By Nita Stella, senior vice president of product strategy, ActiveHealth Management
Increasingly, companies are encouraging employees to be accountable for their health and lifestyle choices by building incentives or disincentives into their wellness programs. Generally, these employers also provide health plan members with resources to help them make better health and lifestyle decisions. Often these resources are delivered though a website that includes a personal health record (PHR), which can be useful to integrate wellness and incentive programs.
Personalized Information and Guidance
Employees who want to improve or maintain their health can be overwhelmed by the wealth of information available. How do they know what is credible? Which information applies to them? And what are the most important steps they should take for good health?
A clinically intelligent PHR, driven by clinical-decision support technology, can guide them. More than just a data repository, such a record uses sophisticated technology to analyze an individual’s health information and provide individualized feedback, including health alerts and personalized health reports.
While the most sophisticated PHRs can automatically receive claims data, the value of the feedback provided to members increases considerably when members add information that only they would know, such as height, weight, allergies, and over-the-counter medications or herbal supplements they may be taking.
In an intelligent PHR, the data provided by members are compiled with claims data and analyzed by the clinical-decision support technology. The system continuously compares the claims and member-provided data with evidence-based medical standards to identify potential opportunities to improve care. For example, the system might identify a procedure or medication that should be considered for a member with a particular medical condition. Or it might use member-provided data to identify that an herbal supplement could interfere with a prescription medication.
When a potential opportunity for better health care is identified, the member is notified via an alert in his PHR and the member’s physician is notified via phone, fax, or mail, depending on the urgency of the alert.
While data can be solicited from members in any number of ways, an integrated health risk assessment (HRA) can guide a member in providing the data that is most important for his health situation. The most sophisticated assessments use branching logic so that members are asked to answer only questions relevant to them, based on their answers to previous questions.
In addition to being used to identify health alerts, the information in the HRA is used to generate a personal health report for each member, including items such as issues to discuss with the doctor, health warning signs to watch for, and steps to take for better health. The report can include links to educational information relevant to that member. The data collected in the health risk assessment should also populate other portions of the PHR, so a member only has to enter data once, and he immediately has a fully populated, integrated record.
Making a Case for Integration
Numerous Fortune 1000 employers are offering these sophisticated PHRs and integrated HRAs. Incentives such as gift cards and premium credits have resulted in high PHR registration and HRA completion rates, when compared to industry averages.
Offering members incentives to complete an HRA that is integrated with a personal health record can not only boost HRA completion rates, but it can also help build awareness for other online resources. When members visit their PHR to obtain their incentive, they have the opportunity to see firsthand the number of tools available to make their lives easier and help them take accountability for their health.
For example, a member who has just been referred to a specialist may be able to use his PHR website to look up more information about his health condition, create a calendar reminder of the specialist appointment, print out a form containing the information that is commonly needed when visiting a new doctor, and print a copy of the health summary to take to the appointment.
Other members will gravitate toward different website tools. For example, a member with diabetes might use the health tracker tool to document his blood glucose readings and grant his physician access to the PHR to monitor his progress. A parent can use the website to print out a child’s immunization record for school or camp.
A Gateway to Other Programs and Behavior Change
Clinically intelligent PHRs can serve as a gateway to other components of an employer’s wellness program. The clinical decision support technology that powers an intelligent PHR can also analyze a population and identify members who could benefit from other programs.
For instance, a member with heart disease may be invited to enroll in a disease management program, or a member who indicates in the HRA that he is under a lot of stress may be invited to enroll in a lifestyle coaching program.
The invitation to participate may be included as an action item in the individual’s personal health report. It can also be supplemented with other communications delivered outside of the PHR, such as personalized mailings or phone calls.
The PHR can be used to communicate incentive programs designed to drive employee accountability. For instance, the invitation to enroll in a disease management or lifestyle coaching program can include information about the opportunity to earn an incentive. The PHR can also be used to post more general messages about incentives or wellness programs, helping to maintain awareness.
Offering a personal health record that is prepopulated and contains information that is useful to a member is a good first step. But offering a clinically intelligent PHR supported by clinical decision support technology that can proactively reach out and alert members on specific personalized activities they can take to better manage their health is a better step. Coupling that intelligent PHR with a comprehensive communication and incentive strategy that motivates awareness and accountability on the part of the member is what can really drive sustainable adoption and significant results.
Case Study: An Integrated Wellness Program Centered Around a PHR
Nita Stella is senior vice president of product strategy for ActiveHealth Management. Her role includes defining product strategy and helping to bring new products to market for the organization, such as the ActivePHR. ActiveHealth Management is a clinically based, technology-driven health management services company serving health plans and employer groups. Contact: media[at]activehealth.net; 212-651-8200.