Talking about change is easy. There are entire industries built around the idea people want to be fitter, smarter, or better organized. We tell ourselves we’re ready to start on the road to self-improvement, but taking the first step is never as easy as we’d like.
For employers interested in improving employee wellness, that gap between intention and action is important. It’s easy to give people the tools they need to live a healthier life, just like it’s easy to buy the latest diet book, but getting someone to change lifelong health habits is a steeper hill to climb. When you’re asking employees to change their routine, even a small barrier to entry is enough to deter people from taking action. While tools like wearable fitness trackers are growing in popularity, employers looking to integrate devices into their employee wellness programs should consider any factor that might keep employees from taking part.
When Ochsner Health System introduced wearables into its employee wellness program in 2008, it was part of a broader effort to modernize the program. The southeast Louisiana health care provider has more than 17,000 employees and more than 2,700 affiliated physicians. Wellness program managers wanted to increase participation in the organization’s Pathway to Wellness program, and saw fitness trackers as a key to achieving this goal.
When implementing this change, Ochsner made a decision it credits for much of the program’s success: It gave employees their first device free to remove cost as a possible barrier to participation.
“We recognized the potential of wearable devices to engage employees in their own health. Devices give employees the data they need to monitor their progress, and they allow wellness coordinators to monitor overall participation,” said Susan Piglia, assistant vice president, corporate wellness, Ochsner. “As an increasing number of employees began participating in the program, we gained a clearer picture of employee preferences and participation trends.”
Wearables open the door to better health awareness
Wearables were one tool in a broader wellness effort for Ochsner, but for that tool to work, leadership at Ochsner knew they needed as many people as possible participating. Since more than half of Americans believe wearables are too expensive to justify a purchase, giving the wearable devices to employees removed a barrier that might have kept some from signing up.
Ochsner is among a growing number of employers who see promise in wearables. According to the Health Enhancement Research Organization (HERO) Wearables in Wellness survey report, employers have several reasons for including wearables in their wellness programs, such as:
· 94 percent use wearables to increase physical activity,
· 77 percent hope to increase employee engagement in their health,
· 62 percent want to see improvement in employee health habits,
· 58 percent want to add a “fun factor” to their wellness program, and
· 51 percent are looking to improve performance.
Ochsner is not alone in its decision to provide wearable devices to employees at no cost. The HERO report found 51 percent of employers who use wearables in their wellness programs pay for the full cost of the devices. Another 12 percent pay for part of the cost, and 20 percent use alternative funding methods. Most — 91 percent — allowed employees who already owned a fitness tracker to use their own device.
Opportunities for engagement with wearables go beyond simple step counts. When it modified its program, Ochsner also made changes to its online wellness portal to share additional information with employees. Every time employees went online to upload their data, it was an opportunity for Ochsner to put fitness at the top of their minds. The wellness portal employees used to track their activity was full of information about the broader Pathway to Wellness program, and about opportunities to improve their health. Ochsner also created onsite opportunities, including weight and blood pressure checks to keep health and fitness top of mind for employees.
An investment in better health pays off
For Ochsner, the potential benefits of wearables justified the up-front expense of providing the devices to employees. That investment paid off with healthier and better-engaged employees, but also with cost savings for the employer. The health system tracked two groups of employees through the program — one that enrolled in Pathway to Wellness and uploaded data from their device, and one that did not enroll and did not log steps. Their outcomes included:
• Participating employees decreased their body mass index by about two points in the program’s first year, and employees with a high starting BMI have decreased their BMI by about three points as of 2017.
• Participants with a high-risk blood pressure decreased their systolic blood pressure by 15 points.
• In 2012, the first year of their comparison, employees in the wearables group had health care costs 2 percent higher than costs for employees who did not enroll.
• In 2013, however, the wearables group had 2.89 percent lower medical and prescription claims.
• In 2014, the wearables group had 9.66 percent lower medical and prescription claims.
• As a result of the health care cost trend differences, Ochsner estimates it saw a return of $3.20 for every dollar invested in the wellness program.
The introduction of wearables drove the higher level of engagement Ochsner was looking for. In 2015, 84 percent of Ochsner’s 11,000 eligible employees participated in Pathway to Wellness, a fact the health system attributes in large part to its use of wearables. In addition:
· 46 percent of participants completed all program requirements that year and earned an incentive.
· 62 percent of employees enrolled in the program met or exceeded the CDC’s recommended levels of physical activity for good health.
· In 2015 and 2016, Pathway to Wellness participants left Oschner about half as often as non-participants.
· Participating employees who started below 7,000 steps daily when joining the program are now averaging 8,200 steps daily, and high-risk participants who started below 5,000 steps have increased their average daily steps to 7,500.
· As of December 2016, participation remained high at 84 percent.
“Our goal when we started this program was to inspire employees to take control of their health and fitness, and that’s exactly what happened,” said Piglia. “Employees were more active and more engaged in their day-to-day activity. We were thrilled to see how many people had physical activity at the top of their mind.”
Promising practices for wearables success
The success of Ochsner’s program is no accident. It’s a matter of design. According to a 2017 update to the HERO Wearables in Wellness report, giving devices to employees is one of six promising practices for running a successful wearables program. The HERO Wearables in Wellness Case Study Report is drawn from case studies highlighting Ochsner’s program as well as programs from BP and Emory University. The best practices identified in the HERO report are:
1. Start with a pilot program.
2. Offer wearables to spouses and domestic partners.
3. Incorporate culturally relevant incentives and tie them to wearable use.
4. Incorporate wearables into a program that goes beyond a single challenge.
5. Provide ongoing enhancements to keep things fresh.
6. Develop goals for the program and use wearables data to evaluate its success.
For Ochsner, making it easier for employees to use a wearable fitness tracker made it more likely physical activity would become a regular part of their daily lives.
There is a clear up-front cost to providing wearables, but if you want to ensure all employees have an equal opportunity to participate in your program, it’s an investment that can pay off and deliver long-term benefits.
About the author:
Jessica Grossmeier, Ph.D., is vice president of research for HERO and served as lead author of the Wearables in Wellness Case Study Report. She can be reached at jessica.grossmeier@hero-health.org. Trent Tangen is director of health coaching at HealthCheck360⁰. He can be reached at trent.tangen@healthcheck360.com.