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Are You Triggered Toward Success or Doomed to Failure?

March 28, 2016
Bryce Williams

I have the pleasure of welcoming Marshall Goldsmith, New York Times bestselling author of “Triggers: Creating Behavior That Lasts--Becoming the Person You Want to Be,” to the HealthMine advisory board. In conjunction with Marshall becoming an advisory board member and contributor to the HealthMine site, we will be publishing excerpts from his website, www. MarshallGoldsmith.com that provides advice on how to change behavior. This advice can be applied to wellness program adherence and to changing behaviors that bring people closer to achieving their health goals.
 
We welcome Marshall, and hope our readers will benefit from his expertise in behavior modification and goal achievement.  --Bryce Williams, CEO and President of HealthMine

 
Are You Triggered Toward Success or Doomed to Failure?
By Marshall Goldsmith


 
This is an incredibly important question to answer, and it holds significant and long-term ramifications for those who are just starting out in their careers.
 
Being triggered toward success means that instead of blocking you from your goals, you are propelled toward them. It may sound impossible, but it’s not. First, let’s clarify the term trigger so you know what to look for.
 
A behavioral trigger is any stimulus that impacts our behavior.
 
Within this definition, there are six distinctions that will help improve our understanding of how triggers influence our behavior.
 
A trigger can be direct or indirect. Direct triggers are stimuli that immediately and obviously impact behavior. There are no steps in between the triggering event and your response. For instance, a child chases a ball into the street in front of your car. You slam on the brakes. Simple. Indirect triggers take a roundabout route to influence our behavior. For instance, you see a family photo, it triggers thoughts and memories – and you remember to call your sister. 

A trigger can be internal or external. External triggers come from the environment. Our five senses pick up on them, as well as our minds. Internal triggers come from our thoughts and feelings and are not connected with anything on the outside. Have you ever heard that “little inner voice”? That’s what I’m talking about here. It’s not prompted from the outside, but if it stimulates behavior, it’s as valid as any external prompt. 

A trigger can be conscious or unconscious. Conscious triggers require awareness. Hot plate – withdraw hand! Unconscious triggers are beyond our awareness. Most people are oblivious to how much the weather influences their moods. Respondents to the question, “How happy are you?” claimed to be happier on a perfect weather day than respondents to the same question on nasty weather day. 

A trigger can be anticipated or unexpected. Anticipated triggers are visible a mile away. For instance, we know right now that the National Anthem will be played at the Super Bowl next year. Unanticipated triggers take us by surprise, and often stimulate unfamiliar behavior, possibly even a drastic desire to change! 

A trigger can be encouraging or discouraging. Encouraging triggers push us to maintain or expand what we are doing. They reinforce us – like the finish line for a marathon runner. Discouraging triggers push us to stop or reduce what we are doing. Chatting in a theater and hearing a barrage of “Shhh!” is one such discouraging trigger. 

A trigger can be productive or counterproductive. This is an important distinction. Why? Because productive triggers push us toward becoming the person we want to be. Counterproductive triggers pull us away from that goal. 

So, now that you know the six distinctions of behavioral triggers and how they influence your behavior, try this exercise. It will make you smarter about specific behaviors and help you connect them directly to your behavioral successes and failures.

Pick a behavioral goal you’re pursuing: losing weight, being more patient, calling your parents once a week, etc. 

List the people and situations that influence the quality of your performance / progress towards these goals. Stick to the trigger or two that relate to one specific goal. Define them. Are they encouraging or discouraging, productive or counterproductive, etc.? 

Chart the triggers to see if you are on the positive or negative side of your goals. 

While this exercise may not solve the puzzle of achieving behavioral change, it will point you in the right direction. And, starting off in the right direction will put you that much closer to success! 

Take Your Medicine: A Heavy Dose Of Digital Data

March 22, 2016
HealthMine Team

The Accenture 2016 Consumer Report on Patient Satisfaction reveals that consumers are increasingly comfortable with digital health, accessing their electronic health records (EHRs) and utilizing wearables to manage their health. However providers are not always delivering the type of access consumers want.
 
While 92% of individuals believe they should have full access to everything their doctor sees, just 18 percent of physicians feel the same. This could be because physicians believe individuals will not be able to understand all the information contained in the EHR. Or, perhaps providers are worried that medical record data may be too confusing for consumers.
 
But consider this: even as consumers become more comfortable with digital health, they largely remain in the dark about their health metrics. What’s more, they struggle to understand what their health data means or what to do about it. According to an October 2015 HealthMine survey, 53 percent of consumers can’t access their health data from a computer and 60 percent say they are unsure or do not have all of their health data stored in electronic medical records (EMRs).



On the flip-side, nearly three-quarters of consumers (74%) say easy electronic access to health data would improve their knowledge of their health and improve communication with their physicians. The irony is that while physicians may be limiting access to EHRs to reduce confusion, the net effect is leaving patients even more mixed up. Improving access to health data facilitates knowledge. Knowledge enables understanding about health—and it shouldn’t be confined to the exam room. 
 
For the full report from Accenture, click here.
 
[Photo Credit: Vincent Lock on Flickr via Creative Commons 2.0]
 

Removing the Barriers to Health Data Access

March 15, 2016
Bryce Williams


Imagine if you went to your bank or financial advisor and asked to see your financial records, and you received this answer: “No.”  Sounds crazy, right?  You know you own your financial assets, so it only makes sense that you can access information about them on demand. For most, a snapshot of wealth simply requires a login to your accounts. You can quickly assess if you’ve earned money or lost it, and quantifiably measure the change. It’s important to get a “financial check-up” regularly.
 
Now imagine you went to a medical professional and he or she held the chart of your health data and did not share it with you, or charged you a fee, or delayed your access by days or weeks.  This may not sound crazy, but familiar.  You also own your health data, but unfortunately, getting a clear picture of your health status is blocked with obstructions for many patients. Most people lack on-demand access to their medical records, labs, and other key health information. This is despite rising out-of-pocket healthcare costs and increasing pressure from both health plan sponsors and providers to manage your own healthcare. But why?
 
While there’s no question you own your financial data, only 41% of people believe they own their health data. They are right; by law, patients only own their medical records in one out of 50 states: New Hampshire. Even when it comes to health information collected on a Fitbit, digital heart-rate monitor or other device or app, 37% of consumers don’t believe they are the owners of their health data. Self-collected health data remains disconnected from data in your medical records. 39% of people are unable to access all of their clinical and behavioral health data from a single source. The ‘not sharing’ goes both ways; 45% of consumers have never tried to share data from their health devices and apps with their doctors. At the end of the day, all of the parts never add up to a whole.
 
When you’re not in control of your health information—every piece of it—it’s hard to control your health. Nearly 50% of Americans have a chronic disease. Most are not fully aware of their health status and lack the knowledge and motivation to manage their health and spend their healthcare dollars wisely.
 
Easy, affordable access to comprehensive health data should be a right, not a privilege. If consumers are expected to own their health, they first need to be empowered with knowledge. They should always be able to answer three questions about their health:
1. Where do I stand?
What is the meaning of my personal clinical and behavioral health data?

2. What do I do about it?
Education, guidance, and connections to the individual care I need.

3. What’s in it for me?
Motivation to take action at the right time.
The ability to access all your health data in one place is the starting point. But despite the industry’s movement to electronic medical records, patients remain disconnected. Even though 78% of office-based physicians were using an EHR/EMR system by the end of 2013, 53% of consumers say they can’t access their health data from a computer. Another 39% have not even tried to access their clinical health data from a mobile device.
 
Even when patients can get a hold of their health information, they often don’t know what it means. 42-56% of consumers say they “sometimes” understand their clinical health data. 38% are confused about what the data from their devices and apps means, and only 42% know what actions they need to take after looking at this data. While millions of people are collecting terabytes of data that has the potential to illuminate health, most people remain in the dark.
 
Providers, insurers and employers can help empower consumers with the same access to health as wealth by doing five things:
  1. Provide digital access to clinical health data anytime, anywhere.
  2. Connect behavioral/lifestyle data to an individual’s personal health record, so they can see the big picture in one place.
  3. Offer clear analysis of health data so individuals understand what the numbers mean.
  4. Provide guidance on what health actions individuals should take and when.
  5. Offer motivation—and incentive as necessary—to follow-through. 

Owning your health data is essential to managing your health and healthcare dollars. Let’s remove the barriers to access, unite the disparate pieces, and empower ourselves to truly own our health.

As published in Becker's Healthcare on January 6, 2016.

What A Healthy Population Can Do For The Bottom Line

March 7, 2016
HealthMine Team
Improving wellness programs can do more than benefit employee health and productivity. A high performing wellness program can actually whip your bottom line into better shape.
 
New findings from the Health Enhancement Research Organization indicate that wellness programs also benefit the sponsor’s balance sheet. Data taken from 45 publicly traded companies with “top shelf wellness programs” saw their stocks appreciate 235 percent over a six-year period. This compares to 159 percent for the S&P 500.


 
Why is this true? Because a wellness program is a fundamental component of a company’s HR strategy. Population health improvement is an important goal for wellness, but plan sponsors should set their sights higher. In the long run, a plan sponsor’s wellness program will either become a strategic business investment, or a deadweight. Those wellness programs that are smartly designed should pay off with measurable return. The ones that aren’t built to last will ultimately end up on the chopping block.
 
The co-author of the study, Jessica Grossmeier, said it best:
 
“We’re not saying conclusively that if you want x amount of return you should invest in wellness, but we can say with confidence that companies that are performing well on the stock market have this one thing in common: They have high-performing wellness programs.”
 
For the full article in Workforce, click here.
 
[Photo Credit: Micky Aldridge on Flickr via Creative Commons 2.0]

Trillion Dollar Price Tag For Sick Employees at Work

March 3, 2016
HealthMine Team


While exact cost savings from wellness programs can be unclear due to lack of measurement, what is clear is the cost of “unwellness” in the workplace. This is according to a new report from the Global Wellness Institute, which revealed that “unwellness” at work costs the U.S. economy an estimated $2.2 trillion per year.
 
The “unwellness” figure incorporates the following in its calculation:
 
$550 billion - lost productivity as a result of disengaged workers
+$1.1 billion - workers with chronic disease
+$250 billion - work-related injuries and illnesses
+$300 billion - work-related stress
___________________________________
 
The cost impact of unwellness, as illustrated here, is not something to be taken lightly.
 
Wellness programs serve the dual purpose of keeping people healthy and helping them monitor their own health so they can address illness early if needed.
 
Diabetes, for example is chronically under-diagnosed and can be incredibly costly if it isn’t caught early and managed. According to the American Diabetes Association, diabetes and pre-diabetes cost the United States $322 billion per year. Approximately one in four people with diabetes do not know they have it.
 
Cardiovascular disease is another example, costing more than $320 billion in annual healthcare costs and lost productivity, according to the CDC Foundation. Like diabetes, heart disease is largely preventable with lifestyle changes. But the first step is knowledge, and according to a January 2016 HealthMine survey, 53 percent of U.S. adults do not know their own cholesterol level and one quarter do not know their blood pressure.
 
“Americans can’t address what they don’t know, and health plan sponsors have a responsibility to be the compass,” says HealthMine CEO Bryce Williams. “Physical activity, weight loss, and nutrition are all keys to managing diabetes, heart disease, and co-morbidities, but plan sponsors must play a part in illuminating the health status of their members and then guiding them through prevention and disease management.”
 
For the full article on the study in the New York Business Journal, click here.
 
[Photo Credit: Colin Dunn on Flickr via Creative Commons 2.0]

Some Welcome News About Wellness

February 29, 2016
HealthMine Team


A recent study, called the “The Wellness Effect: The Impact of Workplace Programs,” had optimistic findings about the effect of wellness programs on employees’ health and productivity.
 
The study, released jointly by Humana and the Economist Intelligence Unit, revealed that 91 percent of employees participating in wellness program improved their fitness. In addition, 89 percent said participation improved their overall happiness and wellbeing.
 
Wellness program participation does not only benefit the employees themselves. According to the study, 67 percent said it upped their engagement in their employer’s mission and goals.
 
Obstacles remain before these benefits can be reached however. Lack of time was the primary obstacle to increased participation in programs. In a May 2015 HealthMine survey of 1,200 insured consumers, 27 percent said that lack of time keeps them from engaging in their wellness program. Additionally, stress remains one of the main obstacles to workplace wellness.
 
For the full article on the survey findings in Beck’s Hospital Review, click here.
 
[Photo Credit: Michael Havens on Flickr via Creative Commons 2.0]
 

Can Genetic Testing Help Wellness Programs Work Better?

February 10, 2016
HealthMine Team


A recent article in Bloomberg suggested that testing workers’ genes could be the secret to making employer-sponsored wellness programs work. A pilot wellness program called Newtopia that includes genetic testing found that individuals who received their own genetic profile gained “a certain understanding and mastery of their condition that they didn't have before.”
 
In fact, 74 percent of consumers believe wellness programs should include genetic testing as a way to identify risk for chronic conditions. The data comes from a 2015 HealthMine survey of 1,200 consumers with health insurance.
 
This finding is especially significant as the prevalence of chronic disease is rising in the United States, but many people go undiagnosed. For example, an estimated 29 million people had diabetes as of 2015 according to CDC data, and as many as 1 in 4 did not know they had it.
 
Discovered early, many chronic diseases like diabetes can be managed with lifestyle changes rather than more drastic measures.
 
Genetic testing is just one tool in the wellness arsenal that can help people understand their health data. Whether it comes from a biometric screening or other test, having meaningful health data can be empowering. It can even motivate individuals to modify their behavior and make real improvements to their health.
 
Aprillia Jeffries, for example, featured in the Bloomberg article, lost 50 pounds and dropped eight dress sizes in 2.5 years after a DNA test revealed she had a genetic predisposition to being overweight. Her story is a beacon -- a shining example of what employer wellness programs could be and the effect they could have on the people using them. Genetic testing is just one piece of the puzzle, but it may be an important one as we learn what makes wellness work better.
 
For the full article in Bloomberg, click here.

A Side of Sticks To Go With Your Carrots?

February 1, 2016
HealthMine Team


Instead of rock-paper-scissors, it’s carrot-stick when it comes to employer-sponsored wellness programs, and the stick is coming out more often than before.
 
A recent article in the New York Times highlighted the increasing use of “sticks” or penalties, as opposed to “carrots” or incentives, to motivate employees to participate in employer-sponsored wellness programs.
 
This comes in the wake of a recent Equal Employment Opportunity Commission (EEOC) decision in favor of employer-sponsored wellness programs levying penalties against employees who fail to participate or meet certain goals.
 
The case featured in the article involved a Wisconsin-based company, Flambeau, which required its employees to fill out a biometric screening and a health questionnaire. One employee missed the deadline and ended up losing his health insurance coverage when the company refused to pay its share of the cost.
 
Motivation is personal. One size fits none when it comes to wellness. Ideally, wellness programs adapt to each member and strike a healthy balance between incentives and deterrents, driving progress toward personal goals.
 
A recent large study of CVS employees revealed that combining sticks and carrots doubled the success rate of smoking cessation over offering carrots alone.
 
This was not the first EEOC ruling on this subject of workplace wellness (remember Honeywell?) and it will likely not be the last. How this will change the landscape of employer-sponsored wellness programs remains to be seen.
 
For the full New York Times article, click here.
 
[Photo Credit: Alan O’Rourke on Flickr via Creative Commons 2.0]

High Deductible Health Plans Don’t Make Shoppers Savvier

January 20, 2016
HealthMine Team
A recent article in Kaiser Health News challenged the commonly held belief that switching to high deductible health plans (HDHPs) would give consumers more “skin in the game.” In other words, consumers would finally be compelled to compare prices before choosing healthcare services.
 
High deductible health plans place a greater burden of the cost of care with the plan member. This hypothetically would create an incentive for plan members to search for the most affordable medical service option available.


 
Data from a research letter published in JAMA Internal Medicine indicated, however, that this was not the case.
 
“There is a big incentive for consumers in high-deductible health plans to price shop, and they just don’t seem to be doing it,” said Neeraj Sood, one of the authors of the letter and director of research at the Leonard D. Schaeffer Center for Health Policy and Economics at USC. An August 2015 HealthMine survey found that 75% of consumers do not price shop for medical services.
 
The answer may not be that plan users are lazy, but rather that the information is not readily available. 81% of consumers enrolled in wellness programs say their program does not offer a price comparison tool. More cost information, quality metrics, and other ways to quantify and differentiate between healthcare offerings would be a good first step in enabling people to be “savvier shoppers” when it comes to purchasing medical services.
 
For the full article in Kaiser Health News, click here.
 
[Photo Credit: Polycart on Flickr via Creative Commons 2.0]

Wellness Programs Can Affect Medication Adherence, Recent Study Finds

January 20, 2016
HealthMine Team


A recent study from the Employee Benefit Research Institute focused on the effect of wellness programs on medication adherence among individuals with chronic disease. Specifically, it explored the potential benefit of health risk assessments (HRAs) and biometric screenings on medication adherence for six key chronic conditions.
 
The study findings indicated that HRAs and biometric screenings positively affected medication adherence for two of the six chronic conditions the study observed: dyslipidemia and depression. The study concludes with the intended outcome of giving plan members access to their health risk and biometric data. “The hope is that information derived from these wellness programs will prompt patients to make meaningful lifestyle changes, use preventive care, and commence and comply with recommended treatment.”
 
This is a good start, but only the tip of the iceberg when it comes to the potential of wellness programs, which should go far beyond HRAs and biometric screenings.
 
Biometric data can help an individual to understand their health status. But that’s only the first piece of the puzzle. The other pieces include knowing what to do with that information, when to do it, and having the motivation to get it done.

While the narrow focus of the study does not necessarily invalidate its findings, it certainly invites the reader to think more broadly about wellness program offerings. For plan sponsors, it is a reminder that simply providing plan users with their data may not be enough to compel them to act. And for plan members, it is an invitation to look beyond the data and seek motivation to set and achieve wellness goals.
 
For the full report on the study, click here.
 
[Photo Credit: frankieleon on Flickr via Creative Commons 2.0]