A question for hospitals: How healthy is your workforce?

Health system leaders are familiar with a rich irony when it comes to their own workforce. Although hospitals are anchor institutions of health in every community, the wellbeing of those who work inside the hospital is too often put on the back burner.

This content is sponsored by Cerner.

Healthcare workers are accustomed to putting others before themselves. For many, it's their primary motivator for going to work, and the mentality usually spills over to affect other parts of their lives — sometimes to the detriment of their own health. When a hospital's employees neglect their own care, and don't take time for their own well-being, the deficits can collectively affect patient care, dampen employee morale and engagement, and fuel greater employee health coverage costs, among other repercussions.

Enter the corporate health and well-being program. The majority of large companies offering health benefits in 2017 offered workers the opportunity to complete health risk assessments and biometric screenings or participate in well-being programs, such as those to help quit smoking, lose weight or adopt healthier lifestyles and behaviors, according to Kaiser Family Foundation.

Health and well-being programs offer a range of benefits for any company in corporate America, including reduced absenteeism, greater employee morale, reduced healthcare spending, improved productivity and higher attraction and retention rates. But hospitals and health systems stand to gain something uniquely important from these initiatives: credibility in their community.

"Health systems have this unique responsibility to a community: They act as icons of health and well-being," says Mike Heckman, vice president of population health for Cerner. "There are a lot of health systems that want to diversify revenue or advance the types of relationships they have with their communities. One of the best ways to do that is through corporate health and well-being programs."

Hospitals and health systems need workforce well-being programs that not only inspire worker involvement but grow more robust and personalized over time to build upon employees' efforts year over year. To thrive as anchors of health in their communities, hospitals can take advantage of the tools to treat their employees' well-being with sophistication, personalization and privacy.

As anyone in healthcare knows, working at a hospital is challenging in its own right and the emotional investments are only exacerbated with a patient population of children. To envision a thriving employee health and well-being program, look to one children's hospital in Missouri.

In 2013, as an extension of its workforce health program, this employer of approximately 8,000 lives established a full, on-site medical home for its employees. The organization built a new primary care facility, which exclusively cares for hospital employees and their spouses. "A lot of the patients are clinicians," says Mr. Heckman. "It is not like they are unfamiliar with the healthcare world. They are very familiar with it, but they take care of themselves last."

The medical home launched with a robust offering of medical services. In a short amount of time, hospital leadership could not ignore how meaningful the center was to employees. This is when the medical home transformed from a clinic to a hub for community, health and well-being. Employees can visit the center to participate in yoga and fitness classes, address their mental health needs and receive care for illnesses or conditions — all with a strong focus on privacy.

So how did this pediatric hospital in Missouri do it? It all started with data, says Mr. Heckman.

The winning well-being program is data-backed

Richness and diversity of data is what distinguishes rudimentary employee well-being programs from those that ultimately improve health and morale, boost productivity and reduce healthcare costs.

"The thing that is most important to start with is an understanding, objectively and empirically, of what the population looks like. You have to know your data," says Mr. Heckman. "The more you know and understand your population, the more you will know how to engage them."

For a workplace health program to move the needle on physical and mental wellness, ideally employers need three types of data — claims, wellness and clinical. What's more, they need to access it in an integrated way that lets them parse data sets to discern patterns in employees' health outcomes, behaviors and costs.

Claims data. "This data may not have the best depth, but it has good breadth," says Mr. Heckman. Systems need claims data to understand opportunities to improve the health of their workforce, but access to this data depends upon the system's relationship with its payer. If a health system is not self-insured, does not have an amicable relationship with its health plan or disagrees with the insurer over data and how it is used, gaining access to valuable claims data can be a slow and time-consuming process. "That's when it is employers' responsibility to advocate for themselves and their employees and say, 'This is my data. I want to use it to understand my population and their health-related needs,'" says Mr. Heckman.

Wellness data. Wellness data is the more traditional information employers obtain through health risk assessments, wearable devices, biometric exams and other health activities requiring employee participation. This type of data is relatively limited, as it only reflects the health of participants rather than the workforce at large. "Some employers do a great job at driving engagement and participation and others, quite frankly, don't," says Mr. Heckman.

Clinical data. Clinical data is deeper in scope and derived from a health system's EHR or population health technology. "If you can connect the dots between the broad claims data and deep clinical data, you can really understand your population," says Mr. Heckman.

The challenge is this: claims data, wellness data and clinical data can all have different owners and come from disparate places. Employers' wellness partners need to access each of these three distinct categories and house the data in a platform that allows it to be viewed holistically versus in silos.

For its own employees, Cerner combines claims, wellness and clinical data using their big data platform called HealtheIntentSM. The programmable, cloud-based system is designed to take in disparate pieces of data, which arrive in a variety of formats. HealtheIntent synthesizes the data, normalizes it and makes it actionable so users know how to best engage and manage their population's health needs. Cerner "walks across the data elements" and gains a longitudinal view of their employee population.

When using HealtheIntent, health systems can aggregate, transform and reconcile data to paint a portrait of their employee population's health while facilitating meaningful well-being interactions at a person level. The platform is also vendor agnostic; health systems need not have a Cerner EHR to use HealtheIntent.

Cerner has interacted with data sets for hundreds of health systems and is familiar with the ways an organization can slice and dice claims,use wellness and clinical data to identify patterns, and more effectively allocate resources and intervene in a meaningful way.

"We can look at patterns around particular clinical areas, high-spend areas and other trends that might be identified based on what is happening with the health of the population, including what is spent or consumed from a healthcare standpoint," says Mr. Heckman. "Or we can look from a demographic perspective. Are we seeing different patterns based on different attributes of the population, such as gender, age or location? I might have people sitting in one building that, for whatever reason, are not exercising at all or have a higher proportion of chronic disease than I'd expect. Maybe there is something about that location, building or culture that can explain it, and we address it."

Personalized engagement strategies

When health systems have longitudinal views of their workforce's health and well-being, they are better positioned to segment and customize their engagement strategies for individual employees. After all, not every employee approaches health or wellness with the same motivations and goals.

For example, say three employees share the same two chronic conditions. One worker is unable or uninterested in actively managing his conditions right now. Another is deeply motivated to address these conditions — she wants to take the bull by the horns and tackle them herself. The third employee does not want to manage these conditions by himself, but he is willing to work with a clinical care team to change.

To really drive improvements, employers must understand the big picture of their employees' health while also tailoring incentives and engagement strategies to account for individuals' preferences. Organizations deploy a wide range of engagement strategies, but an incentive strategy is in the DNA of every successful health and wellness program.

Incent people to participate Incentives for participation help employers build a baseline for their health and wellness programs. For example, among large companies that offer health risk assessments, 52 percent offer workers an incentive to complete the assessment, according to the Kaiser Family Foundation. These incentives include lowered premium contributions or reduced cost sharing; cash, health savings account or health reimbursement arrangement contributions; gift cards, merchandise or raffle entries; or eligibility for other wellness rewards.

Incent people to take action Beyond incentives for participation, employers also impose rewards for employees who change their lifestyles or adjust their daily behaviors. For example, companies may offer rewards for employees who exercise four times a week, quit smoking or take a certain number of steps every month.

Incent people to achieve outcomes Finally, employers may offer incentives to motivate and reward employees who improve their vitals and health metrics over a specified amount of time. For instance, some companies offer incentives when employees lower their blood pressure or body mass index.

"All three of these types of incentives can be effective," says Mr. Heckman. "I think their success is highly dependent on the culture of the workforce at that moment in time. In my mind, there is a logical progression from participation to activity to outcomes. If you go through that progression at a speed that is acceptable to the workforce culture, you can be successful. If you go straight to the end and start by incentivizing outcomes, you are less likely to be successful."

The best workforce well-being programs also present a wide range of options for incentives and change the incentives so they aren't perceived as an entitlement. As one company told Mr. Heckman, some employees are motivated by monetary incentives whereas others go the extra mile for a free t-shirt. Giving employees a say in their reward is especially critical given the diversity of a health system's workforce. People from distinct generations, cultural backgrounds or of different genders may not find the same things inspiring. Mr. Heckman recommends a visual display of incentives and reward options. "You might give someone a prize catalogue and they can spend their incentive points on what is attractive to them," he says. "You can definitely differentiate based on optionality."


As the American healthcare landscape continues to shift its focus from reactive care to preventive care, whole-person health and well-being, it is critical for health systems to lead the way and serve as examples of what companies can (and should) do for their employees.

A data-driven workforce health program is better suited to improve outcomes and lower costs than programs based on guesswork and convention. But that is only step one of what is possible. Looking beyond these immediate benefits, health systems have the chance to walk the talk and prove to their communities and local employers that they are masters in managing the health of populations. In doing so, employers in the area are more likely to see these organizations

as providers of choice and healthcare professionals are more likely to see them as employers of choice. "You will see a lot of companies where a positive, healthy culture attracts people with positive, healthy attitudes. You can influence that culture and the type of people who stay and who want to work for your organization," says Mr. Heckman.

A living, breathing and thriving employee health and well-being program brings a lot of positives for any organization in America. But again, hospitals and health systems stand to gain something unique when they deeply understand and support the health of their workforce.

"Healthcare is a stressful industry," says Mr. Heckman. "Anything you can do to improve the joy of being at work is a value in and of itself."

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