Follow it to big savings for California healthcare

Dr. Mehmet Oz joined California state officials Monday in launching a pilot workplace-wellness program aimed at getting public workers to improve their health as a way to save the state money on health care costs.

The host of “The Dr. Oz Show” appeared with the state controller and state treasurer in Sacramento to launch “Health Happens in the Workplace,” which will focus on preventing chronic diseases.

“Remember, for every dollar we invest to make you healthier, the state and you save three bucks,” Oz told a crowd of several hundred state workers gathered in the outdoor courtyard of the California Museum. “It’s the wisest decision.”

A study commissioned by the state controller’s office found that California could save between $18 million and $54 million a year if between 5 percent and 15 percent of its government workers are able to prevent chronic diseases.

The study by the Urban Institute found that California spent $1.6 billion on health care in 2008. About 22 percent, or $362 million, was spent on preventable conditions such as diabetes, heart disease and high blood pressure.

State Controller John Chiang told workers that staying healthy will help control skyrocketing medical costs. State Treasurer Bill Lockyer used himself as an example, noting that he has lost 40 pounds this year through exercise and eating right.

HealthCorps, a Sacramento-based nonprofit founded by Dr. Oz and his wife to fight childhood obesity, will partner with the state on the pilot program along with The California Endowment, Kaiser Permanente and the Service Employees International Union Local 1000, which is the largest state workers union.

Oz said he hopes the workplace-wellness program will be a model for the rest of the country.

“I’m pleading with you. You guys are going first. If we don’t do it right in California, it’s not going to be able to spread across this nation,” Oz said.

Oz told the audience that he performed bypass heart surgery three years ago on a 25-year-old woman. To celebrate, her husband brought her a platter of hamburgers and fries.

“I realized right then and there, that all of you pay people like me a lot of money to do things to you. But that’s not where the value is,” he said. “The reason you ignore that message is that we haven’t given it to you the right way.”

The pilot program, which will start with the Department of Public Health, will focus on health education, employee screenings and supportive physical and social environments.

During the rally, Oz, a heart surgeon, jumped off the stage to tend to a state worker who had fainted while standing in the sun during the event. Department of Public Health worker Eunice Pannell said afterward that she didn’t know she had blacked out. She was treated and released by paramedics on scene.

It’s official: distracted driving is a prominent and serious threat to employee safety, and the Department of Labor is pulling out the big guns to tackle the problem.  Last week, Labor Secretary Hilda Solis announced the DOL’s Occupational Safety and Health Administration will partner with the Department of Transportation for a new initiative combating distracted driving.  Sec. Solis specifically called out American employers, challenging them to do more to discourage employee cell phone use while driving.

Los Angeles, CA, United States (KaiserHealth) – It would be easy to confuse Dr. Mitch Katz with any other doctor at the Roybal Comprehensive Health Center in East Los Angeles. His desk in a closet-sized, windowless office is littered with patient records, x-rays and cans of Diet Coke.

Dr. Mitch Katz rides his bike to work, defying the commuting norm in Los Angeles. (Photo by Michael Wilson/L.A.County Health Services Dept.)

Dr. Mitch Katz rides his bike to work, defying the commuting norm in Los Angeles. (Photo by Michael Wilson/L.A.County Health Services Dept.)

His everyman demeanor belies his stature: As director of the county’s Department of Health Services, Katz oversees LA’s public hospitals and clinics, the health care of last resort for millions of low-income Angelenos. He has 22,000 employees and a $3.7-billion dollar budget.

Los Angeles, the nation’s second largest city with some 2 million uninsured residents, has long had one of the most disorganized systems. To fix it, Katz, the former director of San Francisco’s health department, insists on seeing patients at this public health clinic one afternoon a week. It’s a demand that struck many as odd, if not impossible. How would Katz have time to treat patients with a system in ruin? Katz is starting one clinic at a time.

On a recent morning, Katz sits opposite his patient, a middle-aged man who is a bundle of nerves. Katz speaks Spanish with his native Brooklyn accent and patiently explains the possible causes of his tumor and what he hopes a visit to a lung specialist will reveal.

“I wanted him to know that he would never be abandoned or alone figuring it out. My view is that this lowers people’s anxiety levels and they don’t wind up in the emergency room because now they’re very frightened about what they have. They need a plan,” he explained.

Katz’s primary aim though, and what he came to Los Angeles to do, is to steer low-income Angelenos away from the overburdened emergency rooms they’ve long relied upon and into primary care clinics where costs are lower, chronic diseases can be managed and problems, like a tumor, can be detected earlier.

He says that when he took the job, “they sent me the LA org chart, I said where’s primary care? They said, ‘Well, it’s under the hospitals.’ [I said] Well, that may explain why you have a problem with primary care!”

It didn’t take long for that to change: In the last six months, his team has assigned nearly 250,000 people to a primary care doctor at county clinics, he says, adding: “In fact, I didn’t have to hire a single additional doctor. What I did is say: ‘No, we’re not running this anymore as a drop-in, see-who-you-see-and-no-one-is-responsible’ system.”

Katz’s predecessors promised many of the same reforms, but government observers here say they were stymied by a Board of Supervisors which often governs Los Angeles like five competing fiefdoms.

But Michael Cousineau, a professor at the University of Southern California’s Keck School of Medicine, says those supervisors are scared of what’s to come. Under the health law, many of those currently uninsured are expected to be covered beginning in 2014. When that happens, the federal government will reduce the extra money they now give to public hospitals to offset the burden of caring for these patients.

One report commissioned by the county put it bluntly: If LA loses its paying customers and is left treating only undocumented immigrants, the financial survival of its health system is at stake. Cousineau argues that to move the system from one of “last resort to a system of choice is not going to be an easy thing. But the price of failure is: thousands of people losing their jobs, closing of health centers and hospitals. So that’s what the supervisors have to grapple with.”

Gloria Molina, who represents East Los Angeles, is one of the supervisors – each of whom represent more voters than many U.S. Senators do. She is supremely and unusually confident in Katz: “I was one that was worried he was just going to be another guy that just took us so far and then would leave us. But instead he’s had the most daunting challenges and he’s meeting all our expectations.”

One test of Katz’ vision for re-making LA into a desirable public health system is taking place at the heart of where it all went terribly wrong. The Martin Luther King Junior-Harbor Hospital in South Los Angeles closed in 2007 after it reached near-third world standards and one woman died of egregious errors.

It’s now re-opened as a clinic where patients with chronic diseases are counseled by a team of nurses and medical assistants. The clinic’s nurse manager Kimberly Thomas says customer service is now a top priority: “They’ll bring patients who have diabetes and high cholesterol then bring them in again and look at their labs and see if they’re improved or gone down.” She says patients love the gifts they get if they improve their test results.

Assigning low-income patients to a medical home makes for better medicine, but whether it engenders good will – and loyalty – when these same patients gain insurance is an open question. And this may, in fact, be Director Katz’s greatest challenge: giving Angelenos a reason to believe in what the county can offer.

“Someone will talk to me about their medical problems, and I’ll start asking them about what’s going on in their marriage, with their kids, in their home and people will begin to cry,” says Katz. “People will begin to tell you amazing things about what are really the issues. And often the physical symptom both to you and to them is just the opening salvo in a conversation that they want to have with someone who cares about them.”

This story is part of a reporting partnership that includes KQED,  and Kaiser Health News.

– Provided by Kaiser Health News.   Article © AHN – All Rights Reserved

Workplace wellness programs are a win-win for both the employer and employees. Employees who participate in workplace wellness programs are fitter, more productive, have better morale, and are safer than employees who do not otherwise treat their chronic conditions. Employers who offer wellness initiatives have achieved excellent returns on their investment.  Programs that follow best practice guidelines return $2 to $3 dollars for each dollar invested.

Brochure
Please read this brochure for instructional steps on how to set up a workplace wellness program.

Instructional Video
Listen to an expert in the field, Anne Marie Ludovici-Connolly, give a brief tutorial on how to set up a workplace wellness program. Ms. Ludovici-Connolly is a subject matter expert in health, wellness and prevention, and author of Winning Health Promotions Strategies, a how-to guide on how to plan, develop, and implement successful worksite wellness programs.

By Ken Terry  InformationWeek

April 19, 2012 12:30 PM

A major West Coast health plan has jumped on the social gaming/networking trend in fitness and wellness applications. Blue Shield of California is already offering one such program to its employees and will soon provide two more. The company is also trying to sell its employer customers on the idea that this approach can help engage workers in their own healthcare.

Blue Shield launched Wellvolution, a wellness initiative for its own employees, in 2009. This program had some impact, but the company eventually realized that it could do even better, Bryce Williams, director of Wellvolution, told InformationHealth Healthcare.

Recent research had shown the power of social connectedness in improving health outcomes, and mobile health apps were suddenly catching on among consumers. “So it made sense to take the technology that people were already using and comfortable with and migrate that to a health platform that included social media and social gaming,” Williams explained.

Blue Shield’s first move was to try an application called Shape Up Shield that focuses on increasing physical activity. “This is an eight-week-long, social-media-fueled challenge that uses an online platform to let employees form teams, post comments in forums, set team and personal fitness goals, and give virtual ‘high fives’ for encouragement,” a Blue Shield spokesman said. “In 2011, over 1,800 Shape Up Shield participants walked, hiked and ran 600 million steps,” about 300,000 miles.

[ To find out which medical apps doctors and patients are turning to, see 9 Mobile Health Apps Worth A Closer Look. ]

One of Blue Shield’s new programs, The Daily Challenge from MeYou Health, is similar to Shape Up Shield, in that it uses social media, including Facebook, to make wellness fun. But instead of confining itself to physical exercise, it gives participants a series of individually tailored Daily Challenges, Williams noted. The Daily Challenge is “a simple activity that improves your wellbeing.” That might be physical, emotional, or mental, he said. (The MeYou website says, “the Daily Challenge promotes everyday wellbeing by encouraging the small actions and fostering the social ties that drive meaningful change.”) MeYou’s program features the hallmarks of social gaming, such as points, badges, status, and progression.

Another application, Healthrageous, uses mobile devices to get patients involved in wellness and chronic disease care. Based on personal data collected on these devices, Healthrageous advises and supports patients in meeting their health goals. The program also includes a social media element: participants can compete and share their experiences online.

What makes Healthrageous different from the other online wellness programs, Williams said, is that its coaching “is related to what I’ve done rather than to some generic recommendation about exercising more or changing health behavior. That enables us to tie our actions to almost immediate feedback.”

Including the impact of Shape Up Shield, Wellvolution has had an impressive track record. In the past three years, Williams said, 80% of Blue Shield employees have participated in at least one of its wellness programs. During that period, there has been a 50% drop in smoking prevalence and a similar increase in regular physical activity among employees. The incidence of hypertension has fallen by two-thirds, and disability claims are down among participating workers, but not others.

One reason for the high participation rate is the incentives offered to employees. Wellness program participants are paying $3 million a year less in their share of insurance premiums, and they’re getting a total of 2,500 “health days” off from work. The company has also benefited by cutting annual health cost growth for its employees from double to single digits.

Now that it has shown the effectiveness of the social networking approach, Blue Shield is starting to offer its customers Healthrageous. They may buy the program either as a standalone product or as part of the company’s Blue Groove consumer-driven plan, which already includes some wellness and care management aspects. Eventually, Williams noted, Blue Shield may also sell Shape Up Shield and the Daily Challenge to California employers.

“Doing wellness is hard work,” noted Williams. “It’s hard to eat less, exercise more, and give up addictive habits like smoking. But there’s no reason it can’t be social and fun, too. And once it becomes relevant to people’s everyday experience and becomes less of a chore, and less about willpower and abstinence, that’s when engagement rates start to rise.”

by Lucas Mearian, Computerworld   Apr 17, 2012 9:00 am

Editor’s Note: This story is excerpted from Computerworld. For more Mac coverage, visitComputerworld’s Macintosh Knowledge Center.

A third of U.S. consumers now use social media sites such as Facebook and Twitter to seek medical information and track and share symptoms. They’re also using the sites to vent about doctors, drugs, treatments, medical devices and health plans.

The survey of 1040 U.S. consumers was put together by consulting firm PricewaterhouseCoopers (PwC) and includes data from a separate survey of healthcare and pharmaceutical executives on how social media is used in their business strategies.

Not unexpectedly, young adults rely on social networks for healthcare information far more than older Americans. The survey found that more than 80 percent of those between the ages of 18 and 24 said they’re likely to share health information through social media channels—and nearly 90 percent said they would trust information found there.

By comparison, less than half (45 percent) of those surveyed between the ages of 45 and 64 said they’re likely to share health information via social media.

The PwC report showed that four in ten consumers have used social media to find health-related consumer reviews of treatments or doctors; one in three have sought information related to other patients’ experiences with their disease; and one in four have posted comments about their health experience.

“The power of social media for health organizations is in listening and engaging with consumers on their terms,” Kelly Barnes, U.S. Health Industries leader at PwC, said in a statement. “Social media has created a new customer service access point where consumers expect an immediate response.”

And 72 percent of those surveyed said they would use social networks for scheduling doctor visits and nearly half said they would expect a response within a few hours after doing so.

When asked whether information on social networks would affect their health decisions, 45 percent said it would play in role in whether to get a second opinion; 41 percent said it would affect their choice of a specific doctor, hospital or medical facility; and 34 percent said it would affect any decision to take a certain medication.

PwC’s report found that consumer activity on social media sites dwarfs that of healthcare organizations such as hospitals, insurance and pharmaceutical companies. Social media, the report notes, is changing the nature of healthcare interaction, and “health organizations that ignore this virtual environment may be missing opportunities to engage consumers,” Barnes said.

Community sites that allow people to weigh in on various medical and healthcare issues had 24 times more social media activity than corporate sites, according to PwC. That shows how much room to grow corporate sites have.

“Health organizations have an opportunity to use social media as a way to better listen, participate in discussions and engage with consumers in ways that extend their interaction beyond a clinical encounter,” Barnes said. “Savvy adopters are viewing social media as a business strategy, not just a marketing tool.”

PwC’s report includes the results from its Health Research Institute (HRI) social media survey of U.S. consumers in February and 124 members of the eHealth Initiative (eHI), a national association focused on health information and technology. HRI found that eight out of 10 healthcare companies had a presence on various social media sites.

HRI also interviewed more than 30 industry executives and tracked the social media activity of a number of hospitals, insurers, drug manufacturers and online patient communities to create a “week-in-the-life of social health” snapshot.

PwC says that hospitals, insurers and pharmaceutical manufacturers can benefit from the interactive nature of social media, which can offer instant feedback on products or services along with new ideas for innovation. That could lead to higher-quality care, more loyal customers, increased efficiency and even revenue growth.

And 82 percent of those surveyed by HRI indicated that their organization’s social media efforts are managed by marketing/communications employees. The PwC report also said few organizations indicated that their IT departments and digital teams oversee their social media strategies. And half of those surveyed said they are concerned about how to integrate social media information into business strategy and processes.

“Social media is another source of business intelligence that provides information at the aggregate level, not only about what consumers ‘like,’ but what they need, how they behave and when their experiences demand an immediate response,” said Daniel Garrett, U.S. Health Information Technology leader, PwC. “Health organizations can engage IT to integrate social data intelligence with existing systems and processes, yet most are still struggling with how to manage the data from their own clinical systems.”

businesses, cost of living increases pushing workers to work longer hours, as well as personal choice to spend time on other activities besides sleep because of a lack of knowledge about the importance of sleep…

Inadequate sleep has critical negative impacts on the workplace. The risks from fatigued workers are broad reaching and extend from workers to employers and society. Risks to employers include reduced productivity and increases in worker errors and incidents ranging from medical errors to industrial disasters. Fatigue is a recognized risk factor for vehicle crashes and has been implicated in well-known disasters such as the 2009 Buffalo jet crash and the 2005 BP Texas City explosion.

In December 2010, Healthy People 2020, the US national public health goals for the next 10 years, launched a new chapter for Sleep Health. There are four objectives: 1) increase the proportion of persons with symptoms of obstructive sleep apnea who seek medical evaluation; 2) reduce the rate of vehicular crashes due to drowsy driving; 3) increase the proportion of students in grades 9 through 12 who get 8 or more hours sleep each day; and, 4) increase the proportion of adults who get 7 or more hours sleep each day. NIOSH scientists are working on training programs to improve fatigue and sleep-related issues for workplaces. These will be added to the NIOSH topic page for work schedules as they become available (http://www.cdc.gov/niosh/topics/workschedules/). Check out the latest entry on the NIOSH Science Blog related to Sleep and Work http://blogs.cdc.gov/niosh-science-blog/2012/03/sleep-and-work/

For more tips on improving sleep and to learn what scientists are doing to improve societal well-being through sleep research, check out:

• Your Guide to Healthy Sleep – (http://www.nhlbi.nih.gov/health/public/sleep/healthy_sleep.pdf .
• The Healthy People 2020 Topic Page for Sleep Health (http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=38.