June 15, 2012
Wellness and condition management in the workplace
As I discussed previously, onsite
clinic and pharmacies are one way employers
are addressing how to get, and keep, employees healthy. This location shift for
traditional health care services can certainly prove beneficial for both the
employer and the employee. But what about looking for ways to reduce the
overall need for those services?
importance of prevention isn’t a new concept, but it is receiving additional
emphasis lately (see Surgeon General Regina Benjamin’s recently-announced National
Prevention Strategy). Many employers are initiating chronic
disease management interventions, such as diabetes management. Employers face a challenge in identifying the
most effective strategy, given the variety of programs and lack of definitive
guidelines reported in the literature. I worked with Ross Miller, MD, MPH, with the Cerner Employer Services team, and others to perform a systematic review of the literature to determine the effectiveness of interventions designed to
manage the clinical and financial outcomes of a population of employees with
diabetes1. This research could be used to both validate and prioritize
development of diabetes management solutions for the consumer and the provider.
Other condition management programs address musculoskeletal problems,
a considerable economic and clinical burden on both employees and employers. In 2010, Cerner introduced chiropractic services at
our onsite clinics. To determine their effectiveness, Dr. Miller, myself and others performed a study to determine the influence of onsite chiropractic
care on health care utilization and associate-reported outcomes2. The study found lower rates of health care utilization (health care
visits, radiology procedures, physical therapy) and musculoskeletal medication
use among Cerner associates who received chiropractic care onsite versus
offsite. In addition, those receiving care onsite showed improvement in
functional status over time. This indicates onsite chiropractic care has potential for reduced
indirect costs including absenteeism and productivity losses, and direct cost
savings may result through lower rates of health care utilization.
In additional to chronic disease management programs, rising number of companies are sponsoring wellness
programs to improve employee health and lower health care expenditures. Dr. Miller, myself and others conducted a review of academic and real-world literature to
identify the characteristics and outcomes of employer-sponsored wellness
programs and found that companies
that implemented and maintained wellness programs demonstrated improved
employee health and cost savings3. These companies tended to have strong support and participation from
highly motivated senior leadership, management and the rest of the employees; a
culture based on the idea that healthy employees are the most productive; and
an environment that encouraged participation. While the need to cut costs was a strong motivator for implementing and
updating wellness programs, companies were also concerned with the health and
well-being of their workforce.
K, Foster A, Kaspin L, Kindermann S, Miller R. Systematic review of diabetes disease management interventions. Accepted for presentation at the 17th
Annual Meeting of the International Society for Pharmacoeconomic and Outcomes Research (ISPOR), June 4, 2012, Washington, DC.
CA, Kaspin L, Gorman KM, Miller RM. Value of chiropractic services at an onsite health center. Journal of Occupational and Environmental
Medicine, in press, 2012.
LK, Gorman KM, Miller RM. Systematic
review of employer-sponsored wellness strategies and their economic and
health-related outcomes. Population
Health Management, in press, 2012. Also accepted for presentation at the 17th Annual
Meeting of ISPOR, June 4, 2012, Washington, DC.
Kathleen M. Gorman, MPH, is a scientist with Cerner
LifeSciences and has been involved with a variety of projects that promote best
practices and evidence-based medicine. Increasingly, she has been focused on
researching the value of employer-sponsored wellness initiatives. Prior to joining
Cerner, she was a researcher at The Parkinson’s Institute. Ms. Gorman holds a
BS from the University of California, Santa Cruz and an MPH from the University
of California, Los Angeles.