage long-term success. This commitment might include individuals taking the following steps:

1. Identify one health behavior change you want to make in your life. Confirm this change is important to you and you have the ability to make the change if you committed to it.
2. Pledge that you will make this change for the next 30 days by writing this commitment on paper and sharing it with a spouse, friend or confidant who will support you in your change. 
3. Identify when you will start this new behavior and mark the calendar.
4. Determine the reward you will provide yourself when you achieve your goal, write it down on the calendar on day 30 so you are reminded to reward yourself.
5. If this change is still challenging, continue for another month. If you are ready to take on another healthy habit, repeat the process while maintaining the first change.

Although well intentioned, I believe the indirect consequences of offering programs are hindering our ability to help participants achieve long-term behavior change. The American culture craves one-stop shopping and quick fixes. Discovering a way to weave health management into this culture challenges us every day, but setting realistic expectations is the beginning of success in this area. Managing your health is a lifestyle, not an activity.

Thursday, April 21, 2011

ROI of Your Tax Return

If you are one of the lucky ones receiving a tax return this season, have you already allocated the $$ to a purchase, activity, bill payment, or otherwise? What is the ROI of your decision?

Have you considered spending that money on improving your quality of "health"?  Seriously..... if one of the barriers to exercising, eating healthy, managing stress, being compliant with medication, or another healthy activity is having the income to afford taking care of yourself, here is your opportunity!

Often times I hear that if a person "had the treadmill" or "could spend the extra two dollars on the healthy lunch option" or "could stomach the cost of the prescription" they would take better care of themselves. If this is truly a challenge of yours, it is worth considering. The ROI can be tenfold to a one-time purchase - it may just be the jump start you need - permission to spend your money on the gym membership that motivates you, the high-end health food store that serves great tasting food, or the message you typically only get every other year. Whatever this investment might be - make it for yourself, and your quality of life.

All things considered, your health is directly related to your success in this world. Without our health, we cannot achieve great things, it is constant drain on our impact in this world. With health, we are a powerhouse of potential. Invest in your health this tax season and embrace the opportunity to "spoil" yourself with some healthy treats!

Monday, April 11, 2011

Parenting - making it healthy

Tonight I read an article in the Star Tribune, a Minneapolis newspaper, explaining how new parents are a "high risk" population because they are not effectively managing their health (http://t.co/oza6nRF). I thought to myself, well this is not enlightening or surprising to many of us who have embarked on the adventures of parenthood. The sleepless nights, unhealthy eating habits, lack of exercise and turbulent emotional health status are just par for the course.

Regardless of the number of years you have been in the game, it is safe to assume that maintaining a healthy lifestyle "pre-children" looked a whole lot different before your beautiful offspring came along. In fact, for some of us, exercise was a staple in our weekly routine, a healthy diet was attainable, and sleep happened when it was suppose to. No doubt, healthy habits were easier to manage and prioritize. In addition, if we had a few "less than healthy" weeks, our bodies were more forgiving.

This article and topic intrigues me. As a parent of three children, I realized that with each child we welcomed into our family, the better I got at re-establishing my exercise routine and healthy habits. With my first daughter, it took a solid year before rejoining my tennis league. With my second, it took about nine months to begin a regular walking and running routine. Then with my last child, it took only four months for me to be out with a couple running partners at 5:45am each weekday morning. Was this because with each child I further realized the importance of maintaining my own healthy balance?

Despite my success with maintaining my pre-parenting exercise focus, with each child it was a challenge physically, but even tougher mentally. I felt starved for the physical exertion because I have always been an avid exerciser, but trapped with time constraints and demands that I never had to accommodate before. Most importantly, I felt I needed to be "on call" and available 24/7. How could I accomplish this and allow myself to truly re-energize regularly. My husband felt similar pressure, during his free time he felt compelled to help with the kids rather than relieve some stress.

I am glad to see that the article highlighted the "high risk" status of parents in an effort to heighten awareness of the additional support and resources that are needed by active parents. I often wonder if it is a matter of providing good programs that can reflect the needs of parents and their families, or if a cultural shift is needed to emphasize the importance of a parent's health in the upbringing of their children.

What if a parent's health status ultimately determined the fate of their child's success in this world? The child's ability to live a quality life to the fullest, manage their own health and be productive in our world. Would a study that proved the value of a parent's health status as the determining factor in a child's success convince parents to take better care of themselves. My guess would be that such a study would help, because when we become parents our biggest motivator  is to protect and enhance the lives of our children. Hummmm, interesting research idea....

Friday, April 1, 2011

How Healthy is Your Community?

Almost four years ago, my husband and I decided it was time to move to a new home and neighborhood. This decision was based on many factors - desiring a larger home, wanting more property to call our own, and seeking a strong school system for our children as they begin their foundational elementary school years.

When we set out to determine which communities we were interested in, we focused primarily on the school system, cost of the home, property, neighborhood, community, and distance from our relatives. I can honestly say that we never considered looking into the "health of the community" as a criteria, despite the fact that I am a healthcare professional. One of the primary reasons is likely because there was no source to attain this data four years ago. The closest I came is to ensure there was a safe neighborhood running route for my daily run.

Today, I am happy to share that this data now exists. On March 30, 2011, Robert Wood Johnson Foundation in coordination with the University of Wisconsin Population Health Institute released the 2011 County Health Rankings for almost all counties within the 50 states (http://m.countyhealthrankings.org/). The data allow you to see how your County ranks against a National benchmark, the State and other Counties within your State. It assesses counties on health outcomes (mortality and morbidity) and health factors (health behavior, clinical care, social & economic factors, and physical environment). In essence, you are able to see how healthy a community is and how long people live within the community. It illustrates the factors that influence these two characteristics - education, jobs, income, environment, access to care and others.

So how can we make use of this information? It provides us (community members, educators, healthcare professionals, public administrators) with a starting point to join together and strategically plan to improve the health of their communities, then evaluate the impact of our efforts annually. If done effectively, all residents of the community will benefit by leading healthier lives and living longer - who can argue with these rewards?

After learning where my County ranked this week, I challenged myself to do my part for my community. As a healthcare professional, my "day job" allows me to assist corporations in implementing successful health management programs. I plan on taking this experience and knowledge and help our elementary school plan healthy school programs to enhance our school's culture of health. I am excited about the potential and hope others will join me in lending our skills and expertise to make our communities healthier. Any chance you want to join me?

Monday, March 28, 2011

Health & Family

As a working mother of three children, I am challenged each day to find the right balance for myself and my family. By balance I mean maintaining a healthy approach to our busy lives - physically, mentally, and spiritually. I will be the first to admit, on many days I feel defeated. And some days, I feel like a champion because I successfully guided my "troop" through the chaotic day and their lives were enhanced from the experience.

In today's world it is hard to achieve and maintain balance. Each day you wake up to another email, phone call or conversation that invites you to become involved in a new activity, attend a very important meeting, support a new great cause, or lend a hand to someone in need. With the world tugging at your leg each day, it is hard not to find yourself over-committed and overwhelmed. So, when asked a question such as "Do you prioritize health in your day?" it is tough to answer "Yes". In addition, I think you would be hard-pressed to find many mothers and fathers out there who would confidently say that their family's physical, mental, and spiritual health is at it's optimal level.

So, what if there was a way to help mothers and fathers prioritize their health in their day? For years, companies have been focused on helping their employees prioritize their health by providing great programs and resources to help them understand their health risks, manage these risks, and improve their quality of life. These programs are typically provided to employees and their familiy members, and sometimes retirees of the organization. Although some of these programs are best-in-class, state-of-the-art programs, families do not engage at the level to which we would hope. In essence, engagement is a challenge.

So, back to the family structure ... And the working mother-of-three, when asked "Why is it so hard to maintain balance in your day?" for me, it is well beyond understanding my health risks, knowing the programs available, and understanding how engaging in an activity will improve my quality of life. It is more about looking at each of the activities my family and I do, and identifying which ones contribute to a healthy life, and which ones simply negate these efforts. Could there be a health management program that can help families and parents do this in today's world? Be customized to reflect each families goals, interests and priorities? If so, would it be more effective than an exercise or weight program they cannot even consider fitting into their day because they are just getting through the day and all it's demands. Would it provide parents the ability to truly become more balanced, enabling them to make healthier choices.

I believe these are interesting questions.

Thursday, March 24, 2011

Connectivity for Health

A few weeks ago I attended a healthcare conference and one of the keynote speakers mentioned the importance of technology in facilitating healthcare interactions with patients. In another session, the speaker described the relevance of understanding the key components of successful games to better understand what is necessary to build a successful online health experience for participants. While I was on Twitter yesterday, a world-renowned hospital posted a tweet about the value of social media for physicians.

Connectivity for health is a field that is only in its infancy. We are just beginning to understand how individuals make health decisions through consumer segmentation data, how one's culture can impact a person's likelihood to make behavior changes, how a social network can be used to facilitate and predict behavior change, and how individuals may adapt to new technologies as the access and use of these innovative tools become more prevalent.

The question is how the various stakeholders in the health arena will utilize this evolving medium of communication. Will healthcare choices and interventions feel more like Apps we download today? Will the physician-patient relationship ultimately change based on the use of technology and the access to healthcare information? Will healthcare consumers be guided through the maze of benefits and health management based on their personal needs, preferences and available resources captured through back-end technology? What role will the government, health plans, employers and vendors play in this evolving field?

I am not sure of the specific answers to these questions, but do know that the landscape of healthcare in the US is and will continue to change based on the technology available. Employers are looking for innovative solutions that "engage" their population in every aspect of their health. It is exciting to ponder the possibilities that new technologies will provide us, and overwhelming to contemplate how this changes the breath and depth of our efforts as healthcare professionals. Let's look at this as an opportunity to change how we have approached health management in the past, change how we implement health benefits, and better understand how technology can help individuals engage in their health on a daily basis.

What have you done to manage your health today? Did it involve the use of an App, website, online program, social network, text message? If not, could it have and would it have been more enjoyable, effective, and fun if it had? If it did, what were the reasons you engaged with the technology? Think about the possibilities we have upon us.