culture of health at johnson & johnson – a model of prevention · 2010. 5. 28. · culture of...
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Culture of Health at Johnson & Johnson –A Model of Prevention
Hospital Authority Convention – Hong KongFikry Isaac, MD,11 May, 2010
Today’s Discussion
The world’s largest and most comprehensive health care company
2009 sales of $61.9 billionMore than 250 operating companies selling products throughout the world
Three worldwide business segmentsConsumerMedical Devices/DiagnosticsPharmaceutical
Managed by a unique form of decentralized management 115,500 employees worldwide.
New Wellness & Prevention growth platform established in 2008:Established to deliver workplace health and wellness programs and services –HealthMedia® and Human Performance® Institute
J&J – Corporate Background
Business Value
“The health of the employee is inseparable from the health of the Corporation.”
“An important part of our Credo responsibility to our employees is providing them with resources to lead healthier lives. Good health is important to all of us. Good health is also good business.”
William C. Weldon CEO Johnson & Johnson
Global Health Strategies
Transforming care for health from a financial liability to a
business advantage
WHO WE AREWHERE WE HAVE COME FROM
Our History
Why we do what we doOUR VISION: Have the healthiest, most engaged workforce for J&J - allowing for full and productive lives
OUR MISSION:Deliver a competitive business advantage to the J&J Family of Companies, by providing the leadership and resources that enable the well being, full engagement, and productivity of J&J employees worldwide.
Culture of Health Evolution: Our Roadmap
LIVE FOR LIFE®: Partnership between Benefits, Safety, Medical, Wellness and EAPJames E. Burke, J&J Chairman and CEO, set two major program goals:Encourage employees to become “healthiest in the world”Reduce health care costs through on-site programs and services
Established Health & Wellness Shared Service, integrating: Employee AssistanceOccupational HealthWellness & Health PromotionDisability Management
Global expansion of integrated services to provide:LeadershipConsultationGuidanceSupport
Health & Wellness key policies harmonized as part of Global HR Transformation (GHRT)
Wellness & Prevention identified as key New Business strategyAcquisition of HealthMedia, Inc. and Human Performance Institute, Inc.
Our Strategic Approach
Keep well—mind and bodyKeep safe
Identify and manage health and injury risks
Identify and manage/mitigate disease impact
Identify and focus medical and disease management resources
Address spectrum of needs
Use proven programs/methods
Measure outcomes/manage program investments
Emerging Global Health Issues
Global Health Programs seek to proactively address these issues
Global Health Concerns – WHOA Focused Effort
Mental Health450 Million people currently suffer from these conditions, placing mental health disorders among the leading causes of ill-health and disabilities
Obesity and Physical ActivityOne billion overweight adults – 300 million of them obesePhysical Activity causes 2 million deaths per year
Tobacco Use and CancerTobacco use is one of the biggest public health threats the world has ever faced. 100 million deaths were caused by tobacco in the 20th century. If current trends continue, there will be up to one billion deaths in the 21st century
Occupational Injury/Illness“Exposure to occupational hazards accounts for a significant proportion of the global burden of disease and injury, which could be substantially reduced through application of proven
risk prevention strategies.”
HIV/AIDSForty million plus people living with HIV and AIDS at end of 2006
Global Prevalence of Health Promotion Programs
77%
44%
42%
31%
43%
32%
North America
Latin America
Europe
Australia
Asia
Africa/ Middle East
2009 Wellness Survey- Buck Consulting
Health Issues Driving Wellness Strategy
Africa Asia Australia Canada EuropeLatin
AmericaUnitedStates
Stress 1 1 1 1 1 3 5Physical activity/exercise 4 2 2 4 2 1 1Nutrition/healthy eating 10 3 4 5 6 2 2Work/life issues 3 6 3 2 3 11 9Chronic disease (e.g., cardiac, diabetes) 8 7 5 8 10 6 3
High blood pressure 9 5 7 10 11 4 4High cholesterol 13 4 8 9 13 5 7Workplace safety 6 8 6 6 5 8 11Depression 5 11 10 3 7 13 10Tobacco use/smoking 12 14 12 11 4 10 8Psychosocial work environment 10 10 13 7 8 9 15Obesity 15 12 9 15 14 7 6Personal safety 6 9 14 12 9 15 13
2009 Wellness Survey- Buck Consulting
CRITICAL ELEMENTSCulture of Health
14
5 Key Culture of Health Components
1. Leadership and Commitment
2. Enterprise Programs
3. Policies and Procedures
4. Promotion and Communication
5. Measurement and Results
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1. Leadership & Commitment
Public advocacy for healthy, innovative workplaces
Internal management emphasis (talking the talk and walking the walk)
Communications inside and outside
16
Mental Health & Wellbeing
Mental Health & Wellbeing
Healthy LifestylePrograms
Healthy LifestylePrograms
• Access to Employee Assistance Professionals
• 24/7 Telephonic Counseling• Online Mental Health Screening • HealthMedia Digital Coaching Programs• Resiliency/Stress Management Training• Yoga and Meditation
Occupational Health & Disease Mgmt.
Occupational Health & Disease Mgmt.
Health Education & Awareness ProgramHealth Education & Awareness Program
• Health Profile & Biometrics• Health Profile Counseling• Digital Coaching Programs• Pedometers and Million Step Challenges• Weight Watchers and Nutritional Counseling• Tobacco Cessation Programs (PIQ)
• Onsite Occupational Health Clinics• Employee Health Centers• Medical Surveillance Compliance• Medical Case Management• Value Added Services (Phlebotomy, Pharmacy
and Physical Therapy)• CareConnect & Health Advocate
• My eHealth (Tip of the Day, Family Health Guides, Personal Trackers)
• Healthy People News• Healthy People Bulletin Boards• Global Health Observances (ie Move For
Health, World Diabetes Day, Breast Cancer Awareness, World AIDS Day)
Johnson & Johnson
Employees and Families
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2. Enterprise Programs
Wellness & Health Promotion
• To help employees achieve optimal health, Wellness & Health Promotion programs provide global affiliates with leadership, consultation, guidance and support for the delivery of a wide range of quality health promotion programs and services.
• Improving the health of employees can deliver significant corporate benefits, including increased productivity, but most importantly, employees can enjoy improved health, both on and off the job.
• Programs include: Activity Promotion; Eat Complete; Tobacco Cessation• US: Programs are delivered via Health Fitness Corporation• OUS: Program delivery varies but is usually coordinated with GH regional
managers and site HR
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Addressing Lifestyle Factors
• Healthy People Initiative• Annual Health Profile• $500 Medical Benefit Discount• Tracking and Enterprise-Wide
Reporting• Operating Company-Level
Reporting/Accountability• Started in U.S. in 1995 with
global expansion currently underway.
• US Participation Rates 2009: 83%
Mental Health & Wellbeing –Employee Assistance
• Provides employees, their families, and management confidential assistance with a wide range of work-related and personal problems
• EAP professionals are trained to facilitate solutions for a variety of challenges that may negatively impact individual or organizational health if left unresolved
• Programs include: employee counseling; critical incident debriefing; management/organizational consultations
• US: Provided to every site via Value Options
• Globally: Various service delivery approaches
• Healthier consumers
• Fewer ER Visits
• Decreased inpatient hospital stays
• Higher productivity
• Lower absenteeism
• Better controlled health care costs
• Improved bottom lines
• Healthier consumers
• Fewer ER Visits
• Decreased inpatient hospital stays
• Higher productivity
• Lower absenteeism
• Better controlled health care costs
• Improved bottom lines
HealthMedia, Inc.: Digital Health Coaching Treats the Individual, Not the Condition
• Health Risk Assessment
• Weight Management
• Smoking Cessation
• Stress Management
• Nutrition Counseling
• Insomnia
• Back Pain Prevention
• Adolescent Health
• Physical Activity
• Health Risk Assessment
• Weight Management
• Smoking Cessation
• Stress Management
• Nutrition Counseling
• Insomnia
• Back Pain Prevention
• Adolescent Health
• Physical Activity
•Chronic Illness Management Hypertension, Hyperlipidemia, etc.
•Doctor-Patient -Pharmacist Relationships
•Management of secondary symptoms: stress, fatigue, etc.
•Diabetes
•Pain Management
•Back Pain Mgmt
•Chronic Illness Management Hypertension, Hyperlipidemia, etc.
•Doctor-Patient -Pharmacist Relationships
•Management of secondary symptoms: stress, fatigue, etc.
•Diabetes
•Pain Management
•Back Pain Mgmt
• Insomnia
• Depression
• Binge Eating Disorder
• Obesity
• Alcohol and Addiction
• Insomnia
• Depression
• Binge Eating Disorder
• Obesity
• Alcohol and Addiction
DiseaseManagement
DiseaseManagement
Digital Health Coaching ProgramsDigital Health Coaching Programs
Health &WellnessHealth &Wellness
MedicationAdherenceMedicationAdherence
BehavioralHealth
BehavioralHealth
Proven science-based behavior change modelsProven science-based behavior change models
3. Policies & Procedures
Global harmonized policies • Tobacco Free• HIV-AIDS• And Others….
Standardized Procedures (“toolkits”) that allow for program/implementation WW
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4. Promotion & Communications-engaging employees
5. Measurement and Results
Making an Impact by Focusing on Risk Reduction
General health risks status and absence
High number of risks equals increased days lost
0
2
6
8
10
12
14
4 2.45 Days
0-1 Risks
5.28 Days
2-3 Risks 4+ Risks
DA
YS/Y
R
13.16 Days
HEALTH RISK IMPACT ON ABSENTEEISM
General health risks status and medical claims
High number of risks equalshigher costs
$1,000
$2,000
$3,000
$2,500
$1,500 $1,389
0-1 Risks
$1,730
$2,701
2-3 Risks 4+ Risks
HEALTH RISK IMPACT ON MEDICAL COSTS
Source: Wayne Burton, MD, IHPM North American Summit Meeting 2000
J&J Approach : Improving Health Risks via Tailored Health & Wellness Offerings and an Engaged Culture of Health
High Risk (5+)
Medium Risk (3-4)
Low Risk (0-2)
OVERALL INCREASE IN LOW-RISK CATEGORY OVER TIME. OVERALL DECREASE IN MEDIUM/HIGH-RISK CATEGORY OVER TIME.
POPULATION HEALTH RISK REDUCTION (2006 TO 2009)
20081.1%
13.9%
85%
1.6%
20.6%
2007
77.8%78.1%
1.4%2006
20.5%
20090.9%
12.0%
87.1%
Employee health risk trends between 2002 - 2008 suggest the Johnson & Johnson health and wellness program has an annual ROI of between $1.57 - $4.09 for every dollar spent.
High Risk Factor(in descending order by High Risk
Prevalence)
Johnson & Johnson
CDC US Data*
Unhealthy Eating(<5 Servings / Day)
60.0% 75.6%(2007)
Obesity (BMI 30.0+)
20.4% 34.1%(2003-2006)
Inactivity(<150 Moderate Minute Equivalents)
20.4% 30.5%(2005-2006)
Hypertension(Blood Pressure 140+/90+ mmhg)
6.3% 17.9%(2003-2006)
Cholesterol(Total Cholesterol 240+ mg/dl)
5.3% 16.3%(2003-2006)
Tobacco Use(Current User of Any Tobacco)
3.9% 29.6%(2006)
Glucose(126+ Fasting)
2.5% 10.2%**(2003-2006)
Stress (Heavily or Excessively Stressed)
1.6% 3.0%***(2006)
*Based on “Health, United States, 2008” a publication by the Centers for Disease Control and Prevention and National Center for Health Statistics, except for “Unhealthy Eating” which is based off of the Behavioral Risk Factor Surveillance System (BRFSS) data from 2007.
**CDC’s definition of high glucose / diabetes = “Physician Diagnosed and Undiagnosed Diabetes”***CDC’s definition of stress = “Serious Psychological Distress”n=30,595
• Population health risks trending superior to other industries
• Per capita health care costs consistently 1%-2% below benchmarks for past 10+ years
• J&J medical plan ranked in “top quartile” of peer group benchmark
• Projected ROI from 2002 to 2008 estimated at $4 :$1 (medical expenditure and productivity.
Proven Multi-dimensional Approach Yields Sustainable Results
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HealthMedia® Relax™
25.11%Baseline Productivity
Impairment(Participants who decreased stress)
$2,720Productivity savings per participant per year
180 Day Self-Reported Outcomes
19.67%180 Day Productivity
Impairment(Participants who decreased stress)
5.44Point Reduction
=-
=x $50,000 average salary/benefits
60%Of participants decreased stress
180 Day Self-Reported Outcomes
Realizing the impact of our programs – an illustrative example
For every employee who quits smoking….
Direct savings related to decreased burden on Insurance Rates, & Disability Costs
Direct savings related to decreased burden on Insurance Rates, & Disability Costs
Increased productivity realized via decreased Absenteeism, Improved Energy levels, less “breaks”
Increased productivity realized via decreased Absenteeism, Improved Energy levels, less “breaks”
Retention of J&J Human Resources via improved wellness, presenteeism and longevities of employees
Retention of J&J Human Resources via improved wellness, presenteeism and longevities of employees
Improved Environment and Safety for co-workers via absence of cigarette-related smoke and fires
Improved Environment and Safety for co-workers via absence of cigarette-related smoke and fires
“Our Stockholders”
“Our Employees”
“Our Environment”There is an impact to:
Realizing the impact of our programs – an illustrative example - Japan
Pictures of smoking area next to the J&J HQ building
Estimated Productivity Savings for NO SMOKING: JPY:
412,500,000
“This morning I felt very happy to find a white-eye (bird) at the former smoking area. If it continued to be a place for smoking, we would never see such a beautiful bird
there.”
Now 100% Tobacco-
Free!
Estimated Productivity Savings for NO SMOKING: JPY:
412,500,000
Achieving Global Health Objectives
• Global Health Assessment Tool (GHAT)
Culture of Health —Measuring our Progress
• Global Health Assessment Tool
– Captures metrics that support 3 Global Health goals and objectives
– 2009: 413 locations (worldwide) reporting
– Immediate feedback provided to the site after tool completion (Culture of Health Scorecard)
– Global Health Leaders review results 1:1 with Franchise Leaders for followup/next steps
Putting it all Together
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In Summary
• A focus on health risk factors can yield strong results• We believe driving behavior change and creating a sustainable culture of health are
critical to enhancing health, productivity and performance• A seamless and holistic approach is necessary at the organizational and individual
level, driving participation and behavior change• Increasing rates of chronic disease, rising health care costs, economic downturn,
stretched work force present the opportunity to make an impact with employee prevention & programs
• “Carrots” can work• Employee buy-in is important• Global wellness requires “feet on the ground”• Phased approaches and pilots to understand critical learnings and subsequent
course corrections• Nothing happens overnight!
BACK-UP
Key Elements of Success
CommitmentSenior/middle management commitment Visible leader or championBuild the most appropriate business caseSpeak the language and align with the business
ProgramsScience-basedCustomized and individualized interventionsApplying behavior change modelsLong-term efforts in maintaining changeRegulatory environment (laws, health systems, policies, etc.)
Effective ApproachTriaging individuals into programs that produce greatest impact/payoff
Protecting confidentiality
Collaboration between all involved parties
Leverage global, national and regional health trends and initiatives
MotivationSuccessful recruiting strategies
Easy access to programs and facilities
Effective marketing and communication