The promise of worksite health screening is compelling.
Imagine an employee with unrecognized high blood pressure (slowly developing damage to arteries and major organs) one day having a serious heart attack requiring prolonged hospitalization, intensive medical and surgical treatment, and extensive rehabilitation.
Now, imagine the high blood pressure had been detected early at a worksite health screening and successfully treated. The employee maintains good health, and the employer avoids medical claims costs and lost productivity. But having a successful worksite screening also means knowing what to screen for and what to avoid.
In addition to early detection of illness, worksite health screenings are also a low-cost, high-profile way to enlist employees in improving their health and an important value-added service an advisor can help deliver.
Some employees avoid preventive medical care and miss the opportunity to address the behaviors that cause chronic illness, such as inactivity, obesity and tobacco use. Worksite screening also can identify employees with these lifestyle risks, and a nurse or health educator can counsel these individuals on the consequences of their choices and make available opportunities to help them change.
As part of a broad health promotion effort, this kind of direct medical contact can motivate employees successfully to change their behavior.
There are a number of national vendors that can deliver effective, professional screenings at a cost between $25 and $40 per employee. For employers on a tight budget, the health carrier may be able to sponsor some elements of the screening, and local hospitals or medical groups may be willing to donate nursing support as part of their community outreach.
The screening should be supported with employee incentives to participate and will benefit from a comprehensive communications plan to reach and remind every employee. It is also an opportunity to conduct a “health fair” showcasing the health plan, other vendors like the employee assistance program and local resources to improve health risks, such as fitness centers and legitimate weight loss programs. The employer should be careful to avoid vendors who seem likely to use the event primarily to generate revenue at the employer’s expense.
Besides the goodwill generated by the employer’s desire to support better employee health, the employer also can access the cumulative results of the group. While individual results are confidential and protected, the results for the group as a whole can give important insight into the overall health status of the group. This allows for planning to address the most compelling risks through directed health promotion programs and gives early warning of future claims costs, which can be important in professionally managing the health benefit program. An advisor who can help the employer deliver on the promise of worksite health screening also has arranged a very public display of the value that advisor brings.
Do’s And Don’ts
What should be part of every worksite health screening?
Worksite testing should be limited to activities that have been proven to be effective in identifying illness for which early intervention makes a real, measurable impact. These activities also must be practical to administer in a work setting.
1. Blood sugar–A quick finger stick can provide early indication of diabetes. Fasting is more accurate than a random measurement but is not essential.
2. Cholesterol–A total cholesterol reading also can be done via a finger stick, with the results immediately available.
3. Blood pressure–It is one of the most important measurements for a very treatable and very dangerous medical condition.
4. Body fat–It is most often based on height and weight to determine Body Mass Index, an indirect and occasionally misleading predictor of obesity. Body fat content also can be measured directly, which can provide more compelling results.
5. Health risk assessment–This is best performed via computer to allow more detailed evaluation and better modeling of the results and can uncover other health risks, such as depression and substance abuse.
6. Counseling–An exit interview with a nurse or health educator can help clarify any findings of the screening, address any questions or concerns the employee might have and help plan the next steps to address the risks or illnesses identified.
What might be included in some settings?
For some employee populations, other health screening measures may also make sense:
1. Flu vaccinations–if the screening is planned for late September, October or November.
2. Mammography–Especially in rural locations or areas underserved by conventional mammography, mobile mammography can provide life-saving early detection of breast cancer.
3. Vision screening–particularly where the employee population has a high proportion of employees over age 65.
What is not recommended?
In my opinion, some activities are inappropriate in worksite settings, or have no real value as screening activities for illness, because they are too expensive, the disease is infrequent or early detection does not change the outcome.
These activities include:
1. Colorectal cancer screening and Pap smears are generally not appropriate.
2. Chest X-ray’s have not been shown to be an effective screening measure.
3. EKG is not a cost-effective way to screen for heart disease.