By David Anderson, Ph.D., chief health officer
The annual health assessment has long been a staple of employee health management programs as a cost-effective approach for giving individuals a snapshot of factors that might be affecting their overall health from year to year. In fact, health assessment has proliferated so widely that it is even sometimes mistakenly thought of as the entire wellness program. So, why am I writing about a tool that’s more than 30 years old? Because the health assessment isn’t what it used to be, and much more change is around the corner.
Since the health assessment was first used in 1980, the tool itself has changed and been influenced by technology (moving from its original paper format to an online format) and by the growth in personal health monitoring devices that help individuals track and manage their health throughout the year.
The “teachable moment” that is one of the most important benefits of the health assessment remains; providing a catalyst for initiating lifestyle change for individual participants at a time when they are receptive to health-related information and recommendations. In these teachable moments, health improvement messages can become a trigger for taking the first steps toward behavior changes that reduce health risks and improve health. For example, facing the fact that your stress-related risks are higher than most or that you are at elevated risk for developing diabetes is just the jump-start many people need to finally take action and make changes that truly improve their lives. In many cases, the first step toward change is to enroll in a wellness program intervention, such as completing a health coaching program or participating in a worksite challenge.
Now, thanks to the proliferation of apps and monitoring devices, it’s easy for people to stay engaged in that teachable moment beyond receiving their health assessment results and beyond the workplace. Technology has created a world where people can be continually connected to resources that support their personal health. According to a Pew Internet survey, 56 percent of U.S. adults own a Smartphone and 52 percent of them have used it to look up health information. In addition to seeking health information online, 19 percent of Smartphone users have downloaded an app designed to help them track or manage their health. While actual usage is still an open question, the ability to provide wellness tools that are with people throughout the day opens exciting possibilities to the developer that “gets it right” in sustaining participation over time.
When it comes to health assessment, the number of available sources of relevant health data is also increasing exponentially. Sources include activity or participation data from mobile apps (such as weight loss or fitness apps), health care and disability claims, lab tests from doctor visits, personal health records, electronic medical records, electronic health records, and wireless monitoring devices (e.g., activity trackers, blood pressure monitors, scales and metabolic measures).
Employee health management programs are moving toward integrating these diverse data sources and extracting relevant data elements from each to provide a more complete health assessment and action plan. This will enable ever more tailored services for every individual in the population, ranging from the very healthy to those with serious chronic health conditions.
Ultimately, this integration of technology and data sources into health management programs will have a positive impact on health assessment because, rather than a single comprehensive health assessment at the beginning of each program year, individuals will be able to provide both self-reported and objectively measured data (e.g., weight, blood pressure, eating habits, and exercise) throughout the year. The end result will be a broader, deeper and more dynamic health assessment that supports an ongoing view of an individual’s personal health and opportunities for health improvement. Web apps are being used to deliver immediate value to participants in the form of brief, risk-specific health assessment modules integrated into intervention components such as coaching, worksite challenges and web-based “games” and trackers.
Using technology to acquire a continuous stream of data about an individual’s daily life has been labeled the “Quantified Self” (a term coined by Wired magazine alums Gary Wolf and Kevin Kelly), and it has the potential to generate data about behaviors like food consumption, emotional states or moods, blood pressure, and physical and mental performance, among other things.
Using technology to provide dynamic, real-time feedback throughout the year, integrated into a continual stream of program interventions, offers the opportunity to transform the role of assessment in health management. While an annual health assessment “event” can sometimes be seen as a burden by participants relative to its perceived value, technology now enables offering a series of engaging opportunities for them to get personally tailored and motivating, real-time feedback on their health that leads immediately to health improvement opportunities. An important consideration along the way for wellness providers will be assuring that any information captured from devices or apps is used in a HIPAA-compliant manner on behalf of the sponsoring organization.
To learn more about health assessments, including research on their effectiveness, the predictive nature of health assessment data and best practices, check out one of these resources:
- Comparing Alternative Methods of Targeting Potential High-cost Individuals for Chronic Condition Management
- Analyzing Best Practices in Employee Health Management: How Age, Sex, and Program components Relate to Employee Engagement and Health Outcomes
- Use of a Normal Impairment Factor in Quantifying Avoidable Productivity Loss Because of Poor Health
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