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Onsite Wellness vs. All-Digital Wellness

Presented by Extracon Science LLC

How to run a better employee wellness program by not doing anything onsite.

Case Study:  Connectivity Wireless



Jesse Hercules, President Extracon Science LLC

Suzy Mason, Connectivity Wireless


I’d like to welcome everyone to this presentation, Onsite Wellness vs. All-Digital.  How to run a better employee wellness program by NOT doing anything onsite. 

My name is Jesse Hercules, and I’m the president of Extracon Science. 

This presentation includes a case study with Connectivity Wireless, an employer with an award winning all-digital wellness program.

My co-presenter today is Suzy Mason. (Suzy says hello to everyone)  Suzy is the Manager of Human Relations at Connectivity Wireless. Her job at Connectivity is to Hire and retain top talent, drive and develop the company’s culture and lead the team in a broad based comprehensive wellness program.  Because of her efforts, Connectivity Wireless has won “Atlanta’s Best and Brightest Companies” for the past three years.  The Best and Brightest award is given by the National Association for Business Resources.   Suzy has run a successful all-digital wellness program for several years now, and you’ll get to hear about it in just a few minutes. 

Our sponsor today is Extracon Science.  Extracon designs and implements digital wellness programs.

We combine design, technology and incentives to create engagement and results.

We offer turnkey and custom wellness programs that run on our own technology platform and apps.

Jesse: Our customers include insurance organizations like Highmark Blue Cross.   Large employers like MARS and UCSF, all the way down to smaller employers like Connectivity Wireless which has less than 200 employees.

We work with a number of hospitals and healthcare organizations, including Methodist healthcare. 

So here’s our agenda for today.   I’ll take the first half of the presentation, and explain what kinds of employers should consider a Digital Wellness Program, How to go Digital for biometric screenings, physical activity, and coaching.  in your, and how you can have a better program by going digital, and not doing anything onsite.

Then, Suzy will present a case study of her experience at Connectivity Wireless, a company that’s had an award-winning all-digital wellness program for several years now.

Let’s get started.

Let’s talk about what kinds of employers should consider an all digital wellness program.  There are three big characteristics.

The first one is an employer with multiple, smaller worksites scattered around their local area or around the country.   Connectivity Wireless is a perfect example of this. 

The second one is a self funded health plan.  Self funding means you see the savings when the wellness program makes people healthier.  Also, being self-funded makes it easier to use wellness incentives.  

The last one is smartphone access.   In the US today, about 85% of adults with jobs and health insurance have a smartphone.  So if you have an average, normal amount of cellphone access, you’re in good shape.

So what kinds of employers might not want an all digital wellness program?

If you have a large single site with thousands of workers, then onsite can work pretty well. 

The other situation is if you have worksites in remote locations with very low technology access.  Or employees that for some reason are 10 or 15 years behind the curve on technology.  We know some mining companies like this.  But that’s not really a lot of companies. 

Let’s get to our first Poll question. 

We see that for many of you, at least SOME Of your worksites are too small for onsite.  Very few employers we see have ALL their worksites big enough for onsite.  And that means that Digital has a place in your wellness program.

So here’s our agenda for today.   I’ll take the first half of the presentation, and explain what kinds of employers should consider a Digital Wellness Program, How to go Digital in your wellness program, and what the advantages are of an all-digital wellness program.  

Then, Suzy will present a case study of her experience at Connectivity Wireless, a company that’s had an award-winning all-digital wellness program for several years now.

Let’s get started.

So now we’ll talk about how to go digital in three main areas of wellness:  Biometric Screenings.   Physical Activity and BMI, and Health Coaching.   Everyone is familiar with onsite biometric screenings.  Onsite fitness centers.  And health coaches onsite, usually in the fitness center.    Let’s talk about how to take each of those digital.

So the traditional program has onsite biometrics screenings.   If you can’t do onsite, what are your options?  The most direct replacement for an onsite screening is a voucher program with a national clinic or lab.  So you give everyone a voucher to go to LabCorp or Walgreens.  That’s an exact, drop in replacement at a similar cost.  Some employers ship out at-home test kits, but our experience with those has not been really positive.  If you want a drop-in replacement we think the voucher programs are the way to go. 

But what we really recommend is sending every employee to their own primary care doctor.  We think that’s a better option because you can get more prevention done at the doctor’s office than you can do with an onsite screening or voucher program.  And you can do more to follow up on biometrics if you include the doctor.   So let’s talk first about the prevention side.

So what I have on this slide are the recommendations of the US Preventive services task force, or USPSTF.  This a summary of the official recommendations for prevention, tailored by age, gender and other factors. 

What percentage of your employees do you think are up to date on everything they need for prevention? Most employers have no idea how many of their people are up to date.  The CDC says it’s just 25%.    Even if you’re doing onsite screenings or a voucher program, you’re not covering all of these items.

But the good news is that the Affordable Care Act established a standardized Annual Wellness Visit.  The purpose of the visit is for the doctor and patient to go through the USPSTF checklist and close the gaps.  The ACA says anything rated A or B by the USPSTF must be covered by every health plan, and offered at no cost to the participant.  So doctors, patients and health insurance are all on the same page about what will be done and how it will be paid.

So at the end of the Annual Wellness visit, the goal is for the patient to be 100% up to date on what they need.  And that’s why sending your employees to their doctor can be really beneficial. 

So how do you collect the data from the doctor visit?  We’d love to tell you it’s a fully digital process.  But here’s how it really works.  You send participants to the doctor with a paper physician form.  The doctor fills it out and FAXes it to the wellness vendor.  Then you get all the same data you get from an onsite screening.  This process works, across thousands of participants our experience has been that 98% of doctors return the completed form on the first try.

So we’ve talked about how sending participants to the doctor lets you do more prevention that a voucher program or onsite screening.  It also lets you do a better job of following up on biometrics.  

This Spring we surveyed 8,000 employers and wellness programs, and asked how they followed up on their onsite screenings or voucher programs.  58% didn’t track any kind of followup after the screening.   That’s kind of crazy, right?  They spend all this money on screenings but they have no idea if the problems were treated and resolved.   Only 3% tracked whether the problems found at the screening were actually resolved, according to the treating physician. 

If you’re working with the employee’s doctor, you can do a much better job of followup.  You remember sending the participant to their doctor with a form for the initial visit.  Guess what, you can also send them with a form to the followup visit.   So you get the data that says the problem was treated and resolved. 

And you can even put an incentive on that.    So if you’re working with the doctor, it’s possible to do really good followup and put incentives on it.  

Now let’s talk about the second place you can go digital.  Going Digital with Fitness and BMI.   So instead of an onsite wellness center with fitness classes and equipment, you will be using technology.  

So the first part is, you’re replacing onsite fitness with apps and devices.  Some employers buy apps or devices for employees, others allow employees to connect consumer apps and devices.  There are three big advantages to using apps and devices.  First, you’re letting people be active when they want, where they want.  So if they want to go walking or running in their own neighborhood, or in the city park – they can be active wherever they want to be active.  And if they want to be active on Saturday or Sunday, or some time the fitness center is closed, they can be active then. 

The second big advantage is that you are collecting data on actual physical activity.  So it’s not just how many times they check into the fitness center.  You can actually see how much activity they got.   The third big advantage is that walking is really appealing to the people you need to reach.  The sedentary people who need to start doing something can be intimidated by a fitness center, where everyone is in shape and wears special workout clothes.  Being able to walk in their own neighborhood is appealing.

However, we can’t forget about the importance of the onsite fitness center as the social hub of the wellness program.  One of the big reasons people join and stick with an exercise program is the social interactions at the fitness center. So if you’re digital, you need something to replace that social aspect of the onsite center.  Most wellness programs do what Suzy did and use online, team and social Challenge programs. 

So if you’re going with apps and devices, you probably want to know how many of your people already have a favorite app or device.   The hype is that everybody has one.  The reality is that only about 11% of US adults have a fitness tracker and use it every day.   About 14% use an App.  And three quarters of people are not doing either.  So you can’t expect everybody to have their own app or device. 

Does that mean you should just buy a device for everybody?  Then everybody will be super active?  Unfortunately it doesn’t work that way.   Devices alone are not the answer. 

According to the Endeavor Partners study you see on the left, there’s a pretty steep dropoff curve for devices.  The study says, most of these devices fail to drive long term sustained engagement for a majority of users.  Another way to say that is, “There’s probably a fitness tracker abandoned in a junk drawer near you”. 

And consumer apps have the same problem.  (Discuss).  About 15% of consumer fitness apps are only used once.  Two thirds are used 10 times or fewer.  Only 35% are used 11 or more times.

So what is the answer?  Integrate Apps and devices with programs and incentives.  You’re running a wellness program.  Your role is to put the pieces together. 

OK, let’s talk about going digital with Coaching.   So the traditional approach was either expensive onsite coaching, or saving money by using telephonic coaching.   Studies show that 55% of communication is facial expression and body language.  So if you’re telephonic only, you’re missing half of the conversation.   Onsite coaching is great, but it’s not practical or affordable for many employers.  

When we think about digital wellness, we now have the opportunity to have the best of both.  The face to face part of onsite coaching, along with the convenience and low cost of telephonic coaching.  Several technology vendors now have video-calling services that are secure and HIPAA compliant.  So the secure technology is in place for health coaches to work with their participants face to face – via smartphone or tablet. 

So it’s our chance to have the best of both. 

We think face to face coaching is part of this next practice.  Here’s why. 

There was a famous study done by Albert Mehrabian and his collaborators at the University of California.  What they found was that only 7% of the credibility and effectiveness of communication came from the words themselves.  It’s not what you say, it’s how you say it.  38% of the effectiveness came from the voice and the tone – the things you get from a telephone call.  But fully 55% of the impact came from body language and facial expression.  So here’s what that means for coaching.  When you can see someone’s face it’s more than twice as credible and effective as a voice alone.   Seeing someone’s face is a big, big deal when you’re establishing a trusted relationship. 

And with almost 85% of employees now having smartphones, it’s possible to have these face to face coaching sessions at the same price as a phone call

If you’re doing onsite screenings, you’re limited to the same 5 screenings.  Blood Pressure, Cholesterol, BMI, Glucose, Tobacco.  If you’re NOT doing onsite screenings, that means you can send participants to their own doctor for an Annual Wellness Visit, where they can get comprehensive prevention that covers everything they need.  It covers 20 or more items, tailored by age, gender and other factors.  It’s more comprehensive.


If you’re doing onsite screenings, then your screenings are not coupled to diagnosis, treatment, or medical followup.  And in many cases the followup never happens.  If you stop doing onsite screenings and send people to the doctor, you can put a process in place for better followup.  Your wellness vendor can tell you how many of the problems found were actually fixed, and you can pay incentives to those who work with their doctors and fix the problem.


If you’re using Apps & Devices instead of an onsite fitness center, it’s more flexible for your participants.   They can be active in their own neighborhoods, on any day of the week, at any time of day.  People who aren’t comfortable putting on workout clothes and exercising in front of their coworkers can take a walk around their own neighborhood instead.  Using Apps & Devices also gets you better data.   The wellness program can measure whether people are really getting more active, instead of measuring whether they scan their badge at the fitness center. 


Going digital means you’re moving from onsite and telephonic coaching to using the smartphone.   Telephonic coaching means you’re missing half the conversation because facial expression and body language are not there.   Face to Face Coaching via smartphone means you get the whole conversation at the same cost as telephonic. 

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