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IBM Commit to Health IBM Integrated Health Services Dr Balaji Lakshmipuram, India Dr Tong Chen, China
April 2014
Global Healthy Workplace Awards Shenghai, China April 2014
2 © 2014 IBM Corporation
Japan Successful Smoking Cessation & Stress Reduction
India Popular Health Screening “Camps” & leading support for Women’s Health
IBM Leadership in Health Promotion Around the World
China First to offer Hepatitis B vaccination & education
Brazil IBM Baby provides support for new mothers
US & Canada Financial incentives for healthy living
South Africa Health plan tools & retail discounts for healthy living
Germany Unique peer coaching for well-being
France Manager & team training on stress
ANZ Access to web-based tools for healthy living
ASEAN Social events for physical activity & other topics
SSA Family safety at home and on the road
Mexico Network for retail health screenings
CEE&RCIS Web-based stress assessment tool
Examples of local innovations:
Africa Wellness checks & health risk assessment
7 © 2014 IBM Corporation
Core Global Team
Global Priorities SMEs & Teams
Local/Regional Leads
Health Promotion Pillar Owner
Teaming Approach Provides Leadership & Collaboration
8 © 2014 IBM Corporation
Global Health Promotion Program Framework
Healthy Worksite Environments
Health Assessment & Screening
Health Education & Awareness
Targeted Support Programs (High-tech & High-touch)
Innovative Engagement Strategies
Supported by: Driven by:
9 © 2014 IBM Corporation
Global Health Risk Assessment & Surveillance
§ Assessment, feedback, and triage to follow-up programs
§ Translated, acculturated, and aligned to local country needs
§ Country and global data dashboards on key metrics
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Virtual Health Fair & Online Health Community
§ Virtual global health event (live and on-demand access)
§ Live presentations from 20 experts around the world
§ Interactive booths for Q&A with experts
§ Presentations and materials in 8 languages
§ Employee exchange and sharing through online Commit to Health Community
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Triage Counsel Support
Medical Support Behavioral Support
Wellness Support
Medical Line Pregnancy Support
Treatment Decision Support
Condition Management
EAP Services
Wellness Coaching
§ Symptom check & self-care advice § Questions on medications, vaccinations, screenings § Minor injuries § Upper respiratory infections § Acute pediatric illnesses
§ Healthy habits during pregnancy § Questions about medications § Prenatal visits planning § Healthy delivery § Prevention of post-partum depression
§ Questions about and alternatives to surgery § Management options for back pain § Options for management of uterine problems
§ Diabetes § High blood pressure § Stable heart disease § Hepatitis B § High cholesterol § Arthritis
§ Stress management § Depression and anxiety § Relationship issues § Manager assistance § Critical incident support § Financial and legal advice
§ Weight management § Smoking cessation § Physical fitness § Sleep § Cholesterol management § Developing and maintaining healthy habits
Wellness Advisor – Integrated Support for Health
13 © 2014 IBM Corporation
Study Populations after Propensity Matching N
Non-participant 1,284 1-2 Years 3,829 3-8 Years 3,849 9 Years 3,790
IBM US Healthcare Claims Cost Trends based on Number of Years Employees Completed Healthy Living Programs (2004-2012, Study Group N=40,784, After Propensity Matching N=12,752)
Med/Rx costs converted to 2012 dollars
Example: Longitudinal Impact on Healthcare Costs
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0.0
5.0
10.0
15.0
20.0 Private Public
0.0
2000.0
4000.0
6000.0
8000.0
Source: 2011 World Health Statistic
Total expenditure on health as % of GDP
Total expenditure on health Per capita (PPP int. $)
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n For most companies in China, health program = health check-up
n Most if not all heath budget goes to health check
n Vendor dominant, diagnosis oriented, not evidence-based, and variable quality
n 50-100 Billion US$ health check market = 100-200M peasants health insurance spending!
Health Screening/Check in China
19 © 2014 IBM Corporation
Screening Plan A Screening Plan B Purpose of the screening
International recommendation ①②
Chinese recommendation ①
Health Risk Assessment Alcohol use/smoking Recommended③ Recommended③
Height and Weight Overweight/Obesity
Blood Pressure (BP) Hypertension <120/80: Every 2y
Fasting Blood-glucose Diabetes >129-139: Every y
Total Cholesterol(TC) & HDL-C Lipid disorders >135/80: Ever 3 y;
Pap smear(Female) Cervical cancer M>35, F>45: Every 5 y; Every 5 y
Fecal occult blood test(50-75) Colorectal cancer 21-65: Every 5 years
50-75 years,yearly
Mammography F >40 Mammography F >50 Breast cancer Recommended 50-74 years: Every 2 years
Recommended 50-69 : Every 1-2y
Breast ultrasound (F>35)
N/A
Breast cancer
Not Recommended Not Recommended
Prostate Ultrasound Prostate cancer
Chest X-ray Lung Cancer
Pulse、Breathe Non-specific ④
Physical examination Non-specific
Complete Blood Count Non-specific
Liver enzyme: ALT Non-specific liver damage
Blood BUN,CR Chronic kidney disease
Abdomen ultrasound Non-specific
Pelvic ultrasound Non-specific
Uric Acid ( UA) Gout
Hepatitis B serology Hepatitis B infection Urine test
N/A Chronic Kidney Disease
Insufficient evidence to recommend or against
Not recommended TG、LDL-C Lipid disorder Recommended Evry 5 y Eyes, Ears, Nose Examination Non-specific No Data
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Workplace Strategy to Reduce Smoking
WHO MPOWER Policies Smoking Cessation Methods
Monitor tobacco use and prevention policies Unassisted methods
Smoke-free environment Clinical settings
Offer help to quit tobacco use Medications: NRT, Bupropion, Varenicline etc.
Warn about the dangers of tobacco Individual and group counseling
Enforce bans on tobacco advertising, promotion and sponsorship
Web-based or stand-alone and computer programs
Raise taxes on tobacco Others: competition & incentives; psychological approach; community intervention; substitutes; etc.
22 © 2014 IBM Corporation
IBM China & Public China Male Smoking Rate Comparison
n Lung cancer is a leading cause of
death in China
n IBM was the first employer in
China to implement a non-smoking
workplace policy in the 1990s
Ref.
n China CDC & American Cancer Society
Smoke-Free Workplace Initiative in 2008
n China government has initiated a ‘Non-
smoking Hospital’ since 2011
0%
10%
20%
30%
40%
50%
60%
70%
80%
2010 2011 2012
China smoking rate
Male smoking rate
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n 8% (100 million) chronic infected in China (vs. 34 millions HIV globally)
n 20-30% chronic patients will develop cirrhosis and/or liver cancer
n Liver cancer is 2nd leading cause of cancer death in men
Cirrhosis
Hepatitis B Infection in China
24 © 2014 IBM Corporation
IBM China Hepatitis B Program
China IBM since late 1990’s:
n Eliminated HBV testing in
hiring process
n Created HBV vaccination
program
n HBV health benefits coverage
for both employees and their
family since 2011
Data from China IBM annual health checkup.
IBM Beijing Employee HBV Serology#
0
10
20
30
40
50
60
70
80
90
%100
Y2005 Y2006 Y2007 Y2008 Y2009 Y2010
HBsAb +HBsAg +All −
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Mental Health – Organization Culture & Environment
Crisis Management Case management Special group
EAP first 1998 Resilience program Stress survey tool
Employee education Manager education Mental lectures
Insurance coverage Diversity program Flexible work
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IBM China was awarded 2013 ‘Health Management Pioneer Enterprise' by Chinese Medical Doctor Association
Challenges in China