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Over time, we found that traditional definitions of wellness and health promotion often fell short of encouraging personal responsibility for health and well-being. Highsmith undertook a fundamental transformation in our view of wellness. We think the terms wellness and employee development are interchangeable. Engaging employees in their jobs, emphasizing learning and development, providing tools to balance work/life responsibilities along with health and wellness must all be integrated.

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T.A.G. extends beyond the traditional aspects of job/career development. We
view job/career development as just one aspect of learning and development.
Personal and physical well-being, self-care, and work/life enrichment all
contribute to an individual's overall well-being. Our vision is to create an
environment of positive choices where employees can make actionable decisions
about their development in support of company goals and objectives.

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Within T.A.G., we offer a comprehensive menu of health promotion, disease
prevention activities and programs, mental health education and resources, and
traditional job/career development opportunities - some of which are listed
below.

Monetary Incentive Approach for Health Insurance (See Exhibit 1)
Annual Health Screening with one-on-one feedback for
Employee/Spouse (See Exhibit 2)
Individual Health and Disease Management Consultations with On-site
Health Educator
Intranet with Comprehensive E-Health Resources, Company Information,
and Career Development Information
New employee orientation includes meetings with a learning and
development professional and a health educator to learn about the
T.A.G. initiative.
Wellness Resource Collection in Corporate Library
Employee Assistance Program
WorkLife Services
Financial Services
Legal Services
Flexible Spending for Health Care and Dependent Care
Educational Assistance
On-site Chair Massage
Blood Pressure Screenings
On-site Exercise Classes
Annual Course Catalog offering over 50 educational opportunities for
employees and families in all five T.A.G. components
Ergonomics and Workstation Audits
Stretching Programs in Warehouse and Office
Mental and Emotional Health Programming and Screenings
Menopause Programming
Asthma and Allergy Education
Domestic Abuse Outreach and Education
Diabetes Awareness and Education
Alternative Medicine Programming

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Additional Awareness Campaigns and Educational Opportunities
Focusing on Self-Care, Women's Health, Men's Health, Depression,
Domestic Abuse, Cancer (Breast, Prostate, Skin and Cervical), Safety
and Ergonomics
Pre- and Postnatal Education and Consultations
Employee Lifestyle Challenges/Incentive Programs
Weight Management Programs
Weight Management Support Groups
Healthy Cooking Classes
Tobacco Cessation Programs
Self Care Programming
On-site First Aid/CPR Training
On-site Walking Trail and Walking Programs
Stress Reduction and Time Management Programs
Healthy Snack Days
Citrus Program
On-site Flu and Pneumonia Vaccine Clinic
On-site Tetanus Shots
Healthy Vending Options

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The Highsmith approach is non-traditional and on the forefront of taking wellness
and health promotion to a new level. Highsmith has achieved a high level of
employee participation in the T.A.G. initiative. All employees (100%) are involved
in some aspect of T.A.G.;

83% participate in Highsmith's monetary incentive approach to health
insurance
50-85% of employees are active participants in challenges/ongoing
wellness programming
81% of employees enroll in classes offered through the T.A.G. course
catalog
72% of employees participate in the onsite comprehensive health
screening and complete annual Health Risk Assessments
2004 utilization of our Employee Assistance Program was 22.8%

Highsmith has been investing in the health, wellness and development of our workforce for over a decade. That investment has been paying off in many different ways.

Reduction in Health Risk Factors 2000-2004:

53% decrease in number of health screening participants whose total
cholesterol was "high risk" (High risk=240 and over)
52% decrease in number of health screening participants whose blood
pressure was "high" (High=140/90 or above)
72% decrease in number of health screening participants whose VO2
submax was "high risk" (High risk=age/gender specific)
Average of 84% of total participants had a "normal" blood glucose level
(Normal=Under 100)

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Other examples:

At a time when health insurance premiums are increasing at double-digit rates, our premiums have held steady. Over the last four years (20022005), Highsmith's healthcare premiums have risen an average of only 5.4%.

Senator KOHL. Thank you very much, Mr. Herman.
Mr. Brown.

STATEMENT OF MR. STEPHEN J. BROWN, PRESIDENT AND CEO, HEALTH HERO NETWORK, INC., MOUNTAIN VIEW, CA Mr. BROWN. Mr. Chairman and Committee members, I am Steve Brown, and I am the CEO of Health Hero Network, a technology company in Mountain View, CA.

We serve people struggling with chronic illness. Our technologies are designed to enable caregivers to coach and monitor patients at home. I am going to talk about some of the commonsense things that Senator Lincoln talked about, and I am also going to talk about some of the programs we are involved with, which hopefully will make the CBO happy about the results as well.

My view is that health care does not start when we are wheeled into the emergency room, and it does not start at the doctor's office.

Health care starts at home, with our own behavior and with prevention.

Most people in Medicare have a chronic illness. For them, prevention means reducing the complications of chronic illness and living independently longer. From our work with the Veterans' Administration, we have seen that when caregivers and patients work together on daily management and prevention, they can improve the quality of life and reduce costs.

To illustrate this point, I am going to introduce Wally Browning from Huntington, WV, who recently was interviewed in his local paper. I included this in the written testimony.

Wally Browning is a Vietnam veteran. He served our country in Vietnam, and now he is being served by the VA and by Health Hero Network.

Wally has congestive heart failure, one of those high-cost, highrisk conditions that require very close attention and management. It is also one of the leading causes of hospital admissions for Medicare.

Every day a nurse at the VA checks in on how well Wally is doing, remotely, by sending message to a device installed in Wally's home, called Health Buddy, and I brought that for you to see too.

With simple push buttons, Wally is able to answer questions that appear on the screen and tell his nurse how he is doing; tell his nurse about new symptoms transmit data about his blood pressure and his weight and also get feedback and coaching from his nurse about his condition and about his health program and about healthy choices that he needs to make.

A VÀ nurse uses a computer with a secure Internet application to analyze Wally's data every day and flag potential problems before they become worse. The result has been fewer emergencies, fewer stays in the hospital, greater piece of mind, and cost savings for the VA. As Wally puts it, after he checks in with his Health Buddy, he feels like he is good for another day.

Wally is like 20 million Americans with complex chronic illnesses who are at risk of going to the hospital any day. Many of these hospital admissions can be prevented if we coach and monitor patients at home.

The reason our health care system is in trouble, even though we spend nearly $2 trillion a year on it, is that we are not paying for the right model of chronic care. For 40 years, Medicare payment has been based on episodic, face-to-face encounters with a doctor, usually in reaction to a crisis.

But chronic illness is not episodic. It is long-term, and it needs to be managed every day.

If we want to prevent hospitalizations, we need to coach and monitor patients at home before a crisis occurs.

We know it is possible because we are doing this every day across America for thousands of veterans. According to the VA, hospital admissions for patients in the program were 63 percent lower than for a comparison group with similar high-risk conditions.

Last year, we worked with the Information Technology Association of America to look at the question. What if Medicare could achieve similar results to the VÀ with similar patients? The answer published by the ITAA—and that report is also in the written testimony-is that we would save over $30 billion a year.

As a result of your leadership and that of your colleagues, the Medicare Modernization Act starts to recognize that people with complex chronic illness need continuity of care and prevention rather than more episodic crisis management. That is a major step forward for Medicare, and now the challenge is execution. We are participating in two large-scale chronic care improvement pilots authorized by the Medicare Modernization Act. We are also working with the American Medical Group Association and its physician groups, like the one in Bend, OR, to create a chronic care model based on coaching and monitoring patients at home, under the supervision of their primary physician.

Part of the wisdom of the recent Medicare initiatives is in recognizing how technology can play a vital role in transforming the model of care for chronic illness.

Information technologies can extend care into the home and coach patients to improve their own lives and change their own behavior. Caregivers can detect early and deliver the right care at the right time before there is a crisis.

Health care and prevention starts at home, and the right technology can help people struggling with chronic illness and connect them to better care. I thank you for inviting me to testify today.

[The prepared statement of Mr. Brown follows:]

Testimony of Stephen J. Brown
President and CEO, Health Hero Network

before
Senate Special Committee on Aging

Thursday, June 30, 2005

Mr. Chairman and Committee Members:

My name is Steve Brown, and I am the CEO of Health Hero Network, a technology company in Mountain View, California. We serve people struggling with chronic illness by developing technologies that enable caregivers to coach and monitor patients at home.

We have been working with care coordination programs of the Veterans Health Administration for five years. We are participants in two of the nine Medicare Health Support Programs recently awarded under the Medicare Modernization Act of 2003.

My view is that health care does not start when you are wheeled through the emergency room door. Health care does not start at the doctor's office.

Health care starts at home.

Health care starts at home with our own behavior. The little things we do for ourselves every day, and the things that we notice and can do something about while they are still small problems, rather than waiting until they become a crisis.

Most of today's Medicare beneficiaries already have one or more chronic diseases - particularly hypertension, lung disease, diabetes, heart failure, and depression. Today, the concept and practice of prevention in Medicare is really about ensuring that people with chronic illness develop fewer complications and live independent longer – and stay out of the emergency room and hospital, the health care system's most expensive settings.

From our work with patients at the VA, we have seen that when health care providers and patients with chronic illness work together and focus on daily management and prevention, they can have a huge impact on patients' quality of life while reducing the cost of their care.

I would like to show you an article from The Herald-Dispatch, a local newspaper of Huntington, West Virginia, from May 17, 2005. It is about a man named Wally Browning who served our country in Vietnam, and who now is being served by the VA and by Health Hero Network.

Every day, Wally's nurse at the VA remotely checks on how Wally is doing by automatically sending personalized text questions and messages to a device called Health Buddy installed in Wally's home. With simple pushbuttons, Wally answers questions that appear on the screen, telling his nurse how he is feeling and whether he has any new symptoms. Then Wally might connect his blood pressure cuff or weight scale and transmit the latest readings. The system also gives Wally feedback and coaches him to stick with his care program and make healthy choices.

The nurse at the VA opens a secure Internet page to track Wally and other patients. The page flags potential problems according to rules set by the VA and their standard practice guidelines.

The result is fewer emergencies, fewer stays in the hospital, and greater peace of mind for Wally - and tremendous cost savings for the VA. His nurses help him stay on track with his preventionoriented chronic care program rather than letting him fall through the cracks. As Wally puts it, after he checks in with Health Buddy, he feels like he is “good for another day."?

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