occupational health broadens its scope: …...capitalize on the brand of the health system.” “i...
TRANSCRIPT
VISIONSSUMMER 2015 / VOLUME 25 / #4
THE PERIODICAL OF THE NATIONAL ASSOCIATION OF OCCUPATIONAL HEALTH PROFESSIONALS
Inside2 NAOHP News
8 Measuring the Value of Occupational Health and Safety Interventions
12 A New Concentra Era Begins
13 Keynote Speaker Highlight15 Lessons Learned16 Social Media in Healthcare Marketing20 Vendor Program23 Calendar
24 Job Bank
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By Anthony Vecchione
Healthcare in the United States has undergone a transfor-mation in large part due to the Affordable Care Act (ACA). Occupational health has also been transformed by the ACA–and by all the new service lines that have sprouted up in programs around the country.
To help explain some of the latest developments in our field, we asked a few industry experts to weigh in on changes we think are particularly relevant and offer tips on how a program might employ them effectively.
Occupational health began as a discreet, clinic-based discipline. But industry veterans agree the narrowness of that model was not very profitable and the addition of new services has allowed occu-
pational health programs to leverage their relationships with employers by bringing other services to market. “New services will convert an overall effort from poten-tially break even to something that can be very profitable,” said Frank Leone, M.A., M.B.A., president and C.E.O. of RYAN Associates.
LESSONS LEARNED FROM 9/11In addition to being a national tragedy, the experience and
knowledge healthcare professionals gained from treating first
responders and others after September 11, 2001, has had a significant impact on the field of occupational health.
Treatment protocols and prevention strategies that were used to combat the environmental diseases that resulted from the September 11 attacks are now being used in work-places across the country.
“Before 9/11, I did what most occupational doctors did––practice standard occupational medicine, traveling to different factories, consulting, giving advice and perform-ing disability exams and working on policy development,” said Dr. Marc Wilkenfeld, M.D., chief of Occupational and Environmental Medicine at Winthrop University-Hospital in Mineola, New York.
Now toxicology screenings are an integral part of many occupational health programs, Dr. Wilkenfeld said.
While there are certain things mandated by the Occu-pational Safety and Health Administration (OSHA), some companies are being proactive when it comes to screening
Occupational Health Broadens Its Scope: Introducing New Services Helps Redefine Mission
Dr. Marc Wilkenfeld
Town Halls are weekly 30 minute conference calls open to NAOHP members at no charge. There is a new topic every week. The following represents participant questions and selected responses.
Week # 27BUILDING AN OUTSTANDING PROGRAM WEBSITE
Q: What are the key benefits of a website?
“Websites are such a common busi-ness tool that it’s going to reflect poorly on your program if you don’t have one. When it comes to the benefits, two come to mind. The first is image. If you can project a professional confident image on your website, it will carry over subliminally to your program. The second is information. A large part of marketing occupational health is playing the education card. The more your clients access your web-site because it is the most appropriate portal to get what they need, the more you can position yourself as an expert in the area.”
“When I’m prospecting a business, I add our website link so they can just click on it and see all of our services. They don’t have to navigate through the parent organization’s website; they can just click on the link to see our program.”
Q: How do we get our hospital to let us have our own website?
“If you can link, for your health system, the importance of building relationships and creating revenue, you can build a side or micro website and capitalize on the brand of the health system.”
“I think it’s important to reorient the hospital’s thinking. The norm is that there is one centralized website, some-times I get intimidated by such a big site. It takes too long to get from place to place. If there’s a dedicated website, I can get there right from the start and be more comfortable using it.”
Q: What are “must includes” for an occupational health website?
“It’s very important to have lots of white space and to utilize photographs. In terms of substance, it’s critical to have some sort of mechanism by which individuals can let you know who they are. Give them an opportunity to ask questions, send a tip, sign up for this or that so that you can build the all-important contact file. ”
“It’s about getting employers engaged with individuals. Part of occupational health has revolved around health and wellness. One thing we’ve done is create a Community Health Challenge on our website, where employees can sign up. We’ve essentially created a platform for our wellness program and it’s turned into a portal where people receive information. It’s a relation-
ship builder and 75 percent of those members become clients.”
Q: What will a great website look like in the future?
“In the future, the website will be the landing page for the app so people can access our website and our materials wherever they are.”
Week #28 POSITIONING YOUR PROGRAM TO SENIOR MANAGEMENT
Q: What are the core reporting metrics for senior management?
“We begin by telling our clients, ‘What is important to you may not be applicable to them.’”
Q: How often should we provide reports to senior management?
“We provide a monthly overview of volume, revenue, expenses and new clients and [then] a more in-depth quarterly report.
“Reports tend to be boring; make them short and sweet and readable at a glance. Go for one’s subliminal memory.”
NAOHP News
VISIONS Volume 25, Number 4 • Summer 2015 Executive Editor: Frank H. Leone, M.P.H., M.B.A.,• Editor: Isabelle T. Walker • Graphic Design: Erin Strother, Studio E DesignContributing Writers: Karen O’Hara, Phyllis Hanlon and Anthony Vecchione • VISIONS is published quarterly by the National Association of Occupational Health Professionals 226 East Canon Perdido, Suite M, Santa Barbara, CA 93101 • (800) 666-7926 • Fax: (805) 512-9534 • Email: [email protected] • www.naohp.com NAOHP and RYAN Associates are divisions of Santa Barbara Health Care, Inc. © pending • VISIONS may not be copied in whole or in part without written permission from NAOHP.
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NAOHP Town Halls Address Critical Issues
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“Have constituents share their thoughts. Pull out quotes and the person/affiliation who gave the quote. Management tends to see that.”
Q: How can we really get to the senior, senior management team?
“You don’t necessarily have to. Just appeal to those that drive the existence of your program.”
Q: How do we articulate the value of our program to our health system?
“Use actual numbers, use graphs, charts and pictures.”
“Quantity: how many lives do you touch at companies you work with?”
“Play to your communication strengths and use the modality that works best for you.”
Q: In what realistic ways can we involve senior management in
our program?
“It depends on the persona of senior management. Some you want to involve, others not so much.”
“We stress hands on involvement, overt or written, such as a message from our C.E.O. on your webpage. Ask them to meet periodically with key employers. Such involvement will make them less likely to look the other way when you need them.”
Q: How do we know what senior management really wants?
“Ask them what they want but go well beyond that. Why are they com-mitted to your program in the first place? Exactly what do we need to do to succeed?”
“Who is senior management really? Who has the influence to support the program over time? It may be multiple people or just one.”
Q: We provide many free services to our health system. How do we
get credit?
“Track staff time (associated with these services); what would it cost if purchased from an outside vendor?”
“We work hard to quantify ancil-laries ––lab, radiology, P.T., imaging
and measure the in-kind service to our system. We generally get an expense credit for this.”
Week #31 TRANSITIONING FROM VOLUME TO VALUE
Q: Do we still need to measure our volumes?
“Certainly. Volumes provide a platform to in turn measure value. For example, higher Ns mean greater impact.”
“We think of value as an equa-tion: value = a+b+c+d or say volumes, outcomes and patient satisfaction. Measure both quantitatively and qualitatively.”
Q: How do we measure value?
“We strive to meet standards of care. Clients look for lost workdays, accessibility, communication, return-to-work outcomes and lost-time data.”
“Must have the capacity to blend internal definitions of value with your constituents concept of value. Look at client perception of value both in the aggregate across all employers as well as employer specific.”
Q: What do we mean by value?
“At the end of the day, let your consumers define value.”
“Occupational health program
metrics can help programs compare to benchmarks such as turnaround, communication and access to appoint-ments. The NAOHP, AAOHN and ACOEM all offer benchmark data.”
Q: How do we make this transition?
“We began by defining how to measure value; our software helped greatly.”
“In order to make the volume to value transition you must get everyone onboard; becoming more value ori-ented as a team requires a major shift in mindset.”
“Compensate accordingly, not in the same old tired ways. Provide incentives to providers based on productivity, return-to-work outcomes and patient satisfaction performance.”
Q: How does value in this instance connect with accountable care
value?
“Occupational health as we knew it is now part of a larger paradigm, with much less clinic level focus and more [focus] on what can be done to enhance the health and safety of [the] larger population.”
To learn more about programs and services, visit www.naohp.com/menu/naohp/
Town Hall Schedule & TopicsAug. 3 The program director/medical director interfaceAug. 10 Developing metrics for TPAsAug. 17 Innovative occupational health sales and marketing tacticsAug. 31 Developing win-win relationships with senior managementSept. 7 Labor Day/no Town HallSept. 14 Using your EMR for outcome dataSept. 21 Providing over the top patent and customer serviceSept. 28 The role of volumes in today’s value driven environmentOct. 5 Best Practice outcomes for injury managementOct. 12 National conference/no Town HallOct. 19 Using care mapping to manage patient wait timesOct. 26 Developing a client company communications planNov. 2 Roles and responsibilities for developing a program’s standards of careNov. 9 Managing a program director’s multiple responsibilities.
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their employees. For example, at a workplace where exposure to solvents may be relevant, annual liver function tests are now standard.
These screenings, noted Dr. Wilkenfeld, pick-up a chemically related disease at an early enough stage for the worker to be protected from serious harm.
“That’s a health benefit from a com-pany point of view. If the worker stays, they get sicker and potentially involved in litigation. Avoiding one case can save millions of dollars and terrible publicity for the company,” Dr. Wilkenfeld said.
By preventing one case of lead poisoning or cancer due to exposure, he added, you’re doing the patient and the company a tremendous favor.
Dr. Wilkenfeld said that occupational health doctors should seek training in toxicology. “It’s a boutique part of occupational medicine.”
Many occupational health programs today are putting time into researching the kinds of industries that generate toxic and potentially toxic environments.
For occupational health programs considering adding environmental medicine to their service line, Dr. Wilkenfeld has this advice:
“You have to get trained. It’s a very specific field. If you’re an ER doc and go to work at an occupational medical center you’ll do fine. Not true for the practice of environmental medicine. You need training.”
Environmental medicine is some-thing people don’t automatically learn, Dr. Wilkenfeld said. For instance, if someone comes into a doctor’s office and says they were exposed to arsenic, you have to know something about it.
Another piece of advice: be 100 percent honest with your clients. Don’t sugarcoat anything. “If you’re wor-ried about a chemical exposure in the plant, don’t be concerned about how management is going to react. Ulti-mately you’re doing them a huge favor by telling them things up front,” Dr. Wilkenfeld said.
WOUND CARE AND OCCUPATIONAL HEALTH: GO WELL TOGETHER
Crush injuries, amputations, neck and back wounds are common in certain workplace environments. But they’re not limited to the workplace by any means.
Two years ago, West Georgia Worx, a hospital-based occupational health clinic in LaGrange, Georgia, partnered with Jacksonville, Fl.- based Healogics, a company specializing in wound heal-ing, treatment and prevention.
Nick Vla-chos, M.D., medical direc-tor at West Georgia Worx also oversees wound care and a hyper-baric oxygen clinic.
“The learn-ing curve was quick and
I found a needed resource for work-related crush injuries of the hand and foot as well as for burns,” said Dr. Vlachos. Dr. Vlachos said that novel dressings and grafting materials have made it easier for these wounds to be treated in the occupational health setting.
“There is no reason why these same techniques and materials can’t be used at the local occupational health clinic, whether it be private, hospital-based or on-site delivery,” said Dr. Vlachos.
Dr. Vlachos said that in many instances occupational wounds are improperly treated. For example, wounds are soaked in Betadine prior to suturing and dressed 100 percent of the time with Bacitracin. Dr. Vlachos noted that there are many other dressing materials that promote growth factors and minimize scarring. “I’m seeing faster healing, less restricted work and less disfigurement all sup-porting the employer’s bottom line,” Dr. Vlachos said.
It’s important to recognize that the biggest risk in work-related wound cases is for one or more comorbidities to go unrecognized, Dr. Vlachos said. For example, underlying diabetes,
venous and arterial leg disease, smoking and obesity all delay wound healing. “The occupational health doctor who delegates his patients to someone else might find that they will have complications because the underlying comorbidities were not [treated],” said Dr. Vlachos.
Wound care, Dr. Vlachos noted, is an excellent preretirement specialty for physicians in the occupational health field and for anyone who has been practicing occupational health after leaving primary care.
Occupational health doctors, said Dr. Vlachos, are constantly referring patients to other specialists. He con-tends that there are many physicians practicing occupational health in various venues who will never acquire board certification.
“I find that many occupational medi-cine physicians have very low comfort levels when it comes to treating some common work related conditions. In particular, conditions that require some additional training or experience, such as back and neck injuries as well burns and crush injuries of the hands and feet,” Dr. Vlachos said.
Dr. Vlachos said he completed the McKenzie courses for neck and back pain. McKenzie (www.mckenziein-stitute.org) is a method of physical therapy and exercise for back pain or neck pain.
“I now make it mandatory for my physical therapists to be certified in McKenzie therapy. In no time an occu-pational physical therapist can become comfortable treating back and neck pain without expensive imaging or long term pain medication injections.” Dr. Vlachos said the vast majority of these conditions are treated as muscle injuries when in fact they are disorders of the disc. Reducing the derangement mechanically heals the patient, some-times immediately, he said.
As far as giving advice to other occu-pational health programs that want to expand or get involved in wound care, Dr. Vlachos recommends partnering with an organization that has experi-ence in this area.
Dr. Nick Vlachos
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Occupational health physicians must be rooted and comfortable in the treatment of neck and back pain and should not be too quick to order imag-ing scans, Dr. Vlachos said. He said that occupational health physicians should feel very comfortable approach-ing patients with the idea that these are disc injuries that are probably going to get better on their own, but the process will be faster with focused therapy.
VIRTUAL ON-SITE CLINICS: WAVE OF THE FUTURE
Virtual on-site health clinics would have been viewed as strangely futurist a few years ago. Today they are not only a reality, according to industry experts, but the natural evolution of virtual care.
Carolinas Healthcare System (CHS), an integrated hospital system based in Charlotte, NC, launched a virtual clinic in August 2014.
Steve Jones, vice president, Carolinas Healthcare System Medi-cal Group, defines virtual care as a “vir-tual visit” and on-demand service; a pro-gram patients must enroll in to access providers.
“We operate all of our own provider coverage for the CHS Virtual Visit product. If you want to take a CHS virtual visit, you log on via an applica-tion or webpage and within three to five minutes you have access to avail-able providers who can treat a limited number of acute episodic conditions that are appropriate for virtual care,” said Mr. Jones.
Examples would include seasonal
allergies, cold and flu, respiratory infec-tions, skin conditions, urinary tract infections and pink eye just to name a few. “Today over 65 percent of our virtual visits take place on either an Apple or Android smart phone with a patient satisfaction rating of 4.8 out of 5 stars,” said Mr. Jones.
He explained that it’s a video/audio experience that provides a connection or link-up with CHS providers. It can be accessed via iPhone or Android, iPad or desktop computer. Mr. Jones said over 65 percent of patients access it from their phones. “Today a 10-min-ute experience with one of our provid-ers is priced at $49.”
Urgent care services are also available via a virtual visit. Among the new pro-grams set to launch is health coaching.
“We think it will be more impactful than just a phone call. We’re creating a program whereby you’ll be able to log on through our virtual platform and choose a health coach such as a dieti-cian,” Mr. Jones said.
CHS operates 19 on-site clinics, six are specifically located at their own hospitals in the Charlotte area and intended for their employees. An additional 13 are offered to employ-ers within a 14-county area around Charlotte.
Mr. Jones said the on-site programs have been very successful overall for employers and do help lower their healthcare spending.
“It does take the right size company to justify an on-site clinic (OSC). You need a certain number of employees, ideally you like to see about 1,000 to 1,500 employees who are centralized so that the employee-base can utilize the functionality of the clinic effectively,” said Mr. Jones.
Down the road Mr. Jones believes behavioral health will present more opportunities for virtual visits. “As we progress quickly, we will see full
primary care services [and] to some degree chronic disease management and follow-up incorporated into a video virtual care programming model. It’s early on. As programming contin-ues to develop, you’ll see more of these services.”
For other occupational health programs considering a virtual on-site initiative, Mr. Jones urges them to take a marketplace approach; look at virtual care as a way to connect their providers to local employers. They might also want to consider having an occupational nurse at those locations or setting up virtual programing for those employers.
He also suggests setting up injury management services. A lot of employ-ers are still looking for ways to connect those virtually.
Over the years, Mr. Jones said that occupational health has not been a total revenue source for a lot of groups. Blending urgent care services and virtual care might be a direction to consider.
WORKERS’ COMPENSATION/HEALTH AND WELLNESS: A NEW MODEL
The way Berynce Peplowski, M.D., sees it, workers’ compensa-tion costs are increasing and quality is growing uneven. The problem, said Dr. Peplowski,
medical director of U.S. HealthWorks, is that we aren’t consistently improving the health of our population in com-parison to other nations.
“Yet we continue to spend more money. I believe we should bring what
Steve Jones
“I believe we should bring what we do on the healthcare side to workers’ compensation and wellness and offer a package that’s outcome driven and value driven in an alternative payment model.”
Dr. Berynce Peplowski
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we do on the healthcare side to workers’ compensation and wellness and offer a package for employers and payers that’s outcome-driven and value driven in an alternative payment model,” said Dr. Peplowski.
What she means by alternative model is shared risk, such as capitation consistent with what we are seeing in the Affordable Care Act (ACA).
“The thing that differentiates this from Obamacare is that we would be integrating the workers’ compensation and wellness along with the health plan, all of which would be specific to the work site,” Dr. Peplowski said.
Right now, occupational health is still operating within the old school, fee-for-service, Medicare model that has people getting paid more for doing more.
In a shared risk model, Dr. Peplowski argues, there would be accountability for outcomes. “Important outcomes in workers’ comp are measures such as getting people back to work,” she said.
In the current system there’s no accountability. For example, if a doctor is treating someone for a back injury today, and the patient gets another injury subsequently, or never returns to work, the provider experiences no consequences.
“That model did not work for Medicare or workers’ comp. At the end of the day, what really matters for work-ers’ comp is to have employees
back at work, making enough money to take care of their families. That’s the accountability piece that hasn’t been present,” Dr. Peplowski said.
The win-win for everyone is the sustainability of the economy. This benefits the worker, the employer, the providers and the community, she said.
In addition to a value-driven, outcomes-based alternative payment model, Dr. Peplowski said there also needs to be “transparency of metric.” And that is true for every patient and every case, no exclusion of outliers.
All parties, including workers, need to be able to review return-to-work outcomes, recidivism, narcotic prescrib-ing, medical costs, margins and total claims costs.
TRAVEL MEDICINETravel medicine has played a role
in occupational health for a long time but it’s a bit more prevalent today, and perhaps should be even more prevalent because there is such a close connection.
Travel medicine is a specialty that helps international travelers prevent and manage health issues that arise while overseas.
Typically when you think of travel medicine you think of inoculations and warnings. Mr. Leone said a good travel medicine program should consist of counseling on how to avoid becoming ill and what to do if you fail. In other
words, what resources are available to the foreign traveler?
While most occupational health programs could sustain a travel medi-cine program, the key is to have person-nel with special training and a strong interest in the field.
It’s no surprise that urban areas are more likely to have people who travel on a regular basis, and as a result, travel programs are more valuable in these settings.
“If you’re located near a major airport between Washington D.C. and Boston, you’re going to have a lot of interna-tional travelers, much more so than if you’re based in Wichita,” said a senior industry analyst.
Also, in large urban areas it’s impor-tant for travel medicine personnel to be aware that employees who are traveling aren’t just doing it professionally. It is not uncommon for someone who is from Africa but works in New York to fly home to visit family.
Finally, the industry veteran said, when there is an outbreak of a disease in some part of the world, such as the recent Ebola outbreak, it is important that it gets on the master roster of the travel medicine person so they know what kind of inoculation should be administered.
A medication kit should always be provided to a traveler going to an unusual place, one that includes the appropriate medication to combat common ailments including traveler’s diarrhea and dysentery.
As occupational health evolves within this rapidly changing healthcare land-scape, industry experts urge occupa-tional health executives to spread the word about the innovative new things they’re doing. Initiate outreach initia-tives to employers, let them know about the fringe services available to them. In order to achieve their optimal potential, occupational heath programs must incorporate supplemental services into their service portfolios for employers.
Dr. Wilkenfeld, Dr. Jones, Dr. Peplowski and Dr. Vlachos will all serve as faculty at RYAN Associates’ 29th Annual National Conference.
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By Karen O’Hara
The ability to quantify the effective-ness of workplace health and safety interventions––once an elusive goal––is now within the grasp of employers and their medical provider partners.
A number of studies, tools and formulas are available to demonstrate ways in which health and safety programs help lower costs and improve performance.
The Integrated Health and Safety Index (IH&S Index) is the latest guidance to emerge. Based on the Dow Jones Sustainability Index, the IH&S Index is designed to translate the impact of occupational health and safety initiatives into business value for investors by applying familiar Dow Jones performance categories of economic, social and environmental sustainability.
The IH&S Index is based on the premise that most employers manage health and safety programs as separate functions when they should be treated more holistically. In the absence of health and safety integration, experts say opportunities to achieve econo-mies of scale, standardization, positive impacts on worker behaviors and the bottom line are missed.
Anticipated benefits of IH&S pro-grams include:• Strategic, systematic combinations of
distinct programs and policies
• Prevention of exposures, injuries and illnesses
• Collaborative organizational, per-sonal, occupational, community and environmental activities
• Development of standards that are replicable and measurable
• Improvements in the overall health and well-being of workers and their families
Concepts behind the index are explained in a new paper, Integrating
Health and Safety in the Workplace,(1) which appears in the May 2015 edition of the Journal of Occupational and Environmental Medicine, a publication of the American College of Occupa-tional and Environmental Medicine (ACOEM). The paper was presented in early May at the college’s annual national conference in Baltimore.
The authors represent a who’s who of ACOEM senior mem-bers and execu-tive leaders. Todd Hohn, global director of workplace health and safety at Underwriters
Laboratories (UL), the international safety company known for consumer protection and product certification, is also a key contributor. (UL’s Work-place Health & Safety Division, an NAOHP vendor member, supports OHM and SYSTOC software for occu-pational clinics and employee health departments.)
“While employers have been steadily expanding their efforts to create health-ier and safer workforces, what has been largely missing are strategies to inte-grate the work of the health and safety teams and a way to accurately assess the business impact of that work,” said Mr. Hohn. “This new guidance offers a pathway to both.”
Contributing author Ron Loeppke, M.D., M.P.H., president and vice chair of U.S. Preventive Medicine and former ACOEM president, cites increasing evidence that the health and personal well-being of employees affects business value: “A new way of evaluating and measuring health
and safety will make it possible to significantly accelerate the accumulation of important data – which in turn will increase our understanding and encourage innovation,” he said.
INDEX DEVELOPMENTThe IH&S Index is the byproduct
of a summer 2014 summit sponsored by UL and ACOEM that was attended by more than 30 occupational health and safety experts. The summit was preceded by a spring leadership round-table with the theme, Through the Eyes of the Executive: Creating a Healthier and Safer Workforce, (2) held by UL in collaboration with the Owen Graduate School of Management at Vanderbilt University (owen.vanderbilt.edu) and UC Berkeley’s Center for Catastrophic Risk Management (ccrm.berkeley.edu).
The Dow Jones Sustainability Index is globally recognized by investors as the leading standard for corporate sustainability. With this model in mind, IH&S Index developers evalu-ated existing and emerging health and safety assessment methods, integrated programs and at least 40 different guideline components. It was agreed that standards underlying ACOEM’S Corporate Health Achievement Award self-assessment tool would offer a solid foundation for the IH&S Index because the prestigious award rec-ognizes organizations for exemplary environmental, health and safety performance across the board.
At the leadership summit, partici-
Dr. Ron Loeppke
Progress Report: Measuring the Value of Occupational Health and Safety Interventions
Todd Hohn
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pants examined the three dimensions of the Dow Jones Sustainability Index, economic, environmental and social, through an IH&S lens. Dr. Loeppke said they adopted a 1,000-points pos-sible scoring system to allow employers to evaluate “how well they are doing and how they can be rewarded for what they are doing” in each standard category.
“We ultimately hope this score will show the value of investing in work-place health and safety and that invest-ment, health and insurance industry executives will start to pay attention. It may lead to reduced premiums and increased investment because of the inextricable link between the two. These are exciting times, one might even say transformative times,” Dr. Loeppke told physicians attending the ACEOM conference.
An analysis of Corporate Health Achievement Award winners published in 2013 validates the positive effects of IH&S on value of investment (VOI).(3) Researchers tracked an initial theoreti-cal investment of $10,000 in publicly traded award recipients – including American Express, Johnson & Johnson, IBM and the Baptist Health System – from the mid-1990s to 2012. They found award-winning companies outperformed the S&P 500 in four theoretical investment scenarios. In the highest-performing scenario, award winners had an annualized return of 5.23 percent vs. −0.06 percent for the S&P 500. In the lowest-performing scenario, award-winning companies had an annualized return of 6.03 per-cent vs. 2.92 percent for the S&P 500.
The authors of the 2013 study, some of whom contributed to the new IH&S paper, said: “Evidence seems to support that building cultures of health and safety provides a competi-tive advantage in the marketplace. This research may have also identified an association between companies that focus on health and safety and compa-nies that manage other aspects of their business equally well.”
Achievement award self-assessment categories are leadership and manage-
ment, healthy worker, healthy envi-ronment and healthy organizations. These correspond with the proposed IH&S Index framework of economic, environmental and social standards and related metrics to which numeri-cal values are assigned. Examples of metrics include:• Workers’ compensation claims filed
and total costs incurred
• Absenteeism and presenteeism rates(4)
• Employee turnover
• Accident/incident rates (e.g., frequency measured as OSHA record-able injury rates based on number of hours worked, severity based on restricted duty and lost work days)
• Hazard recognition and prevention activities (e.g., number of inspections, near-misses, observations, education and training provided)
• Health risk assessment and wellness program participation
• Prevalence of chronic health conditions and health risks
At the conclusion, the IH&S integra-tion paper expands on these guiding principles:
1. Plan performance measurement with small- and medium-sized organi-zations in mind to help them lever-age limited resources and adopt core concepts.
2. Apply the IH&S management model to service, manufacturing and other industry sectors; it is not self-limiting.
3. Develop incentives to drive improved collaboration; these may range from favorable tax policies to workers’ compensation insurance
discounts.4. Build partnerships and coalitions
to gain support from health and safety professionals, industry associations, governmental entities, academic insti-tutions and others who may be willing to support pilot projects; align efforts with the insurance sector and encour-age continued research.
5. Develop new educational models to convey IH&S concepts in ways that make them relevant and accessible to employees and encourage continued research.
6. Establish confidentiality and trust; data must be carefully managed and personal privacy protected.
BOILING IT DOWNAs long as operational silos create
barriers to IH&S integration and performance measurement, there will be a need for occupational health professionals to demonstrate the value they bring to the workplace. Common metrics and performance measurement standards can be used by providers and employers to determine exactly where they stand in comparison to best practices, processes and procedures.
There is a lot at stake. For example:• According to the National Council on
Compensation Insurance (based on 2013 data), the average medical cost per lost-time workers’ compensation claim is $28.8 million and the average indemnity cost per lost-time claim is $22.7 million. Medical expenditures are growing at a faster rate than non-medical (indemnity) costs; the oppo-site used to be the case.
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• There were more than three million recordable injury cases in 2013 (the most recent reporting year), with 917,100 lost work days and a median of eight days missed, according to the Bureau of Labor Statistics. Lost work time could be prevented in many of these cases with appropriate health and safety interventions.
• The Centers for Disease Control and Prevention estimates $3 of every $4 employers spend on health costs are used to treat chronic conditions such as obesity, hypertension, diabetes, asthma and depression.
• A 2015 Society for Human Resource Management survey found employ-ers are not well prepared to manage the aging workforce; less than a third of respondents said workforce aging has prompted changes in general management policy/practices, reten-tion and recruiting practices (refer to www.shrm.org/research/surveyfind-ings/pages/aging-workforce-research-initiative.aspx).
To put things in perspective, occupa-tional health providers can assist their employer clients with relatively easy calculations. While the answers may depend on individual employer percep-tions and the nature of their business, the following approaches may be used.
OSHA Reporting: The Occupa-tional Safety and Health Adminis-tration has established calculations that allow employers to report their recordable incident, lost-time and severity rates. The standard base rate for these calculations is based on a rate of 200,000 labor hours. This number (200,000) equates to 100 employees working 40 hours per week, 50 weeks per year. Using this standardized base rate, companies can calculate their rate(s) and get a percentage per 100 employees.
OSHA’S $afety Pays calculator uses company profit margin, the average cost of injury or illness and an indirect cost multiplier to project the amount of sales a company would need to generate to cover lost work day costs. The $afety Pays calculator is available at www.osha.gov/dcsp/smallbusiness/safetypays/estimator_text.html.
Lost Wages Method: This calcula-tion is used to determine the total cost of annual work loss attributable to
absence: Total annual lost workdays x average daily compensation for full-time employees and average wage “multiplier” (cost to an employer of an absence as a proportion of the absent worker’s daily wage).(4)
EMPAQ® Metrics: Employer Measures of Productivity, Absence and Quality are ratios (numerators over denominators) that can be used to calculate the effectiveness of health and productivity management programs. They establish a consistent method for measuring cost, utilization and other performance issues. Refer to www.empaq.org.
PRESENTATION IS IMPORTANTAt the UL
Leadership Roundtable last year, participants asked them-selves how senior execu-tives would most like to see value of invest-ment data presented. Thomas
Parry, Ph.D., president and co-founder of the Integrated Benefits Institute, San Francisco, Calif., suggested confining answers to the following questions to a single page:
• What is the total health and safety experience of the population?
• What does health and safety really mean to the business?
• Where do organizational results come from?
He also recommended narrowing results to a per-employee calculation. “If you can’t tell a story, you are going to lose the opportunity to have influ-ence,” he said. “You have to be able to describe where your population is in terms of health risks: biometrics, chronic condition prevalence, treat-ment indicators, preventive care and so forth. We have to think about metrics
as hierarchies of information.”To gain the confidence of senior
executives and investors, roundtable participants agreed IH&S metrics will have more credibility as a value indica-tor if they:
• Can be summarized in an annual cor-porate report and presented on a bal-anced scorecard
• Are tied to overall company perfor-mance, such as an increase in earnings per share
• Focus on safety benefits rather than risk
• Apply both quantitative and qualita-tive measurement methods, especially if the goal is to engage employees and change behavior
• Take into consideration community and population health data and integrate health and safety measures using leading rather than lagging indicators
Ultimately, the objective is to shape performance parameters around a company’s profit, growth, people and social responsibility goals.
REFERENCES:
1. Integrating Health and Safety in the Workplace: How Closely Aligning Health and Safety Strategies Can Yield Measurable Ben-efits; Loeppke R, Hohn T, et al.; JOEM 57(5) May 2015; http://journals.lww.com/joem/Fulltext/2015/05000/Integrating_Health_and_Safety_in_the_Workplace_.15.aspx
2. Through the Eyes of the Executive: Cre-ating a Heathier and Safer Workforce; find-ings from a two-day workshop attended by subject matter experts and executives to pro-vide a road map for organizations attempt-ing to bring health and safety into closer alignment; UL white paper published online: http://library.ul.com/?document=through-the-eyes-of-the-executive-creating-a-health-ier-and-safer-workplace
3. The link between workforce health and safety and the health of the bottom line: tracking market performance of companies that nurture a “culture of health”; Fabius R, Thayer RD, Loeppke R, Konicki DL, et al.; JOEM, 55(9), Sept. 2013; http://www.cancergoldstandard.org/sites/default/files/attachments/Link_Between_Workplace_Health_and_the_Bottom_Line_0.pdf
4. Measuring Health-Related Productiv-ity Loss; the objective of this study was to determine the relationship between health status and productivity loss and to provide estimates of the business implications of lost work performance; Mitchell R and Bates P; Popul Health Manag, 14(2): 93–98, April 2011; www.ncbi.nlm.nih.gov/pmc/articles/PMC3128441/
Thomas Parry, Ph.D.
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By VISIONS staff
In the last issue of VISIONS, we reported that Humana had just agreed to sell Concentra to a joint venture comprised of Select Medical and Welsh, Carson, Anderson and Stowe. The selling price was $1.055 billion in cash and the deal closed in June.
With more than 1,000 facilities, Select Medical (selectmedical.com) is the largest operator of outpatient rehabilitation clinics in the United States. Welsh, Carson, Anderson and Stowe, familiarly known as Welsh Carson (welshcarson.com), is a private equity firm specializing in healthcare and information services.
When describing the rationale behind the deal, senior management at Select Medical noted the overlap of the two organizations’ facilities in many markets. For example, Select could attract many physical therapy referrals that do not go directly to Concentra centers because of distance or other factors.
Occupational health is not new to Select. According to Select’s Chief Financial Officer Marty Jackson, the company already operates 22 occupa-tional health facilities including the NovaCare clinics in Missouri and east-ern Pennsylvania. The company is not a stranger to alliances with large health-care systems either, having developed joint ventures with such industry giants as the Baylor Health Care System, UCLA-Cedars Sinai, the Cleveland Clinic and Emory Healthcare.
Welsh Carson, a New York-based private-equity firm, owned a majority of Concentra’s equity between 1999 and 2011. In fact, Welsh Carson has financed several deals involving either Select or Concentra (concentra.com). It is familiar with the companies’ capabilities and culture.
One interesting aspect of the acquisi-tion is the faces called back to man the
deck. Four executives who had been part of Concentra’s emergence from a tiny three-center network in the early 1990s are rejoining the fold. After a four-year hiatus, former Concentra president and C.O.O. Keith Newton is returning to serve as its new C.E.O. John Carlyle, a Concentra co-founder and former C.E.O., is also returning in a part-time advisory capacity. Jim Greenwood and Dan Thomas, both former Concentra C.E.O.’s, have joined the Concentra Board.
“I cannot overstate what reuniting the old guard means to Concentra,” said John Garbarino, former C.E.O. of Occupational Health + Rehabilita-tion (OH+R), a Massachusetts-based consolidator that sold its 34 center network to Concentra in 2006. “They are all widely respected and understand how to operate the company. These are the guys that built the company.” Mr. Garbarino added that “I would imagine other suitors also reached out to one or more of the big four.”
Nick Kirby, director of business development at OH+R until its 2006 acquisition by Concentra, stayed on with the company for six more years and thus knows it as a competitor and an employee. “We competed head to head for over a decade; OH+R was one of the smaller consolidators and Concentra was the giant and I came to have great respect for the company.” Mr. Kirby cited the quality of the company’s leadership, its business and organizational competence, willingness to make investments when necessary and ability to stick to well thought out strategies.
“We [OH+R and Concentra] were major competitors for many years and I
was generally skeptical about the com-pany. But I must say that [ultimately] I was extremely impressed.” Mr. Kirby particularly lauded the company’s vision and operating acumen.
When reflecting on the ultimately unsustainable Humana-Concentra rela-tionship, Mr. Kirby reiterated a theme consistent with others interviewed for this story: it is hard for an insurer to also be a provider. “They have vastly different world views and different operating protocols. The two just don’t integrate well.”
New Concentra C.E.O. Keith New-ton noted that “the Humana vision was that the Concentra footprint and management infrastructure could be leveraged to expand into more appro-priate primary care and medical-home models relative to [Humana’s] Medi-care Advantage population. It just did not work; such integration was not a good strategic fit at the end of the day.”
The Select Medical/Welsh Carson consortium was hardly Concentra’s only suitor. Three other suitors, including U.S. HealthWorks, which was acquired by Dignity Health in July 2012, reportedly made it to the nego-tiation table. In fact, many felt a U.S. HealthWorks-Concentra union made considerable strategic sense and was almost inevitable since such an acquisi-tion would result in a national network of more than 500 occupational health centers. One industry insider suspects that negotiations broke down because of incompatible visions: Concentra seemed committed to a value driven model consistent with the principles of the Affordable Care Act, whereas the U.S. HealthWorks vision seemed to place emphasis on volumes.
A New Concentra Era Takes Shape
“A more focused Concentra will bring a jolt of energy to the occupational health field.”
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Mr. Newton, who was Concentra’s president and chief operating officer through 2011 and will serve as its new C.E.O., stressed that Concentra is going to be extremely focused on growing occupational health. When asked how things will be different from the Humana era, Mr. Newton spoke of one over-riding theme: focus and execution. Concentra will be more focused on its core fundamentals while also leveraging the Select partnership but operating as an independent company. “I would not have come back if it were simply to run a division of a larger company,” Mr. Newton said.
Frank Leone, M.A., M.B.A., executive director of the NAOHP, which publishes this newsletter, thinks the latest Concentra acquisi-tion will be good for the industry. “At the end of the day, despite isolated competitive situa-tions with health system-affiliated programs, Concentra is likely to bring a great deal to our sector. They are sound operationally and that will set the bar higher for other programs. And they are looking to joint venture or otherwise engage with existing programs,” noted Mr. Leone. “A more focused Concentra will bring a jolt of energy to the occupational health field.”
Select Medical views the partnership as exceptionally positive. Mr. Jackson, Select’s C.F.O., shared that some of their investors voiced initial concern that Select Medical was making a foray into the urgent care sector. “[This] is not about urgent care,” Mr. Jackson said. “This is about occupational health. Our focus is on growing the business by align-ing Concentra centers with Select Medical facilities in certain markets, engaging in joint ventures with hospital systems and smaller hospital entities, making acquisitions and even building new facilities.
Mr. Newton feels that rather than integrat-ing with a Fortune 400 company such as Humana, Concentra will now have the free-dom to concentrate on its core fundamentals and growth.
One thing is certain, Concentra will play an even more prominent role in the occupational health niche going forward and will have a significant effect on occupational health programs within and beyond their domain.
And the Keynote Speaker is... George Kerwin, Bellin Health Systems President
George Kerwin, F.A.C.H.E., president and C.E.O. of Bellin Health Systems in Green Bay, Wisconsin, will be the keynote speaker at RYAN Asso-ciates’ 29th Annual National Conference in Chicago. Mr. Kerwin is a long-time advo-cate of change in the healthcare system so it should surprise no one that his comments will focus on adapting to the new healthcare environment––the con-ference’s theme. His remarks promise to
provide valuable insight into ways that occupational health providers can improve our healthcare landscape.
Mr. Kerwin joined Bellin in 1972, initially working as house-keeping/laundry manager. Through the years he has served in a variety of leadership positions and became the company’s president in 1992.
A staunch supporter of local, state and regional health ini-tiatives, Mr. Kerwin is vice-chairman of the board of About Health, a network of seven health systems serving patients throughout Wisconsin, the Upper Peninsula of Michigan and portions of Minnesota and Iowa. He is also past chair-man of the board of directors of the Wisconsin Collaborative on Healthcare Quality and the Green Bay Area Chamber of Commerce. In 2008, he received the Rotary Club of Green Bay Free Enterprise Award and he also serves as a trustee at Bellin College. Kerwin earned a B.B.A. from the University of Notre Dame and an M.B.A. from the University of Wisconsin, Oshkosh.
Mr. Kerwin is an original member of the Quality Manage-ment Network and a member of the Institute for Healthcare Improvement (IHI) Leadership Alliance. This is a group of healthcare organizations and policy makers that urges industry leaders to get involved in redesigning the healthcare system. He is actively involved in IHI’s Triple Aim Initiative, which encourages the pursuit of three simultaneous objec-tives: improving the patient’s experience of care, improving the health of populations and reducing the per-capita cost of healthcare.
Bellin Health is an integrated health delivery system serv-ing approximately 630,000 people in Northeast Wisconsin and the Upper Peninsula of Michigan. For more than a century, it has been a regional leader, committed to lowering costs while adhering to a tradition of high patient care standards. Bellin has managed to keep costs below the national average for eight consecutive years while sustaining a culture of empow-ering employees as healthcare consumers. Bellin’s achieve-ments have been so inspiring, in 2009 President Obama applauded the region for being a model that other health-care systems should emulate.
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By Frank H. Leone
I had the privilege of speaking to several hundred occupational medicine physicians at the American Occupa-tional Health Conference (AOHC) in May, a talk I titled “33 Lessons from 33 Years in Occupational Health.” It was the 33rd anniversary of my first presen-tation at that conference in Toronto in 1982.
Such occasions invite reflection. Many of the lessons were related to adages I have tried to live by. “Think big,” for example, “one person can make a differ-ence,” “empower others,” “hire happy people,” “nip problems in the bud,” and finally, the very simple, “have fun.”
Other lessons were occupational health specific. A sampler:
1. Patience is a virtue: Back in 1982, (and certainly by 1985 when I estab-lished RYAN Associates) I often spoke about occupational health’s potential to be the next big thing, primarily because of its capacity to effect and manage large populations. I expected the population health concept to kick in by the next decade and surely by the turn of the millennium. I was right on the con-cept––markedly wrong on the time. I learned that we sometimes have to wait years or even decades for our vision to come to pass. Hang in there. Your day will come.
2. The Guard is changing, just like the world: The occupational medicine crowd at that 1982 conference was starkly homogenous: older white men in gray suits based largely in industry. Now, 33 years later, the conference is splendidly heterogeneous, multi-cultural, international and gender balanced. Many, perhaps most, of the participating physicians were based outside the industry at “provider-based” programs, as consultants, in academics or government service. As for those gray suits…
3. Integrate, integrate and integrate: Those who continue to view occupa-
tional health as a narrow discipline applied strictly to work-related condi-tions tend to miss the point (that it can be infinitely broad rather than painfully narrow). Such a narrow vision, if col-lectively held, would doom the field to a peripheral niche, and to a fraction of its potential.
An exceptional work in the Journal of Occupational and Environmental Medicine (JOEM) by Dr. Robert McClellen et. al. provides an excellent overview of how occupational health fits well with the emerging healthcare paradigm by integrating the workplace, home and community to achieve opti-mal delivery. Read the article here: https://www.acoem.org/uploadedFiles/Public_Affairs/Policies_And_Position_Statements/Optimizing%20Health%20Care%20Delivery%20Position%20Statement.pdf
4. Educate, educate, educate: Whether you are a physician, non-phy-sician provider, program director or sales professional, informing and educating others is critical. There are so many groups to educate, including patients, employers, fellow staff, specialists, senior administrators and the community at large. Regardless of the circumstance, occupational health professionals must learn how to educate others and seek opportunities to do so.
5. Balance is the key: In a black or white “you’re either with us or against us” world, it is critical to consider both sides of every issue. Be nimble, open-minded and seek the balanced middle ground. In occupational health, this includes the worker/employer balance, the work/life balance, the bottom line/quality of care balance, restorative/pre-vention balance and a balance between authoritative and passive management styles.
6. Adapt to the modern technolo-gies: In 1982 I had just started using WordPerfect, printed pages on my ink jet printer and hadn’t heard of cell
phones, faxes, email or the Internet. How did I get anything done? The pace of technological advance during the next ten years is likely to be equal to the total advances of the previous 33. All activity in our information-driven discipline will be propelled by yet to be invented tech-nologies. Stay on top of, if not ahead of, the curve.
7. Think and speak of value: The core principle in our macro-healthcare world is the strong movement from a volume-driven mindset to a value-based mindset. All key staff need to associate the “what we are doing” with the “why we are doing it” and command some understanding of the economic implica-tions of our actions.
8. Learn the language: An over-reliance on healthcare terminology when speaking to non-healthcare individu-als has been a chronic failing. When speaking with employers, engage in “employer-speak” by parroting their buzz words; when dealing with patients, frame all of your comments in words and concepts they will understand.
9. Respect the profession: If you are in occupational health you are in very good place. It is a niche in its infancy; it is continuously expanding and redefin-ing itself and by the nature of its dual emphasis on direct patient care and environmental causation, seems poised to have a bellwether role in the 21st century healthcare paradigm. Believe in and commit to what you are doing and share that commitment with others.
10. Be yourself: We all have but one life to lead; best that we commit to excellence. Think big and go for it. But be yourself. I learned long ago that I am not a clinician and that I should “stick to the knitting,” by confining my activi-ties to what I do well.
Frank H. Leone, M.A., M.B.A., is the founder and president of RYAN Associates and the founder and Executive Director of the National Association of Occupational Health Professionals (NAOHP).
Lessons Learned
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The Effective Use of Social Media in Healthcare Marketing
The following are excerpts from the first session.
“What are the most common pitfalls of using social media as a healthcare marketing tool? What should an organi-zation do to mitigate these risks?”
Dean Browell These are not actually our tools.
They are tools for our audiences. We [in healthcare] are often coming late to these. It is unlike the way we look at traditional marketing, whether it is a billboard or whatever.
It is their tool, so that ends up affect-ing things like messaging. It is not just broadcasting, but also understanding that this is a place where people converse and engage. In order to mitigate these risks, it is about finding out what channels are effective in your area; I say area in terms of your specific audience as well as your geographic area. As a healthcare marketing tool, we are not the only ones using it. Some of these forms of message boards have been around for ten, fifteen years.
“Dean, as follow-up, please complete this sentence: “Under any circumstance, you must be certain to ––.”
Ensure that your audience is actually on a channel before rushing in. Even in Richmond, people use Twitter differently than they do in Norfolk. A different demographic is using it in Richmond. It is easy to use search. Go to twitter.com
and do an advanced search and look at who is tweeting in a given geographic area. For example, if there are no young moms there, you do not need to be mar-keting a maternity campaign on Twitter; your audience is literally not there.
Dan DunlopOnce you have learned, “… this is
where my audience is, these are the plat-forms they are using,” then the big pitfall is treating these tools and these platforms as [traditional] media vehicles,[having a staff person] treat a platform like Facebook or Twitter in the same manner that they have treated radio or television advertising or direct mail.
What I see throughout the healthcare industry is people using platforms just to blast out content. They become content pushers. That is certainly not an effective use of these platforms. Stop thinking about them as media tools and think about them as platforms for community building. These are community building platforms, and they are best used when they are niche community building. Try to find that area of commonality and then address that and bring those people together who have that shared interest.
Dan, please complete this sentence: “Above all else you must ––––.”
Dedicate the resources to do this effectively. There is this mythology that social media is free and does not take
many resources. To do it right, to be engaged in these conversations and make these conversations part of these online communities, you have to dedicate the resources. You have to have community managers on your team who do this for a living, who are good at it. Above all, you have to be committed.
David HarlowBefore jumping in and expecting
everyone to read and enjoy seeing your messages, you need to figure out where exactly you are engaging. You need to develop social capital in these forums, and that does not happen overnight.
You can mix this together with paid advertising, but it is a mix of organic and paid strategies that is going to help you get a toehold in the conversation. Some people will skip over that and just try to have the conversation, and wonder why nobody is participating.
From my special perspective on the legal front, the risks are many. It’s not just about HIPAA; that is often raised as a first concern when people are talking about social media and healthcare. Obvi-ously it is important not to reveal patient confidences online. It can be tricky, because sometimes patients will reveal their own confidences online and you need to be careful how you respond to something like that in an online forum of any sort.
“Makala, looking back, what was the most unforeseen yet serious curve in the road that the Mayo Clinic had in devel-oping its social media program? What could you have done to minimize or eliminate it from happening in the first place?”
One of the biggest things we learned early on was to reserve our presences on social media platforms. So when we went to Myspace, fortunately for us, Myspace did not take off in the same way Facebook did – but when we went to Myspace to create our presence, a rock band named the Mayo Clinic had actu-ally beat us there. When Facebook came
Makala Johnson, Mayo Clinic, Rochester, MN
Dr. Dean Browell, Feedback Agency, Richmond, VA
Dan Dunlop, Jennings, Chapel Hill, NC
David Harlow, The Harlow Group, Newton, MA
RYAN Associates offered a three session webinar on “The Effective Use of Social Media in Healthcare Marketing” in May. The faculty for the first session were:
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out, it was easy to say to leadership, ‘We do not want that to happen, we want to be able to reserve the name early on.’ Since then, we have been quick to not jump on the platforms, but to at least evaluate whether a presence would be helpful or not.
“Think ten to twenty years from now in healthcare: in what ways will the social media landscape be different? Dan, what are your thoughts about where it is going, and what folks need to do to position themselves for that eventuality?”
Dan DunlopThe key is to be nimble, to adapt as
things change. Things change quickly. Even with existing social media plat-
forms: Foursquare split off and formed two different platforms–– Swarm and Foursquare; each is different in what they’re trying to do. If you’re not paying attention, you miss those things today. It is critical that you pay attention and stay engaged in what is going on in social media. So when something comes out, like a Pinterest…when it first launched, I jumped on the bandwagon and joined Pinterest, not because I thought I needed to be pinning recipes, but because I needed to know how it worked and how it might impact the audiences we try to engage.
My hope is that in ten to twenty years, social media will be easier to integrate into everyday life, that it does not require as much work as it requires right now.
Makala JohnsonWhat we can predict is an increase
in internet access and users across the globe. A Forbes article said that in 2020 there would be over 5 billion internet users, over half of them accessing it on hand-held devices. We know there is going to be greater internet interconnec-tivity – from our perspective – between patients and a big opportunity for researchers, in particular.
One example would be filling clini-cal trials, or finding patients with rare diseases or conditions that perhaps in the future will already be coalesced [in a community]. This has already started to take place, but it will be exponentially more common in the future, where
people of similar health interests have already coalesced into a group.
“What has been the most effective way to build community on social media?”
David HarlowYou need to determine who you are
reaching out to. Find out what the commonalities are. There needs to be a common bond. It is hard to determine online versus in person; but with more metrics and measurements and infor-mation available online there are ways we can do that. It does not have to be about the topic you are trying to start a conversation about. There are going to be secondary things that people are interested in as well.
Makala JohnsonWe need to ask our audience base
what they are interested in, engage them with questions or whatever method we decide to use. We need to be able to look at these data and if it is not work-ing, stop doing it and optimize our posts.
It is crucial that we take a hard look at the communities themselves and understand how they are operating, how they choose to be interacted with. They are giving off social cues, in the same way that someone in the room with you gives off cues as to how they would like to be talked to. These communities do the same. It is important that we listen as opposed to creating generic ways of interaction.
Dan DunlopPeople are natural community build-
ers. It is in our nature; we look for commonality. When you meet someone for the first time, you ask each other questions. Part of that process is look-ing for, ‘What do we have in common? What brings us together? Where are the bonds?’
We need to do the same thing with our online community building and social media efforts. This applies to consumer audiences but it also applies to business audiences. Looking at physicians, hundreds of thousands of physicians belong to private, online physicians’ communities. It is not just
about people getting together and talking about breweries and beer on Facebook. There are business people getting together and sharing information through these communities because they have commonalities.
“How can we examine the demograph-ics of users on social media platforms?”
Dan DunlopIt is highly variable depending on the
platform. For instance, on Facebook you can get great data through Facebook analytics, just through your account: who the users are, their age, their sex. You have to do what everybody else does—get online and Google and find the resources that work for you.
Dean BrowellIn some of these cases, broaden your
definition of ‘social.’ For example, we found a forum for watermen, for fishermen, in eastern North Carolina; they talked about healthcare, they talked about the fish they caught that morn-ing. They were all over sixty and people that would say they were not on social media if you asked them. So sometimes it’s about finding the channel. In which case, just by scanning it or even hand coding it, you would know exactly what the demographics are based on how they are talking and what their profiles say. I echo what everyone else said in terms of trying to find the most statistically-based insight, like Facebook has. It can unlock a lot for you.
“I do not hear young people talking about Facebook at all; I hear Instagram, Snapchat, etc. What programs are you starting to pay attention to?”
David HarlowInstagram is a good example. I use
it to share photos, but I know people of other generations use it for other purposes. You need to stay abreast of the latest tools out there. Not only the tools, but the way they are used by different populations.
Makala JohnsonWe have an Instagram account. But
there are new [platforms] introduced everyday. Wait until there is a certain
continued on page 18
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continued from page 17
amount of people on them, or a user-base. But something like Snapchat, as an example, not that we are not on it at Mayo Clinic, but we have at least read and learned how other organizations are using it to reach their audience.
Dean BrowellIt is about how people are using
these platforms. When you see things like Yik Yak and Snapchat, that is, they are used for messag-ing. That is different than how people are using Facebook. Many teens still are on Facebook, they just know how to use privacy lists so that you never see anything they post. Twitter is still huge. I would just be careful about the shiniest-object syndrome. Just one quick example. We just finished a mas-sive project for the Department of Behavioral Health in Virginia, looking at substance abuse and mental health issues by only using Twitter on a county-by-county basis. And I can tell you flat out, there are plenty of teens, tweens and early twenty-somethings still using Twitter, even in the most rural and urban areas in our state. Look at the behavior, it will tell you whether they have abandoned something or whether they are just using a different platform for a different reason.
Dan DunlopDo not overlook the platforms that
are already there. I am shocked when I go into organizations and they do not even have a page on Google+. Google will assign you a page, but they have not populated it with any information. If you are at all interested in search, you need to be on Google+. LinkedIn is such an undervalued platform. You have to study your audience and their use of media. Understand these plat-forms and how they perform because there is so much you could be doing with Twitter, LinkedIn, Google+ and Facebook.
“Do you have any ideas for bringing a specific department i.e. occupational
health, onto social media? Our parent organization is already doing lots of social media and has hired help to do this, but we have not yet integrated our specific departmental information into it.”
Makala JohnsonWe have many different departments
at the Mayo Clinic. We do internal consults of the different areas to see whether what they are hoping to push out would be effective on our Mayo Clinic Twitter and Facebook accounts. If not, or if they have too much con-tent in terms of how frequently they want to post, then it makes sense to break off and have a separate account so they can reach their niche audience.
Dean BrowellIt is about creating an environment
where they cannot do but so much, but then can see the effectiveness of it. I would first align them and their targets. Especially with occupational health, LinkedIn would sound like an easy group. Start with a group so that they can see how it’s going to work. I favor
internal use, a bit more like when you get a new fish, you put it in a little plastic baggie on the side of the aquarium, so all the other fish get used to it. Use that same tactic in terms of getting a single department into social. It’s finding the right chan-nel and then letting them baby step in so they understand it.
David HarlowSome institutions have a bias
towards having a single voice, which is problematic because it’s important to reach out to individual niches that may be better known to the individual departments. It’s valuable to provide that flexibility. The challenge is to align the voice of the department with the voice of the institution overall.
“What is the most important takeaway you can give to par-ticipants of this week’s webinar, the most important short piece of advice you can offer people?”
Dan DunlopYour focus needs to be on the audi-
ence, on how they use social media, on the kinds of information they’re interested in receiving and the times of day they use these platforms.
David HarlowPlan. Look before you leap.
Makala JohnsonMeasure and adjust. Just having data
does not help you if you are not going to use it to adjust going forward.
Dean BrowellLearn about your audiences. Listen
and learn and that will tell you more than you would ever need to know—whether you go into social media or not.
Note: Dan Dunlop and Makala Johnson will both serve as faculty at RYAN Associates’ 29th Annual National Conference: http://www.naohp.com/menu/education/national15/index.html
The complete audio of the three-session webinar is available on the NAOHP website: www.naohp.com
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urgent care
AssociationsUrgent Care Association of America (UCAOA) UCAOA serves over 9,000 urgent care centers. We provide education and information in clinical care and practice management, and publish the Jour-nal of Urgent Care Medicine. Our two national conferences draw hundreds of urgent care leaders together each year.Joanne RayPhone: (331) [email protected]
Background Screening ServicesSterling Back CheckYou can’t afford to take unnecessary risks. That’s where Sterling Back Check can help. We provide the highest hit rates and more comprehensive com-pliance support available-all from an unparalleled, single-source solution. It’s a customer-centric approach to back-ground screening, giving you the most accurate information available to pro-tect your company and its brand.Sterling BackcheckPhone: (331) 472-3747 • (800) 853-3228Fax: (216) 370-5656clientsupport@sterlingbackcheck.comwww.sterlingbackcheck.com
ConsultantsAdvanced Plan for HealthAdvanced Plan for Health has a plan and a process to reduce the rising costs of health care. By partnering with APH, you can provide customized plans to help employees of the companies, school systems and government offices in your market. You can show the organiza-tions how to improve their health plan, finances and employee productivity.Rich Williams Phone: (888) 600-7566 Fax: (972) 741-0400 [email protected]
Bill Dunbar and Associates BDA provides revenue growth strate-gies to clinics and hospitals throughout the U.S. BDA’s team of professionals and certified coders increase the reim-bursement to its clients by improving documentation, coding, and billing. BDA offers a comprehensive, custom-ized, budget-neutral program focusing on improving compliance along with net revenue per patient encounter. Be sure to contact us to learn about BDA ClaimCorrect!Terri ScalesPhone: (800) 783-8014 Fax: (317) [email protected]
Medical Doctor Associates Searching for Occupational Medicine Staffing or Placement? Need excep-tional service and peace of mind? MDA is the only staffing agency with a dedicated Occ Med team AND we pro-vide the best coverage in the industry: occurrence form. Call us today.Joe WoddailPhone: (800) 780-2500Fax: (770) [email protected]
Press Ganey Associates, Inc.Recognized as a leader in performance improvement for more than 25 years, Press Ganey partners with more than 10,000 health care organizations world-wide to create and sustain high-per-forming organizations, and, ultimately, improve the overall patient experience. The company offers a comprehensive portfolio of solutions to help clients measure patient satisfaction, oper-ate more efficiently, improve quality, increase market share and optimize reimbursement. Press Ganey works with clients from across the continuum of care – hospitals, medical practices, home health agencies and other pro-viders – including 50 percent of all U.S. hospitals. Patty WilliamsPhone: (855) [email protected]
Reed Group, Ltd.The ACOEM Utilization Management Knowledgebase (UMK) is a state-of-the-art solution providing practice guide-lines information to those involved in patient care, utilization management and other facets of the workers’ com-pensation delivery system. The Ameri-can College of Occupational and Envi-ronmental Medicine has selected Reed Group and The Medical Disability Advi-sor as its delivery organization for this
The following organizations and consultants participate in the NAOHP vendor program, including many who offer discounts to members. Please refer to the vendor program section of our website at: www.naohp.com/menu/naohp/vendor/ for more information.
Refer a Vendor — Earn $100
Vendor, individual and institutional members of the NAOHP will receive a $100 commission for every referral they make that results in a new vendor membership. The commission will be paid directly to the referring individual or their organization. There is no limit to the number of referrals.
In other words, if five referrals result in five new memberships, the referring party will receive $500.
If you know of a vendor who would benefit from joining the NAOHP Vendor Program, please contact RYAN Associates at 800-666-7926 x11.
Vendor Program
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easy-to-use resource. The UMK features treatment models based on clinical considerations and four levels of care. Other features include Clinical Vignette – a description of a typical treatment encounter, and Clinical Pathway – an abbreviated description of evaluation, management, diagnostic and treatment planning associated with a given case. The UMK is integrated with the MDA for a total return-to-work solution. Justin FernMarketing Coordinator Phone: (800) 347-7443www.reedgroup.com
RYAN AssociatesServices include feasibility studies, finan-cial analysis, joint venture development, focus, groups, employer surveys, mature program audits, MIS analysis, opera-tional efficiencies, practice acquisition, staffing leadership, conflict resolution and professional placement services.Roy GerberPhone: (800) 666-7926x16Fax: (805) [email protected]
Electronic Claim Management Services
Jopari Solutions, Inc.Jopari is changing the way provid-ers and payers manage their billing and payment processing needs for the workers’ compensation, property & casualty, and group health indus-tries. With Jopari products, provid-ers streamline billing operations, improve payment cycles and reduce the frictional costs of billing and payment status updates.Don St. JacquesPhone: (925) [email protected]
Unified Health Services, LLCUnified Health Services provides com-plete electronic work comp revenue cycle management services from “patient reg-istration to cash application” for medical groups, clinics, and hospitals across the country. This includes verification and treatment authorization systems, elec-tronic billing, collections, and EOB/denial management. Provider reimbursements are guaranteed.Don KilgorePhone: (888) 510-2667Fax: (901) [email protected]
WorkCompEDI, Inc.WorkComp EDI is a leading supplier of workers’ compensation EDI clearing-house services, bringing together Pay-ors, Providers, and Vendors to promote the open exchange of EDI for accelerat-ing revenue cycles, lowering costs and increasing operational efficiencies. Marc MenendezPhone: (800)297-6906Fax: (888) [email protected]
Laboratories & Testing Facilities
Clinical Reference Laboratory Clinical Reference Laboratory is a pri-vately held reference laboratory with more than 20 years experience partner-ing with corporations in establishing employee substance abuse programs and wellness programs. In addition, CRL offers leading edge testing services in the areas of Insurance, Clinic Trials and Molecular Diagnostics. At CRL we consistently deliver rapid turnaround times while maintaining the quality our clients expect.Dan WittmanPhone: (800) 445-6917Fax: (913) [email protected] eScreen, an Alere Company eScreen is committed to delivering innovative products and services which automate the employee screening pro-cess. eScreen has deployed proprietary rapid testing technology in over 2,500 occupational health clinics nationwide. This technology creates the only paper-less, web-based, nationwide network of collection sites for employers seeking faster drug test results.Brian LynchDirector of MarketingPhone: (800) [email protected]
MedDirectMedDirect provides drug testing products for point-of-care testing, lab confirmation services and DOT turnkey programs.Don EwingPhone: (479) 649-8614Fax: (479) [email protected]
Oxford ImmunotecTB Screening Just Got Easier with Oxford Diagnostic Laboratories, a National TB Testing Service dedicated to the T-SPOT.TB test. The T-SPOT.TB test is an accurate and cost-effective solution compared to other methods of TB screening. Blood specimens are accepted Monday through Saturday and results are reported within 36-48 hours.Noelle SneiderPhone: (508) 481-4648Fax: (508) [email protected]
Quest Diagnostics Inc.Quest Diagnostics is the nation’s leading provider of diagnostic testing, informa-tion and services. Our Employer Solu-tions Division provides a comprehensive assortment of programs and services to manage your pre-employment employee drug testing, background checks, health and wellness services and OSHA requirements.Aaron AtkinsonPhone: (913) 577-1646Fax: (913) 859-6949aaron.j.atkinson@questdiagnostics.comwww.employersolutions.com
Medical Equipment, Pharmaceuticals, Supplies and ServicesAbaxis® Abaxis® provides the portable Piccolo Xpress™ Chemistry Analyzer. The analyzer provides on-the-spot multi chemistry panel results with comparable performance to larger systems in about 12 minutes using 100uL of whole blood, serum, or plasma. The Xpress features operator touch screens, onboard iQC, self calibration, data storage and LIS/EMR transfer capabilities.Joanna AthwalPhone: (510) 675-6619 Fax: (736) [email protected]/index.asp
AlignMedAlignMed introduces the functional and dynamic S3 Brace (Spine and Scapula Stabilizer). This rehabilitation tool improves shoulder and spine function by optimizing spinal and shoulder align-ment, scapula stabilization and proprio-ceptive retraining. The S3 is perfect for pre- and post- operative rehabilitation and compliments physical therapy. Paul JacksonPhone: (800) 916-2544 Fax: (949) [email protected]
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A-S Medication Solutions LLCASM, official Allscripts partner, intro-duces PedigreeRx Easy Scripts (PRX), a web-based medication dispensing solu-tion. Allowing physicians to electroni-cally dispense medications at the point-of-care with unique ability to integrate with EHR or be used stand-alone. PRX will improve patient care, safety and convenience, while generating addi-tional revenue streams for the practice.Lauren McElroyPhone: (888) [email protected] www.a-smeds.com
Automated Health Care SolutionsAHCS is a physician-owned company that has a fully automated in-office rx-dispensing system for workers’ com-pensation patients. This program is a value-added service for your workers’ compensation patients. It helps increase patient compliance with medication use and creates an ancillary service for the practice. Shaun Jacob, MBAPhone: (312) 823-4080Fax: (786) [email protected]
Keltman Pharmaceuticals, Inc. Keltman is a medical practice service provider that focuses on bringing inno-vative practice solutions to enhance patient care, creating alternative rev-enue sources for physicians. Keltman’s core service is a customizable point-of- care dispensing system. This program allows physicians to set up an in-office dispensing system based on a formulary of pre-packaged medications selected by the physician.Wyatt WaltmanPhone: (601) 936-7533Fax: (601) [email protected]
Lake Erie Medical & Surgical Supply, Inc./QCP For 24 years Lake Erie Medical has served as a full-line medical supply, medication, orthopedic and equipment company. Representing more than 1,000 manufacturers, including General Motors, Ford and Daimler-Chrysler, our bio-medical inspection and repair department allows us to offer cradle-to-grave service for your medical equip-ment and instruments. Michael HolmesPhone: (734) 847-3847Fax: (734) [email protected] www.LakeErieMedical.com
Med-Tek, LLCCMAP Pro™ Version 2.0 provides physicians, patients, insurance compa-nies, corporate self-insured, and other affiliates the ability to obtain objective, clinically-useful data on soft tissue injuries. CMAP Pro™ manages this through the deployment of a full suite of proprietary technologies.David SchwedelPhone: (786) [email protected]
PD-Rx PD-Rx offers more than 8,000 prepack-aged medications for your in-office dispensing needs. Our FREE, easy-to-use web-based dispensing software enhances the in-office dispensing expe-rience, from managing your inventory and facilitating online ordering, to ensuring state regulatory compliance. PDRxNet software also provides the opportunity to ePrescribe directly from your Electronic Medical Record (EMR) to our web-based dispensing product. PD-Rx is fully pedigree compliant and is licensed in all 50 states. Jack McCall & Bernie TalleyPhone: (800) 299-7379Fax: (405) [email protected]
Software Providers3bExam3bExam is the COMPLETE exam solution to streamline and manage your DOT physical forms and medical certificates. Our browser based application guides you through the physical exam process with separate screens/tabs for each sec-tion of the form; and also includes error checking and validation, drop-down lists of medications and frequently used comments, and electronic signa-tures. Medical Certificates are created automatically and results of completed exams electronically reported to the NRCME on your behalf with the press of a button! Additional features like document management, client access portal, reporting, driver notifications and bill-ing make 3bExam the total DOT Exam Management solution.Richard FryePhone: (844) 222-3926 [email protected]
Axion Health, Inc.Axion Health provides employee health, occupational health, medical surveillance, and emergency prepared-ness software. Axion’s ReadySet 4 is a 100% paperless mobile-friendly, Web-based solution that is easy to use, Internet-accessible, HIPAA and NIST-compliant. The solution also offers robust integrations with clinical, HR, and regulatory systems.Scott MeierPhone: [email protected]
DocuTAPDocuTAP is a cloud-based, integrated EHR and PM software made spe-cifically—and only––for urgent care. Meaningful use certified, DocuTAP has customizable provider templates to streamline patient workflow to down to the second, including occupational medicine and work comp. Save time with employer-specific protocols, fee schedules, and auto form population. Dusty Schroeder Phone: (877) 697-4696 [email protected] www.docutap.com
Net HealthNet Health is the leading provider of clinical solutions for outpatient spe-cialty care. Our certified Electronic Health Record (EHR) is utilized by over 20,000 healthcare professionals in more than 1,100 healthcare facilities. Provid-ers throughout the care continuum use Net Health’s fully integrated plat-form to record clinical procedures and drive financial results while improving patient care and outcomes.Renee VandallPhone: (412) [email protected]
MediTraxMediTrax provides affordable, user-friendly information management for occupational health. Optimize your efficiency with point-and-click sched-uling, user-defined clinical protocols, automated surveillance tracking, integrated EMR, one-click billing and administrative reporting, and much more. With free on-site training, and no per-user fees or annual lease costs, it’s the Gold Standard for affordability and ease of use!Joe Fanucchi, MDPhone: (925) 820-7758Fax: (925) [email protected]
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Practice VelocityWith over 600 clinics using our software solutions, Practice Velocity offers the VelociDoc™—tablet PC EMR for urgent care and occupational medicine. Inte-grated practice management software automates the entire revenue cycle with corporate protocols, automated code entry, and automated corporate invoicing. David Stern, MDPhone: (815) 544-7480Fax: (815) [email protected]
UL Workplace Health and Safety (formerly UL PureSafety)Occupational Health Manager® (OHM) is a results-driven software solution for occupational health and safety pro-fessionals. It has helped thousands of customers – from small onsite occupa-tional health clinics, to employee health departments in hospitals and health
systems, to Fortune 500 companies – increase efficiency and productivity, reduce workplace injuries and illnesses, and improve health and safety aware-ness. Features include: medical surveil-lance, tracking and analysis, case and return-to-work management, immu-nization monitoring, and workforce safety and education modules.
SYSTOC® is a powerful information management software solution for hospital-affiliated occupational health programs, freestanding occupational health clinics, urgent care and mixed-use clinics. Our innovative tap2chart® technology generates transcription with a single click. Interfaces enable the exchange of information for drug and alcohol, lab and radiology diagnostic test results. Additional features include: support of electronic and/or paper-based recordkeeping and sophisticated insurance authorization and billing options.
Lauren HoffmanPhone: (615) 567-0316Fax: (615) [email protected]
Xpress Technologies Inc.Xpress Technologies, offers complete Urgent Care and Occupational medi-cine solutions. Improve your ROI with our intuitive touch screen, integrated (iPad/Windows PC) paper or electronic templates; SureScripts-certified ePre-scribing; complete Practice Manage-ment; Cloud based secure data access, compatible Dragon Medical dictation. Free 24/7 support, 29 years experience, committed to your success! Meaningful Use compliant.Ms. Lisa WardPhone: (904) [email protected]
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Calendar
To list your event,email Isabelle Walker at [email protected]
JulyJULY 13, 2015Stress Management Summit DoubleTree by Hilton Philadelphia AirportPhiladelphia, PAOmics International [email protected]
JULY 21, 2015Innovations in Wellness and Population ManagementSeaport Hotel • Boston, MAWorld Congresswww.worldcongress.com/events/HL15031/
AugustAUGUST 10 - 12, 2015Global Cloud Computing Conference DoubleTree by Hilton Philadelphia Airport Philadelphia, PA Omics International [email protected]
SeptemberSEPTEMBER 27-30, 20157th Annual Corporate Wellness ConferenceHyatt Regency Orlando Orlando, FL 32819Employer Healthcare & Benefits Congressemployerhealthcarecongress.com
OCTOBER 5-7, 20154th International Conference on Nursing and Healthcare DoubleTree by Hilton Hotel San Francisco Airport San Francisco, CA • Omics group [email protected]
OCTOBER 12-14, 2015RYAN Associates 29th Annual National ConferenceThe Drake Hotel • Chicago, ILNational Association of Occupational Health Providerswww.naohp.com
OCTOBER 15, 2015ASSE Safety India 2015 Hotel The Lalit, Mumbai Mumbai, Maharashtra, IndiaAmerican Society of Safety Engineers [email protected]
OctoberOCTOBER 1 - 3, 2015Florida Occupational Health Conference Marriott Orlando World Center Orlando, FL Florida State Association of Occupational Health Nurses [email protected]
PRESIDENTMike Schmidt 2015-2017Director of OperationsSt. Luke’s Occupational Health ServicesSioux City, IA 720-490-4306 • [email protected]
NORTHEAST – DE, MD, ME, NH, VT, MA, RI, CT, NJ, NY, PA, DC, WVDebbie Borisjuk, MBA, PT 2013-2015Practice Manager, Worker Health Solutions, YNHH Urgent Care at FoxonEast Haven, CT203-466-5615 • [email protected]
SOUTHEAST – AL, FL, GA, MS, NC, SC, TN, VABrenda Jacobsen, MBA, CPA 2015-2017Chief Executive OfficerLakeside Occupational Medical CentersLakeland, FL727-532-7645 • [email protected]
GREAT LAKES - KY, MI, OH, WIMary Alice Ehrlich 2013-2015Executive Vice President, MED-1Grand Rapids, MI616-459-1560 • [email protected]
MIDWEST - IL, INTim Ross 2014-2016Regional Administrative DirectorWorkingWellMichigan City, IN866-552-9355 • [email protected] HEARTLAND – AR, IA, KS, LA, MN, MO, MT, NE, ND, OK, SD, TXRhonda Daggs 2015-2017Director, JPS Health and Wellness Center JPS Health NetworkFt. Worth, TX 817-702-1334 • [email protected] WEST – AK, AZ, CA, CO, HI, ID, NM, NV, OR, UT, WA, WYMarilyn Trinkle 2014-2016Director - Business Development / Business Health Services • Silverton HealthWoodburn, OR971-983-5256 • [email protected] AT LARGERick Schneider 2015-2016Executive Director of Occupational Health Services Froedtert & The Medical College Milwaukee, WI414-777-1967 • [email protected]
AT LARGERandy Van Straten 2015Vice President, Business HealthBellin Health SystemGreen Bay, WI920-436-8681• [email protected]
NAOHP REGIONAL BOARD REPRESENTATIVES AND TERRITORIES
The NAOHP/RYAN Associates Professional Placement Service is seeking qualified candidates for the following positions:
Board Roster
MEDICAL DIRECTOR/ STAFF PHYSICIANS
• Denver (Medical Director)• Hawaii (Medical Director)• Iowa (Medical Director)• Illinois (Medical Director)
NON-PHYSICIAN OPENINGS
• Ohio (Program Director)
For details, visit www.naohp.com/menu/pro-placement or contact Roy Gerber at [email protected] • 800-666-7926, x16
226 East Canon PerdidoSuite MSanta Barbara, CA 93101
1-800-666-7926www.naohp.com
Job Bank