In Honor of Colorectal Cancer Awareness Month, Let’s Talk About Prevention

By Ada Brainsky, M.D., Medical Director, Operations Management

Colorectal cancer is the second leading cause of cancer-related deaths in the United States for both men and women combined. Nearly five percent of Americans will develop colorectal cancer in their lifetime. Because there are often no symptoms when it is first developing, colorectal cancer can only be caught early through regular screening. Most colon cancers start as non-cancerous growths called polyps. If polyps are found and removed while they are still non-cancerous, cancer can be prevented. If colorectal cancer has already developed, more than 80% of patients can be cured when the cancer is detected and treated in the earliest stages.

To lower your risk of colorectal cancer, the American Society of Colon and Rectal Surgeons recommends that you:

  • Get regular colorectal cancer screenings after age 50.
  • Eat a low-fat, high-fiber diet.
  • If you use alcohol, drink only in moderation. If you use tobacco, quit. If you don’t use tobacco, don’t start. Alcohol and tobacco in combination are linked to colorectal cancer and other gastrointestinal cancers.
  • Exercise regularly and maintain a normal body weight.

People with an average risk of colorectal cancer should begin screening at age 50. Any one of the following screening strategies is recommended by the American Cancer Society:

  • Colonoscopy every 10 years
  • Computed tomographic colonography (CTC) every five years
  • Flexible sigmoidoscopy every five years, with or without an immunochemical stool test
  • Stool testing every year (for guaiac and immunochemical occult blood tests)
  • Stool testing every three years using a DNA assay and a collection of a full bowel movement

Some people are at a higher risk for colorectal cancer and should be screened at an age younger than 50, including those with a personal or family history of inflammatory bowel disease; colorectal cancer or polyps; or ovarian, endometrial or breast cancer.

Most people can stop being screened around the age of 75, or ,at the latest age 85.

Talk with your doctor to determine which screening strategy is best for you. Being screened–no matter by what strategy–is more important than which test you choose!

Next story: The Power of Healthcare Data Analytics

Data Targets At-Risk Employees to Improve Outcomes and the Bottom Line

By Chris Weale, Director of Specialty Sales, Chronic Care Solutions

About half of all adults have one or more chronic health conditions, such as diabetes, heart disease and asthma while one in four adults has two or more chronic health conditions. Many of these patients are not receiving recommended care for their condition, which drives up healthcare costs and leads to poorer health outcomes. In fact, healthcare costs are five times higher for employees with a chronic condition than those without. Yet, most chronic conditions and diseases are controllable and preventable. Getting employees to take action to adhere to preventive recommendations and better manage their chronic medical conditions is key to lowering healthcare costs and improving member outcomes.

Health Advocate offers solutions that utilize medical and pharmacy claims, lab/biometric screening results and Health Risk Assessment responses to identify and risk stratify members with chronic medical conditions. We then provide members one-on-one coaching from a dedicated nurse coach to educate them to better manage their conditions, reduce long-term medical costs and become more effective healthcare consumers.

Our analytics also enable us to deliver data-driven, proactive, targeted home mailings and mobile app push notification communications to members who are non-adherent to preventive and chronic medical condition care. Employees are reminded of recommended preventive screenings like mammograms and colonoscopies, for example, as well as vaccinations. The communications include information to promote healthy lifestyles.

In addition to delivering preventive messaging, the data enables us to send timely condition-specific messages emphasizing the importance of doctor visits, evidence-based tests like cholesterol monitoring, cancer screenings and medication adherences.

Issuing preventive and condition-specific reminder messages throughout the year provides ongoing intervention to help improve compliance, and to prevent or reduce complications, resulting in better medical care, improved outcomes—and lower costs.

Data Increases Engagement

Our highly integrated, personalized data-driven communications also enable us to increase engagement and drive participation in all our services.  With our mobile app, for example, employees can receive push notifications of eligibility in our chronic care condition management and wellness coaching programs that promote wellness/lifestyle changes. They can also easily connect to us to find in-network providers and schedule appointments.

Our experts analyze the data, enabling our clinical experts to view the employee’s health status, risks and gaps in care. For those with chronic conditions, we then offer coaching providing evidence-based support tailored to the employee’s risk level and needs.

This targeted, one-on one coaching at each point of contact motivates employees to take action to receive important preventive care, and to remain engaged in improving their health to better manage their condition and adhere to their treatment plan.

Insight into Cost Drivers

Our data enables us to provide valuable client reporting, monthly, quarterly or bi-annually. Our metrics provide a breakdown of disease prevalence and risk within the population, and pinpoint specific risk and cost drivers around the impact of chronic medical conditions. For instance, we can identify the appropriate ER use as well as brand-to-generic medication usage.

The Result: A Measurable ROI

With the use of these powerful analytics, Health Advocate helps companies close gaps in care, increase compliance and medication adherence, while offering a measurable return on investment. Our chronic disease programs, for instance, can see an ROI of 4 to 1 or greater.

To learn more about our data-driven programs, visit our Solutions page or contact us today!

Next story: In Honor of Colorectal Cancer Awareness Month, Let’s Talk About Prevention

The Power of Healthcare Data Analytics

The Power of Healthcare Data Analytics

By Dr. Abbie Leibowitz, MD, F.A.A.P., Chief Medical Officer, President Emeritus, Co-Founder

In today’s ever-changing consumer-driven healthcare landscape, engaging employees in their health is critical to controlling costs and improving clinical outcomes. According to the Kaiser Family Foundation’s 2017 Employer Health Benefits Survey, more than half of workers are covered by an insurance plan with a general annual deductible of at least $1,000 for individual coverage. It is certain that the number of people covered by high deductible plans will continue to increase. As these employees take on more financial responsibility for their healthcare, it is more important than ever that they are provided with resources to help them make better-informed healthcare decisions.

Employers struggle to develop effective strategies for getting employees to focus on managing their health and well-being. Healthcare data can be used to increase employee engagement in the medical management process. Data analytics applied to administrative information (medical and pharmacy claims, self-reported health information, laboratory and biometric screening results) can be used to identify gaps in recommended care, stratify risk and initiate outreach.

Organizations that adopt a data-driven approach in which interactions are personalized to each employee and their family members are more likely to be successful in motivating employees to proactively attend to medical needs and lifestyle issues.

Utilizing and Understanding Data Analytics

Healthcare data is complex. Identifying members across multiple data sets to create a picture of an individual’s health journey requires a level of analytic sophistication and computing power that has not been widely available at an affordable price to most employers. This is truly “Big Data!” The goal is to make the information actionable to both employers and employees. For every state and stage of health, there are applicable recommendations for care. These evidence-based practices apply to the management of chronic conditions as well as to preventive care. The challenge is to present them to individuals at a time and in a manner that makes the message more likely to get a response.

In a system in which most workers get health insurance through their employer, the employer is the logical conduit through which this kind of information flows. Regardless of their size or insurance structure, avoidable medical costs impact employers. While the threshold varies, most employers with 500 or more employees are self-insured. They function like small, or not so small, health insurance plans, and depending on their tolerance for financial risk and the limits of their stop-loss insurance, these companies directly pay for the medical care their employees receive. Even when employers are fully-insured, the claims experience of their group will be reflected in the insurance premiums they pay. This is to say nothing of the huge impact health issues have on the productivity and cohesiveness of the workforce.

Employers have historically attempted to address these issues by stringing together multiple interventional programs designed to target individuals with particular needs. However, without sophisticated data analytics and a comprehensive engagement strategy, these efforts are needlessly expensive and routinely ineffective. The programs tend to duplicate each other’s features, and the layering of multiple vendors and touch-points adds to the complexity of the health benefits program. The result ironically, although not surprisingly, is to discourage the very participation they were intended to promote.

Applying Data at the Point of Contact

It is unfortunate that it is so difficult to get people focused on their health, but it is true nevertheless. Using a Big Data approach, we can aggregate data from multiple sources, effectively creating an administrative version of a personal health record. We can identify an individual’s health status, and using this information, determine steps that could be taken to reduce future medical risks. We then can determine if gaps in recommended care exist on this road to better health, and if they do, initiate steps to get the employee to attend to these needs.

Using the individual’s preferred channel for communication is most effective, but even in the absence of this knowledge, communicating using multiple channels increases the likelihood of success. Our motto is that, “Everything works a little bit.” While the general bias is that people don’t respond to mailed reminders, in fact some people do. Just as “some” people respond to email, or text messages, or online notifications, or automated phone calls. It’s an advertising approach to push the message out in as many ways as possible. It is hard to predict which approach will work with which consumer for which message at which time, so the idea is to try them all, or as many of them as reasonable!

Better still is the ability to “tag” an unexpected message to a request for assistance. Psychology explains that people are more receptive to an additional suggestion when they have made an active effort to get information or assistance for a problem they face. In consumer marketing this is referred to as an “up-sell,” and we can take the same approach in healthcare, reminding the person who contacts the service center that there is something extra they need to do to address a gap in care. The fact is, up-sells are far more effective than “cold calls” (to borrow another marketing term) when trying to motivate individuals to address a health need.

Data analytics enables us to create this interface. Using information we know about a person, we can develop a scripted environment and provide the additional message at the point of contact. Engagement is driven by offering the assistance the employee requests, like finding a doctor, getting an appointment, arranging a second (or third) opinion, or discussing the cost of care. Help with benefit questions, claims errors, or denials of coverage also are frequent needs employees seek help for. Once engaged, the agent, whether in a live or a virtual environment, can not only provide assistance for the need, but also offer an additional suggestion tied to the participant’s medical situation. The exchange might go something like this:

“Oh, certainly, I can explain what your deductible is for physical therapy. While I’m bringing up that information, I see that you have not had your annual diabetic eye exam. I can help you schedule that visit if you’d like.”

And with that, we’ve taken advantage of the employee’s need for assistance to deliver a message about an unrelated medical need. Even if she was not interested in further assistance with the appointment at this time, using data analytics we can track whether over the next months she scheduled the eye exam. A large percentage of participants do. In fact, across large populations using a multi-channeled approach, we can expect to close nearly half of the gaps in care in the population over the course of the year.

Developing a Data-Driven Strategy

The additional benefit of applying a data-driven strategy to managing workforce health is the speed with which information can be made available to allow the employer to evaluate results and implement new strategies and programs to address continuing challenges. This calls for relationships with vendors flexible enough to modify approaches on the fly. A good data analytics partner should be consultative in this review, providing not only insights from the trends reflected in the data, but also adapting predictive modeling techniques that show where things are likely to go in the future. Not all data analytics teams are geared towards this anticipatory guidance, but without it, the employer is likely to be continuously “chasing its tail.”

The employee population is dynamic and ever-changing. Building programs and designing outreach based on continuous data analytics and predictive modeling can have a significant impact on engagement, outcomes and medical costs. However, it’s an ongoing process best served when the data analysts and the employer work together towards these common goals.

Next story: Data Target At-Risk Employees to Improve Outcomes and the Bottom Line

Pilot program demonstrates 54% uptake; outbound email and mobile push notifications are new standard feature of member website and app

West’s Health Advocate Solutions, a leading health concierge and benefits solutions company, announced today the first results of its outbound push notifications and emails, called Advice Alerts, over its member engagement platform and mobile app. The website and mobile app, introduced in April 2017, enable members to access all of their Health Advocate services in one place, seamlessly connecting them to experts and resources to help them get the information and assistance they need to navigate the healthcare system, access care and improve their health. With the addition of the Advice Alert push notifications and emails, Health Advocate is able to more effectively communicate with members wherever they are and drive both engagement and positive behavior change.

Since Health Advocate’s new member platform and app was launched, Health Advocate has identified more than 20 million member-specific Advice to help users take steps toward better health. With the new Advice Alerts, members instantly know when a new Advice has been identified.

Through Advice Alert communications, members receive personalized Advice about actions they can take to improve their health and reduce their medical spend, sent via their preferred communications channel (web, app, email or mobile push). Additionally, Personal Health Advocates can also view and coach on Advice when members call for assistance or information. These high-touch notifications leverage machine learning to identify opportunities based on claim, demographic, personal health profiles, biometrics, surveys, and online behavior data, among other sources.

“Organizations are constantly seeking new and innovative ways to engage employees in their health and benefits,” said Marcia Otto, Vice President, Product, for West’s Health Advocate Solutions. “The Advice program utilizes a balance of the latest data-driven technology with the personal touch Health Advocate is known for, meeting people where they are and encouraging them to take action.”

During a recent pilot program of the outbound push notifications and emails, 54 percent of Advice Alert recipients took action in the first week alone by visiting the Health Advocate member platform or calling a Personal Health Advocate for more information. As with the Health Advocate member platform, the Advice Alert communications are HIPAA-compliant to protect individuals’ privacy while encouraging engagement and behavior change. Members receive an Advice Alert each time a new Advice has been identified in their member platform, driving them to visit the website or app, or call a Personal Health Advocate, to learn more and take action.

Currently, nearly 3,000 unique Advice categories are available through the platform, including prescription adherence alerts, preventive screening reminders, relevant wellness workshops, follow-up appointments, and many more, with new Advice being added continuously. Each is tailored to the specific individual based on their specific background, preferences and needs.

The goal of the Advice communications is to provide Health Advocate members with actions they can take to address their health and well-being, including reaching out to a Personal Health Advocate to help them schedule an appointment, identify an appropriate provider, understand alternative treatments, and more.

First time app downloads have rapidly increased more than 250 percent since Health Advocate’s new member website and app were introduced last year, with unique website/app visitors increasing 86 percent. Additionally, overall utilization and visit numbers have both grown. During the Advice Alert pilot program, nearly 2,500 members received alerts, and the program will soon be expanded to all Health Advocate members who have registered on the member platform and app.

To request a demo of the platform or Advice Alert notifications, or for more information, please call 866.799.2655 or email us at:

About West’s Health Advocate Solutions

West’s Health Advocate Solutions makes healthcare easier for over 12,000 organizations and their employees and members nationwide.

Our solutions leverage a unique combination of personalized, compassionate support from healthcare experts using powerful predictive data analytics and a proprietary technology platform including mobile solutions to provide clinical support and engage members in their health and well-being.

Our members enjoy a best-in-class, personalized concierge service that addresses nearly every clinical, administrative, wellness or behavioral health need. Our clients benefit from high levels of engagement, improved employee productivity and health, and reduced medical costs, while simultaneously simplifying and upgrading their health benefits offerings.


By Lisa Roepe | SHRM

Shootings and other violent attacks are a sad reality of the world we live in—and the workplace is no safe haven.

Mass shootings like the one in Parkland, Fla., dominate the news in the days that follow. And while violent incidents in the workplace don’t always generate national headlines, they are every bit as devastating to the victims and their loved ones. For instance, a UPS driver opened fire on his co-workers last June, killing three and injuring five, at a warehouse in San Francisco. That same month, a former employee returned to an Orlando factory where he once worked and shot and killed five former colleagues. In Raynham, Mass., a man was arrested for attempted murder after he stabbed his supervisor in the neck with a box cutter following an apparent argument in September.

Each year, an average of nearly 2 million American workers report having been a victim of violence at work, according to the Occupational Safety and Health Administration. And the U.S. Bureau of Labor Statistics puts the number of annual workplace homicides at about 400.

“You can’t go a week or two without some sort of incident,” says Bethany Holliday, SHRM-CP, human resources director at Cornerstone Insurance Group in St. Louis.

“HR professionals need to recognize that this is the world we live in right now,” adds Bob Kolasky, acting deputy undersecretary for the National Protection and Programs Directorate at the U.S. Department of Homeland Security, which is responsible for protecting the nation’s physical and cyber infrastructure.

Recognition is only the first step. In most organizations, it’s HR’s responsibility to make sure workers know how to stay safe in the face of a threat. And with a steady stream of violent workplace episodes occurring, it is more important than ever to train employees to respond appropriately. Their lives may depend on it.

Training Workers

The most effective prevention plan is one that is put in place long before trouble occurs. Employees need to understand what to do in an emergency and what the company’s response will be. “No one responds well to a situation that they aren’t prepared for,” says Martha L. Boyd, shareholder at the law firm Baker Donelson in Nashville.

While there aren’t any formal government standards in place for training workers, it’s a good idea to provide instruction. Most experts recommend teaching people to run, hide or fight—in that preferred order.

“We train people to do whatever they feel they can do at the time, so they feel empowered,” says Jeff Owens, SHRM-CP, assistant director of human resources at Tulsa Community College in Oklahoma. “We tell them to assess the situation. If they feel there is a path to escape, it’s always better to run to safety.” If they don’t believe they can get out safely, they know to hide.

If they can’t hide and are exposed, they should pick up whatever is nearby—chairs, books, a fire extinguisher—and throw it at the assailant, Owens says. While the guidance used to be to stand down, most trainers today encourage anyone caught in the open to say “we’re not dying today” and put up a fight—an approach endorsed by the Homeland Security Department a few years ago. The exception typically is workplaces in which there are other people who can’t fight back and who may be put at risk, such as hospitals and assisted living facilities. Yet many schools adopt this approach, which is why at least once a year, Tulsa Community College employees can take training that includes discussions of potential threat scenarios, a graphic instruction video or role-playing with campus security staff.

The training may be disturbing to some people, but Owens believes it is helpful. “In the instance of violence, workers may never know how they are going to react,” he says. Some may sit down and cry, for example, while others run straight for the exits. Role-playing could help people prepare for how they might respond by exposing them, in a safe environment, to what may take place in a time of crisis, Owens explains. While the training is not mandatory, it is encouraged.

“The phenomenon of active assailants is frightening and understandably uncomfortable to discuss,” says Kolasky, whose office offers free resources to help companies prepare their workforces for violent incidents. But, he adds, preparation is about “giving people the knowledge to make the right decisions, before help arrives, to protect themselves and their co-workers if they suddenly find themselves in a bad situation.”

Looking for Red Flags

Use pre-employment background checks to make sure your organization isn’t hiring people with recent histories of aggression, says Danna Hewick, SHRM-SCP, vice president of human resources at USSI Inc., a Bethesda, Md.-based cleaning and janitorial services company. Hewick won’t hire anyone who has been charged with or convicted of a violent crime, including domestic cases, in the last 12 to 24 months.

Domestic incidents are often harbingers of more-widespread violence. A past domestic violence conviction, Boyd says, “might give me pause that [the individual has] unresolved anger issues that I don’t want to bring into the workplace.”

Shooters in several recent workplace incidents had histories of domestic abuse. For example, in February 2016, Cedric Ford opened fire on his co-workers at the Kansas lawn mower factory where he worked after being served a court order to stay away from an ex-girlfriend. He killed three people and wounded 14 others. Lewis Starkey III is accused of killing his girlfriend at their home in Wendell, Mass., in July and then driving to the trucking company where he worked and shooting and injuring a colleague.

Work can be a danger zone for those with an abusive partner because often it’s the only place a perpetrator can confront his or her victim, says Bert Alicea, a licensed psychologist and executive vice president of the employee assistance and work/life program at Health Advocate, a company in Plymouth Meeting, Pa., that helps people navigate the health care system. Make sure workers understand it’s their responsibility to notify HR if they have a protective or restraining order against someone and to provide HR or security with a copy of the order, Alicea says.

He and other experts recommend adopting a zero-tolerance workplace violence policy that defines acts of aggression and the circumstances under which employees are required to notify HR if they have a court order against an individual.

Knowing that information helps HR and security to proactively protect staff, says Jack R. Plaxe, founder and managing director of Security Consulting Alliance LLC in Louisville, Ky. He recalls a time when a woman came to work and told the security department that her husband had threatened to kill her. He was a hunter, had a stockpile of weapons and had beaten his wife in the past, Plaxe says. Security personnel determined that he was a credible threat and developed measures to keep her and her co-workers safe. The team circulated his photo along with the type of vehicle he drove and his license plate number, and they stationed a guard near the woman’s work area. Fortunately, her husband didn’t try to confront her at work, but if he had, the company was ready to act.

Preventing Threats from Within

When you’re concerned about the behavior of someone within your own ranks, the first step is to establish whether the individual poses a direct threat to others. If he or she does, the employer can lawfully exclude that person from employment for safety reasons under the Americans with Disabilities Act. “If there is a potential of an immediate threat, that situation has to be quickly assessed and the violent employee needs to be removed,” Owens says.

Since HR typically relies on others to alert them when a person is acting out, teach your workforce to recognize the warning signs of potential violence, which may include angry outbursts, direct or indirect threats, and sudden changes in behavior and work performance. It’s also important to ensure that workers feel comfortable sharing their concerns with you.

“Listen for employees coming to you and using words like ‘bullying’ and ‘intimidation,’ ” says Ria Glenn DeMay, a lawyer and the labor relations manager for the University of Maine System, a network of public universities. The minute someone says, “I don’t feel safe,” it’s time to investigate, she says. It’s unlikely that a person will suddenly come to work brandishing a gun without first acting out in some way, she adds. Often their erratic and intimidating behavior has been building up for days or weeks and then escalates.

Many companies set up a confidential hotline to allow workers to report what they see and hear without fear of retaliation. If you go that route, be mindful of the possibility that people could target others for the wrong reasons. “If employees say they are concerned about an employee [primarily] because he’s Muslim or a veteran, HR is responsible to make sure we’re not letting stereotypes and fears govern our actions,” Boyd says. Ask questions to determine if there is a legitimate threat based on something the person has said or done, she says, such as a worker expressing a desire to hurt himself or others.

Showing Respect and Empathy

Whether you’re talking with an employee about changing his or her behavior after an angry outburst or you’ve determined that the individual should be terminated, treat the person with respect and consideration. “The best thing you can do in those cases is listen to them, let them feel like they are being heard, empathize with them and try to understand their situation so you can best help them work through it,” Holliday says. But also be firm and unequivocal so they understand that displays of anger aren’t acceptable in the workplace.

Think about who should speak with a worker who has displayed anger issues. Generally, it’s a good idea to have both the manager and an HR professional present so that one can do most of the talking and the other can listen and empathize, Alicea says.

If you’re dealing with someone who is prone to angry outbursts, don’t block yourself behind a desk without clear access to an exit. The best place to meet is an empty conference room where there is nothing on the table that could be used as an improvised weapon, Plaxe says.

Involving Law Enforcement

If an employee has made a direct threat or gives you reason to believe he is dangerous, don’t be afraid to contact the police or bring in paid security.

At a previous job, Holliday says management decided to fire someone for failing to show up for work. Company officials were nervous because the employee was a gun collector who had a history of erupting at work. After he was let go, the HR team asked local law enforcement to patrol the parking lot.

Boyd describes a similar situation where a worker who was slated to be terminated for a performance issue told HR he had a gun in his car. HR called the police, and they sent over an armed officer in uniform to monitor the situation. In cases like this, she prefers having the police on hand, as opposed to standard security personnel, because it sends a clear message to the employee and other workers that the company takes the situation very seriously.

​Unfortunately, it doesn’t take much for a person with a short fuse to take matters into his or her own hands, says Lawrence Kane, who frequently has to deal with threatening and violent behavior at his workplace. Kane is a security supervisor at the University of Washington football stadium. In his 26 years there, he has been drawn into more than 300 violent altercations, including once when a patron pulled a knife on him after he broke up a fight. Kane was surrounded by 70,000 fans and several TV cameras at the time, and two law enforcement officers were standing 20 feet away. “If someone is mad enough, has a mental disorder or is passionate enough about things, it doesn’t matter if there are cameras, witnesses and … policies in place that say you can’t bring weapons in,” he says.

In other words, while you can—and should—take steps to ensure workers’ safety by hiring good people and raising awareness, you can never eliminate risk entirely. While no one wants to contemplate the possibility of horrific violence, preparing employees for the worst could help them make it through with the only thing that truly matters: their lives.

Episode 12: Strategies to Drive Engagement

Organizations are continuously looking for new ideas to effectively drive employee engagement in health and benefits. In this episode of Health Advocate’s Ask the Expert series, Marcia Otto, Health Advocate’s Vice President, Product, shares best practices to overcome hurdles to engagement.

By Kathryn Moody | HRDive

Now that you, a forward-thinking HR person, have begun the complicated dance of data analysis, storytelling and employee management, get ready for the next twist: employees having access to all of the data on themselves.

Employers worldwide are on a spectrum of data literacy, but soon, any organization with any sort of global presence will need to establish a data ethics program — and fast, if haven’t already. The European Union’s General Data Protection Regulation (GDPR) may set the pace for worldwide transformation of employee data management at almost every global company, and it’s only the first rule of its kind that promises to do so.

But while GDPR is the shiny new expectation, HR is by now quite familiar with the ever-shifting nature of data management.

Jewell Parkinson, head of human resources at SAP North America, has witnessed the transformation first hand, she told HR Dive.

“When HR was focused on transactional work, the prospect of assembling data was a herculean effort, especially data with a high degree of truth,” she said. But now she is leading an HR department that plays a key strategic role in a company that has been “heavily involved” in the GDPR regulations.

In today’s modern employee tracking ecosystem, HR is both people manager and data ethics steward; the two functions are now blended.

Global changes in regulation mean big shifts ahead

For starters, employers that are thinking about a data ethics management strategy should have been planning for the GDPR months ago — and U.S. employers are behind, Shon Ramey, general counsel at NAVEX Global, told HR Dive. Messages telling employers to prepare should have come out at least a year ago, he said, as any employer with employees in the EU will be affected by the new regulations.

“[GDPR] is impressive in its reach and incredible in its scope, especially when we start talking about employee data,” he added.

The GDPR will go into effect on May 25, 2018, and includes broad-reaching data protection requirements that will impact all businesses and individuals in the EU. A more specific FAQ on its reach can be found here.

At its core, the requirements of GDPR adoption mirrors the questions data-forward employers must consider for all of their employee data, including:

  • Do employees give consent for collection of their data and how much consent is required?
  • How is the data collected? Through which means?
  • What is being done with the data? How is it shared?
  • How is the data disposed of?

It’s common, for example, to put notes in an employee file to establish a succession plan, Didier Elzinga, CEO and founder of Culture Amp, told HR Dive, but it isn’t common to share that information with an employee. GDPR “wants you to do that,” he said. It aims to give employees access to data on themselves.

This particular issue is still developing stateside, but it’s jumpstarting a “fundamental shift” in how employers think about the data they have on employees and when they can see it.

“Why shouldn’t they see what’s in the HRIS on them?” Elzinga said, reflecting on this trend.

The expansion of data privacy rights in the GDPR demands an additional heavy lift from employers, Ramey said, including proactively informing employees about how long data is kept, how it will be used and where it goes. Throw in the complexities of how the cloud manages computing by bouncing data between data centers (some in, yes, the EU), and unprepared employers could have a veritable mess on their hands.

But even for those who are out of reach of the GDPR for the time being, the questions it raises are ones that all HR professionals should be asking themselves as they wrestle with increasing amounts of employee data.

Grappling with data ethics and sensitivity

Having solid systems in place to manage data is a key first step in managing data ethically — and HR likely has an idea of what this needs to look like, anyway.

“HR is no stranger to this because they are used to thinking of the data being important and needing to be protected,” Elzinga said. HR has a long track record of handling sensitive personal data, including case notes and personally identifiable information.

But now that much of HR’s employee strategy building relies on gathering massive amounts of data, HR must be doubly sure to have systems in place to protect employee identities during data analysis.

“You can’t just strip all your data out and stick a data machine learning process over it,” Elzinga said. Employers have an obligation to ethically handle that data and ensure that analysis done in aggregate doesn’t make it so employees can be personally identified. But how do you build those systems?

Slowly, Ramey said.

“It is an elephant,” he said. “One bite at a time. It’s truly figuring out and asking the right questions. And from a list of priorities standpoint, you aren’t going to be able to do it all. Prioritize the risks and be asking the right questions.”

Perhaps among the more difficult but most important priorities, according to Ramey, is understanding the type of consent you have from employees regarding their data.

Benefits need a strong system

If you need an example of this type of data management in action, look no further than benefits administration. Data access has changed how employers approach employee health, allowing better insights and an improved focus on ROI — but privacy is paramount with sensitive health data. Employers have to be extra cautious about personally identifying information.

“It’s definitely opened people’s eyes to what you can do,” Dan Shields, vice president of specialty product sales at Health Advocate, told HR Dive. “Taking sample sizes that are too small can identify people. If there aren’t enough people in a data set, we don’t display it.”

The adoption of wellness programs has spurred interest in health incentives, which naturally requires an employer to identify individuals who complete required tasks in order to grant them said incentives. Even something as simple as giving an employee a prize for attending a check-up requires specific policies and procedures to ensure the employee is protected and the company is compliant with health data requirements, such as those in the Health Insurance Portability and Accountability Act (HIPAA).

Benefits providers and their third-party associates often know what conditions employees have, who has shopped for care, where they received care and why, Marcia Otto, vice president of product at Health Advocate, told HR Dive. Companies like Health Advocate also try to be proactive in reaching out to employees that need care. So they must balance not coming off as Big Brother while also legitimately personalizing healthcare to specific needs.

Since personalization is increasingly part of the HR function, expect that strange dance to affect management in more than just benefits.

Stewards of data — most of the time

HR practitioners may need to take initiative and become true stewards of the vast amounts of people data that runs through their department. Names, social security numbers, healthcare information and compensation details all run through HR, Parkinson noted.

“And it will be the evolving role of HR as stewards to be able to determine how best to navigate the use of information,” Parkinson said.

Luckily, data management provisions have largely improved and grown with organizations — and HR has undergone a lot of “changes for the better.”

“20 years ago I was personally keying data into master systems,” she said, “but now having the ability to readily access information in real time, it really has radically shifted the function.”

Something as simple as headcount was more difficult to gather in the earlier days of HR, and even that can still be difficult for organizations depending on where they are regarding data analysis. But understanding how to manage that data will be key in establishing a strong company culture going forward.

In some cases, particularly around benefits, outsourcing data management to a trusted and vetted third-party partner may be a useful way to arrange some of these processes.

“The smart HR people are realizing they probably shouldn’t be doing this stuff themselves,” Shields said. Often, HR practitioners don’t need to personally know many employee health specifics to do a proper analysis, Otto said. To avoid violating HIPAA or the Genetic Information Nondiscrimination Act, employers need to be very careful with the processes around health data.

After all, for HR to truly innovate in the space, it needs to have the trust and support of both leadership and the employee base. How the department handles data management now can define the future success of the organization.

“How do we safeguard our brand and reputation and live by our value of trust and transparency?” Parkinson said. “That is a real challenge we will face.”

Personalizing health plans with technology

By Cort Olsen | Employee Benefit Adviser
February 4, 2018

Many advisers are using digital monitoring to evaluate the status of wellbeing within a given employer’s employee population.

Craig Schmidt, senior wellness consultant for EPIC, says one of the ways he is able to identify the companies that are offering strong digital wellness plans is through their ability to integrate such programs with claims data. He utilizes a push style notification to a mobile device to inform individual employees about specific plans that can coordinate well with their conditions as a further enhancement.

Samantha Gardiner, director of product management at Health Advocate, says her company has combined wellness, chronic condition management and client outreach all into one program to improve the health of employees and reduce claims and pharmaceutical costs for employer-provided health plans.

“We take the data and provide alerts via our website, email or mobile push notifications to keep employees informed about their personal health conditions,” Gardiner says. “If we have the data, we can really target and personalize the program toward company goals and members’ personal goals.”

In order to identify the best in class among the programs offered by wellness providers, Schmidt says he looks at the number and quality of interfaces and outcomes from the program as well as success stories that employees can share that can flesh out an employer’s return on investment.

“We can look at results six months or even a year after an employee has participated in the program to see if behavior changes have taken place,” Schmidt says. “If the plan integrates and reacts to the systems the employer has in place for his or her employees, then we will know if the program is a right match.”


Monica Majors, vice president of marketing and communications of health plan products at Sutter Health, says a digital wellness program needs to integrate with a multitude of personal devices.

“The site must be responsive to all technology, such as a mobile device, a tablet, or for those who are deskbound, from their computer,” Majors says. “The flexibility of offering individual trackers as well as key based activity challenges through a wide range of activities will keep retention.”

The program can then offer a health assessment that can be aggregated into an overall employer report, which can then serve as a basis for customization for that specific workforce.

Marcia Otto, vice president of product strategy at Health Advocate, says her company offers biometric screenings that can be done onsite, which can then factor into an employee’s health risk assessment to further customize the personal health program.

“If we get biometric data from our biometric data collection or if the employee sends us the data from a third party, that is another data source we can look at to determine if they need further attention for diabetes, hyper tension or so on,” Otto says. “We can also collect data on what their last blood test reported, right down to how many fruits or vegetables they eat, which is then prioritized based on how sick the employee is.”


To influence employees to remain on the wellness plan, employers have offered incentives. These incentives can range from gift cards and cash rewards to funding a HSA or a HRA.

Paul Sterling, vice president of emerging products at UnitedHealthcare, says users who are enrolled in the UnitedHealthcare Motion program – an app programmed to encourage employees to remain active throughout the workday using a smart phone or smart watch – rewards employees by funding money into an HSA or HRA as a way to retain users.

“We have three daily walking objectives through our FIT criteria – frequency, intensity and tenacity – that each of our members try to achieve,” Sterling says. “Each one of those objectives is tied to or associated with an incentive amount.”

For each objective the employee completes, UnitedHealthcare deposits $1 into the user’s HSA or HRA, depending what they have.

Each day, the employee can complete each of the objectives. It resets daily, allowing the employee to continue to receive up to $3 per day.

Over the course of one year, Sterling says participation in the Motion program has held at a steady 67%. “If you think about other products in the health and wellness space, that’s arguably 10 times the level of engagement achieved over that period of time others would achieve,” Sterling says.

While Gardiner says she cannot pin point the number of employees engaged in her program for an extended period of time yet, she thinks incentives do drive continued engagement for some employees who need the extra push to be active or engage in a healthier lifestyle.

“An incentive program that provides at least a $300 incentive to participate is where we see our most engagement,” Gardiner says. “It all depends on the goals of the employer.”

View online here: