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Taming the Frankenstein Wellness Program - Transcript

Hello, I'd like to welcome everyone to this webinar sponsored by Extracon. The title of this webinar is, Taming the Frankenstein Wellness Program.

We have a straightforward agenda for today. We want to tell you a little bit about ourselves, then go right into explaining what a Frankenstein Program is, and what problems it will cause for you as a wellness leader. Then we've explain how to tame your Frankenstein program, using examples from employers like you. Then we'll wrap up with some next steps.

About Extracon: We create wellness portals for employers and resellers - including Health Assessments, Online Programs, Team Challenges, and Incentives. Our portals can also manage the data from your Biometric Screenings, Onsite Classes, Onsite Programs and Events, and Coaching Programs.

Our online, social and mobile platform has been proven at employers large and small across the USA for more than 5 years. Our client list includes Fortune 500 companies, major hospitals, and health insurance plans. Clients include Highmark Blue Cross, University of California at San Francisco, Mars, Red Bull, Costco, University of Phoenix, Indiana University Health, Methodist Healthcare, and many more.

What's a Frankenstein Program

So first, What's a Frankenstein Program? If you remember from the movies, Frankenstein was stitched together using parts from a bunch of different places. And many wellness leaders also try to stitch their programs together using parts from different places. They have a health assessment from the plan administrator, online programs from vendors, onsite events and programs tracked with Excel spreadsheets, and incentive points all over the place. These different pieces were never designed to work together - so it's like a puzzle with pieces that don't quite fit. Does that sound familiar? It's easy to see how this happens. As you build your program, you add a new piece or two every year. Each new piece seems like a good idea, but pretty soon you wind up with a monster!

So What's wrong with having a Frankenstein wellness program? There are three big problems that we'll explore using examples. First, it's clunky. Have you ever seen the way that Frankenstein walks? That's what we're talking about. It takes a lot of work to get where you're going. Second, it's not smart. Your program needs to have answers about program effectiveness and program success. The Frankenstein program can't come up with the answers. Just like Frankenstein in the movies. Third, it can turn on you. Dr. Frankenstein always assumed that he'd be in control of his monster, but then the monster turned on him. We'll talk about the ways that can happen to a Frankenstein wellness program. So let's get started.

The first problem with the Frankenstein program is that It's Clunky: It takes a huge amount of effort to get where you're going. You're manually working with your data that is scattered among a bunch of Excel files and emails. Let's talk about some examples.

Onsite classes can be clunky. Let's say you're running an onsite program like a nutrition class for diabetics. And you have a paper sign-in sheet that you have to type into Excel. Fun, isn't it? And your participants have to complete 4 of the 6 classes to earn an incentive, and then the data is scattered across 6 spreadsheets. Now you need to pull a formula out of a hat to see who has completed 4 of the 6 classes. And hey, there's a mistake in that formula. Can you spot it?

Manual walking programs are very clunky. Some people are turning in paper walking logs, and others are emailing you a spreadsheet with their data. You're supposed to put it all together and send out a leaderboard every week. So you're trying to put data from all kinds of sources together and hoping you don't miss anything or double-count anything. Every time you think you're done with the weekly spreadsheet, your email goes “ding” one more time and you have put in someone else's data. And then someone sends you last week's data that they forgot to send - so last week's standings are now incorrect. And then someone wants to change teams. And what if someone leaves the company - how do you know to take them out of the standings? How do you recalculate the team score? There's a lot of manual work that just keeps coming. One final thing on this page. That weekly email needs to have fresh, educational content along with the team standings. So that's one more thing on your to-do list - finding some interesting article or idea to craft your weekly email around. Most wellness leaders who are running their own programs are having to create emails, newsletter articles, and educational materials for every program and every program year. When you add up all the announcements, posters, emails, deadline reminders, and other communications you send - across all your programs - it can easily be 200 or more communications a year. That's a big burden of time you will spend creating content and managing email lists so it goes to the right place.

And points programs can be very clunky. You may have a points program where people earn different numbers of points for each wellness activity, and so your data has to add up across a dozen different programs of different types. So you have all these old Excel sheets from every program you've run during the year- are you sure you have the “final” version of all those files? What if one of those files gets lost? But you take the files you have and cobble them together into a master file with a bunch of formulas to add up the points. Unfortunately, it's a moving target. Since you still have some “last minute” data and corrections coming into your email inbox. And you're also getting calls and emails from participants asking if they have enough points - and then giving you their version of what their points are supposed to be. What do you do with that person who thought they had enough points, but didn't? You might well wind up changing things in the Master File right up until the date you have to start paying the incentives out.

So that's the first problem with the Frankenstein wellness program. It's clunky, and it takes a lot of work to get where you're going.

The second problem with the Frankenstein wellness program is that it's just not smart. So let's say your leadership asks you some simple questions. First, are the right people joining the programs? Second, after the program, do your participants stay successful? To answer these kinds of questions, you need to connect the dots from the HRA and screening in year 1, through your different programs, and into the HRA and screening for year 2. That first set of arrows on the left is how you answer the first question - are the right people joining the programs. So if you have a fitness program - are we getting the couch potatoes off the couch? Or are we just paying the marathoners to do the same thing they would do anyway? To answer that question, you have to connect the dots from each individual's health risks to program participation. If you have a Frankenstein program, you probably don't have the data to connect those dots. The second set of arrows on the right is how you answer the second question. After the program, do people stay successful? So if you run a weight loss program and your participants lose 20 pounds each - you need to know what they weigh a year later. You need to know if they kept the weight off, or just regained it. If you run a diabetes education program, you want to know if your participants had a better A1C in year 2 than they had in Year 1. If you can't connect the dots, you've got a Frankenstein program. You see, it doesn't matter what your participation rate is, if all the wrong people are joining your programs. And it doesn't matter what your success rate is in a 6 week program if participants go right back to their old habits when the program is over.

The last big problem with the Frankenstein program is that it can turn on you at any moment. So we talked about how much work it is to take data from sign-in sheets, emails, and spreadsheets and try to maintain it and put it together into a coherent picture. But's not just a lot of work, it's also very prone to errors. It's easy to make a mistake when you're handling and retyping so many things manually. You could put a number in the wrong box and a then participant isn't credited with an incentive they earned. Or lose a column when you sort - so now your participants all have the wrong data next to their name. Or your spreadsheets aren't updated when someone joins or leaves the company. You can put together a complex formula and one little AND needs to be an OR. These are easy mistakes to make, and I think we've all made them at one time or another. But it really hurts your program when your CFO has to tell you that your numbers don't add up. Or you have a dozen participants in your office who didn't get the incentive even though they did everything they were supposed to. There's one other important way that the program can turn on you. Excel is not good at version control, backup and disaster recovery. So if you have several people working with a file - whose version is the official one? If you have three files in a folder that you haven't looked at in 6 months - are you sure you're using the right one? ? If you make a mistake in a formula or a sort - can you go back to a previous version to that has good data? And if your hard drive fails and your master file is lost - what do you do then? Keeping track of everything in files and Excel just doesn't help you with version control, backup and disaster recovery. Bad things can happen and there's no way to pick up the pieces.

Taming the Frankenstein Wellness Program

Now we're going to talk about how to tame your Frankenstein wellness program. I think it's important to give practical examples from real employers - and for better or worse, the stories we know best are from our own Extracon customers. We'll go through a set of examples, from Extracon customers who used our online platform to tame their Frankenstein wellness programs. They are still in the driver's seat, running their own unique programs - but now the programs work smoothly. They can get the answers to their leadership's questions. And there's no danger of the programs turning on them. First, we'll talk about a large integrated health system with about 10,000 employees. They had a classic Frankenstein program with disconnected paper and electronic data. Then, we'll have some bonus examples from our other customers.

Let's talk about one of our clients, a large healthcare system in the southern US. They had a classic Frankenstein program, and we helped them get it under control. They had been using the free health assessment offered through their health plan administrator. Did you ever get something for free, and realize you'd gotten about what you'd paid for? They only got about 26% to do the health assessment, even with a $150 incentive. And the only data they could get was aggregate data - the data looked about like the graph you're seeing onscreen. So even if they knew how many people were smokers, there was no way to target those people for their smoking cessation programs. Even if they knew how many people were sedentary, they had no way to target fitness programs to the right people. They ran quite a few onsite programs, and as you can imagine there was a lot of data floating around in Excel. We already talked about how clunky that process can be. But the really scary thing was how the screenings were run. They used a well-known outside screening firm, and paid good money for the screenings. So here's how the screenings worked. The person would come in and step on a scale, get their blood pressure taken, and get a finger stick for cholesterol and blood glucose. And here's what kills me. The screening nurse would take an ink pen, and write the numbers down on a piece of paper. Then the employee would take that piece of paper in their hand and literally walk out the door with the only copy of the data. I was shocked. But this really happens. So this is a health system with lots of resources - full-service primary care, diabetic counseling, weight watchers at work - and no way to target those programs to the right employees. And no way to follow up the next year and see which programs worked best.

We took a three-step approach in working with this client. Step 1 was to get better data. So they started using our health assessment. That means that individual-level data goes directly into our portal. We also solved their participation problem. They had been paying $150 incentive for participants to take the Health Assessment. So they had $400,000 going out the door in incentives every year - and still only had 26% participation. With our advice, they changed the incentive to a penalty - and participation jumped up to 94% the next year. And they saved a lot of money. Second, they started doing their own biometric screenings, so they actually got a copy of the data. They loaded the screening data into the portal. Third, they are able to get data from wearable devices like FitBits. The portal connects to devices for physical activity, weight, blood pressure, and glucose. You get much better data from these devices than you can get by self-report. If you look at this whole slide, you can see they are collecting much better data than they were last year. They have all the puzzle pieces ready to assemble.

The next step we took with this client was to enable self service for participants. Think about all those clunky processes in your Frankenstein wellness program - moving paper data to Excel, cutting and pasting all those spreadsheets together, adding up the incentives and points, and answering participant questions. All those clunky processes go away if you can enable self-service for your participants. They can take action themselves, through the portal, and get their own questions answered. So here are some ways we enabled self service for our hospital client. One of the first things we did was to get rid of the paper sign-in sheets for onsite classes and events. The hospital now has an iPad that participants use to check-in when they walk into the room for a wellness class or event. The data goes right into the portal, and the portal calculates whether the person has a good enough attendance to earn incentive points. We also got rid of some paperwork on their tobacco incentive. They had a paper form that participants had to sign and turn in - stating they are tobacco - free. You can imagine with 10,000 employees that's a lot of paper. You'll remember that this was the client that reached a 94% participation rate in the health assessment. So what we did was to put their language for the tobacco affidavit into the Health assessment that everyone was required to take anyway. The data goes directly into the portal and directly into the incentive reports. The client is also using our online Team Challenge programs for things like physical activity, weight management, nutrition, stress and sleep. These programs are completely self-service for the participants. The participants enroll, form teams, log their progress, compete, and use the social features of the site - all by themselves. Program communications are scheduled and sent from the system automatically. The client had always been afraid to run these kinds of programs manually - how do you do that with 10,000 employees? But it becomes possible by making it self-service. The client is requiring biometric screenings next year for all 10,000 employees - or the employees can visit their own physician and get the biometrics done there. So you can imagine that the hospital doesn't want 1000 or 2000 paper forms or FAXes to arrive. The portal allows participants to upload that physician form on the web, or using an App for tablets and smartphones. This client is actually setting up a table with some iPads so participants who don't have a computer can still use the App to get their HRA taken and upload their biometrics. In other words, it's now cheaper to buy an iPad or two than it is to accept paper documents. We call it, no paper - no excuses.

So Step 1 was getting better data. Step 2 was enabling self-service. Step 3 is using the portal to store the data and connect the dots and keep your data safe. So if you look at those arrows, you can see how we answer the important questions. We can see if the right participants are joining programs. And, we can see if programs are changing behavior for the long term. That's because we can connect program participation in Year 1 to the Health Assessment and biometrics in Year 2. Many employers don't want to see individual information, and that's fine. But it's really important to connect the dots BEFORE we make the aggregate reports. A portal is a much better way to connect the dots than a bunch of Excel files. It's also a lot less likely to turn on you. The portal is how they keep their data safe. All their data is stored in a secure datacenter, behind a firewall and multiple layers of security. All their data is replicated and backed up remotely. There is no way that one bad hard drive, or one bad computer component can make their data disappear. With the portal, they also have one complete and up-to-date version of the truth. Not a bunch of files with inconsistent data. Since the portal is “live” and up to date, participants can answer their own questions about points and incentives just by looking at their own dashboards. So your takeaway from this example is that taming the Frankenstein program requires you to have a portal where all your data connects at the individual level. That's the only way to connect the dots. And your portal should do your version control, backup and recovery for you. In other words, it can do all the things Excel can't do.

While we're on the topic, I want to share some additional ways to tame your Frankenstein program by enabling self-service. One of the biggest places you can enable self-service is around incentives. For a points program, you want your participants to see exactly how many points they have - in real time. And see all the deadlines. And you want them to see all their options to earn more points. And hopefully a lot of those options are programs that run on the portal - like the individual tracking and education programs shown here. For an outcomes based program, you want your participants to see what the primary standard is, what reasonable alternatives are available, and what all the deadlines are. And you want to give them a way to upload a physician's note and request an alternative - right there on the site. For outcomes based programs, you will need to have a variety of alternative standards available. The key is to make those alternatives run through the portal on a self-service basis. For example, some clients have educational workbooks and videos linked right from the incentives page - and they require participants to answer a quiz to make sure they really did the workbook or watched the video. Other clients use online tracking programs that run through the website as their reasonable alternative programs. Still other clients have the participants complete vendor programs - like the American Cancer Society's Quit for Life program - and upload a certificate of completion to the website. Either way, it's all self-service. If you want to tame your Frankenstein program - look for every opportunity to turn a clunky, manual process into a self-service process.

So here's our summary of today's presentation. We see a lot of Frankenstein wellness programs out there. They are trying to cobble together a bunch of mismatched data sets across their health assessment, screenings, and programs. It's clunky, it's not smart, and it can turn on you. It's clunky because you're manually handling data that comes in from email, paper sign-in in sheets, FAXes, and other places. It's clunky because you have to cobble all that data together in Excel and try to make the numbers add up. And it's clunky because you have to create everything from scratch. It's not smart because it doesn't let you answer the key questions. Are the right people joining the programs? And after each program, do they stay successful, or do they go right back to their old habits? And it can turn on you. One lost Excel file, one hard drive that fails, or one bad formula can ruin your whole program year. Then we offered some strategies to tame the monster, using examples from our clients. First, you need to get better data. Make sure you're getting individual-level data from HRA's and biometrics, as well as getting validated data from devices like FitBits and smartphone apps. Whenever possible, make sure your data goes directly into the portal - not going from paper to Excel and then into the portal. Second, use a portal with a robust database that can connect the dots and manage versions, backup and disaster recovery. Connecting the dots is how you make your program smart. It's how you can answer those key questions. Version control, backup and disaster recovery are the ways you keep your program from turning on you. If your portal has the one, authoritative and up to date version of the truth, you will never worry about the program turning on you. Finally, enable online self-service for participants. When participants can complete the wellness process online, see where they stand for incentives, and answer their own questions - your phone and email will quiet down and you can start leading your program instead of just reacting to the calls and emails that come in.

So there you have it - how to diagnose and treat a Frankenstein wellness program. Interested in learning more? Then schedule a discovery session with us. It will give us a chance to learn more about your program and your needs, and tell you more about our solutions. In the meantime, visit our website at We have a lot of great material, including WELCOA expert interviews, whitepapers and case studies. You can also watch any of our recorded webinars. Click on the “Let's Get Started” link at to access these materials or to schedule your discovery session. At some point we'd like to get you on the phone with our clients. They will all tell you that they were trying to cobble together a mismatched wellness program, and needed a way to make it run smoothly. They viewed their decision to go with Extracon as a significant step forward and they are satisfied with their decision. And lastly, I should mention that we will send out a recorded version of this webinar to all attendees.

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