Dr. Maegan Pisman: ABA Therapy, Access & Tele-Health Tech

Season 1, Episode 9

In this podcast we speak with Dr. Maegan Pisman who specializes in providing comprehensive- and focused-treatment applied behavioral analysis (ABA) services using a tele-health model for individuals with learning deficits or behavioral challenges.  Demand for ABA therapy services has accelerated rapidly since the early 1990s with much of the increase coming within the realm of interventions for individuals diagnosed with autism spectrum disorder (ASD). Families of people with Autism have played a major role in advocating for public policies and insurance coverage.  There still remains some confusion, misunderstanding, and misrepresentation regarding these services, its applications, and qualifications for practicing ABA professionally.

Dr. Pisman who has over 11 years of education, training and research experience in this area.  Her range of study includes work and research in areas including assessment and treatment of severe challenging behaviors, ASD and other disabilities, as well as pediatric feeding disorders.  

In this episode, we discuss:

  • Applied Behavioral Analysis (ABA) therapy and its growth within the health field.
  • Why and how tele-health has improved access and outcomes for this therapy.
  • What a tele-health visit “looks” like for her clients.
  • The benefits of engaging with tele-health technology to improve benefits in urban and rural areas.
  • Dr. Pisman’s suggestions on how we can begin opening up to alternative access models for our own health.

Today’s Guest

Dr. Maegan Pisman, founder of Imbueity, providing applied behavior analytic (ABA) services for individuals, families, students, and organizations.

Chef Tank Sanatra: Real People, Real Experience

Season 1, Episode 8

This is our first ‘Real People, Real Experience’ interview where we engage with people, like us, who have a health story and success to share.  In this podcast we talk to Chef Tank Sanatra.  Chef Sanatra’s health issues date back to the age of 11.  He shares with us his thoughts, his trials, and how he’s discovered the best solutions for his health. We get into the details so be sure to listen and be inspired.

We’ll talk to Tank Sanatra about:

  • How he has learned to take charge of his own health over the past 20 years;
  • His life and health beginning at age 11 and how he went from being Tank to Chef Sanatra
  • His thoughts and suggestions on how to interact with our medical community;
  • How Chef Sanatra has adopted a new lifestyle and food habit that some of us may find to be impossible to adopt – yet Tank finds it rewarding.

Today’s Guest:

Chef Tank Sanatra, experienced health challenges at a young age and has been inspired to explore and adopt ways to better health.  You can find Chef Sanatra on Instragram @ChefSanatra

MeruHealth: Making Mental Healthcare Accessible & Effective

Season 1, Episode 7

In this podcast we speak with Kristian Ranta, founder of MeruHealth. MeruHealth is a digital mental health clinic offering an app based treatment program supported by licensed therapist.  The mission of MeruHealth is to make mental healthcare accessible and effective for everyone.  MeruHealth is based on a need that Kristian experienced within his own family.  He is now on a personal mission to help all people have access to the tools they need to overcome depression and anxiety. 

In this episode, we discuss:

  • How MeruHealth is using technology to redefine our access to mental health services.
  • The problems that are now being faced by patients needing care related to stigma, cost, and often slow access to qualified therapists. 
  • The increasing need for mental health services with employer provided health options.
  • How MeruHealth is bringing this option into the physician and corporate employee world where burnout is prevalent and leading to mental health issues such as depression and anxiety.
  • Kristian’s thoughts on how we can begin thinking about how to explore and engage in using technology to support our mental health.

Today’s Guest

Kristian Ranta, founder of MeruHealth, is an energetic and creative entrepreneurial business builder who loves major global challenges.  He envisions a world in which all people have the tools they need to overcome depression and anxiety.
www.MeruHealth.com

Data as a Disruptive Habit for Health and Wellness Leaders

Data as a Disruptive Habit for Health and Wellness Leaders

What comes to your mind when you hear the term “employee health and wellness?”  For me and many employers that I speak with, this term brings to mind the long history of engaging with health and wellness partners who have promised to deliver improved health to an employee population. 

I can recall the large number of health and wellness solutions that were founded on good, solid health principles that, in theory, should have achieved measurable results of lower claim costs, more productive employees, and human resources looking like a star for implementing the program.  Unfortunately many of us have lived through the excitement of engaging with a new vendor solution just to find that lack of engagement and poor results are what laid at the end of the rainbow. 

But does it have to be that way?

I’m a believer in wellness, the healthy employee, and solid health principles.  I’m also a believer in data and tracking the right things.

In some cases it may be difficult or even nearly impossible to demonstrate short-term results that would be better derived through longer term cohort analysis, statistical overviews, and years of evaluation.  To that point, there is a way.  They are called “Guideposts.”  Guideposts are the indicators that shine within the data and can tell us whether or not we are on the right path.  They are critical and particularly valuable when we’re trying to measure the health of a population. 

First the Framework 

First things first (as my grandmother used to tell me).  We need to have a method to get at that data easily and quickly and define clear profiles of our employees. 

 1. Dynamic Data Dashboards are Imperative

What are your data sources for employee data?  Do they include employee information and health data?  I find that some organizations have access to their employee data and use it, others have access and don’t use it, and then there are many who simply do not have great access. 

The only way to “get into” your employee data is to have a system that is current, easy to manipulate and accessible. 

I’ve found that organizations approach this in one of two ways:

  • Have dedicated talent who can incorporate the data using business intelligence software such as Tableau, or
  • Engage with one of the data analytic tool vendors that will provide you with de-identified data and supportive dashboards.

Either way, we need to be able to create a system of ease and access.

2.   Sub-Profiles of your Employee Populations (plural) is Key

Nearly all organizations have different groups of employees or sub-profiles.  These sub-profiles can be described by age group, type of work, geographic location, medical plan enrollment, top diagnoses, etc.  Understanding the different types of employee groups or sub-profiles that we have within our populations, provides an overview of “who’s here.”  This is found to be a more strategic approach than simply fitting all of our employees into one big bucket instead of recognizing that each sub-profile needs a little something different.

Clear Sight in Execution

The junction of having accessible employee data and detailed sub-profiles on the employee population, makes it tremendously easy to employ a health and wellness strategy and engage the best vendors to support that strategy.  In my opinion, it is the cornerstone to a successful health and wellness strategy.  We can more accurately determine the problems we wish to tackle and predict the immediate and long-term results that we expect to see.  Now on to the guideposts…

Guidepost #1 – Expected Health Data

This reminds me of our dynamic phone maps that tell us we should expect to see a gas station, store or favorite coffee spot, as we travel to our destination.  Expected health data is very similar.  We can often expect to see certain movement with specific health or employee data elements as we move forward with a new health / wellness vendor solution.  What is it that we expect to change in that sub-profile once they engage with this new solution?

An example I’ve seen is a company pay for bariatric surgery to those who have both an obesity and type 2 diabetes diagnosis.  The employer may not be able to track an employee’s weight loss however there is the ability to track reductions in diabetic supplies and drugs.  The diabetic supplies and drugs are the guideposts.  In this instance, you can see that an impact is being made and even begin to quantify that impact in your annual budgeting.

Guidepost #2 – Engagement Upticks

One of the most difficult tasks as an employer is to get employees interested and excited about a new health / wellness solution.  We may have a proven communication strategy that we use or perhaps we get lucky because the moon and the stars aligned that day.  At any rate, tracking upticks and attempting to define their existence is a good use of our time.  I would expect that this data is tracked regularly and especially after planned communication is distributed. 

I talked to an employer who had primarily been using email for communication.  They switched to their internal Slack channel and engagement in their wellness program increased.  Funny thing is that initially they did not even notice that was happening.  Regularly reviewing this data keeps us from missing those surprises and allows us to capitalize quickly.

Guidepost #3 – Unexpected Results

Unexpected results may be the most important guidepost.  What I find most fun and interesting about the unexpected results that will emerge is that they tell us 3 things:

  • They tell us something about the type of employee who is really connecting with the program.  Perhaps it’s a different sub-profile than we expected or it’s more sub-profiles than expected. 
  • They tell us that our solution produced a broader impact than expected.  Those who have bariatric surgery not only reduce their usage of diabetes medication.  They also reduce their usage of hypertension and hyperlipidemia medications and have fewer sick days.
  • They tell us when we’re off track.  Perhaps we’re looking at the wrong indicators.  Or perhaps we have the wrong vendor solution or process in place.  Both concerns are worth thought and discussion.

What gets measured gets improved

Data, Data, Data

An effective program requires that we look towards our guideposts while adjusting and adapting throughout the year.  Data is a significant tool that helps us do that.  Data gives us the info to disrupt our status quo of anemic strategies and programs and move towards real disruption leading to positive results for our employees and our organizations.

Sylvia is a strategic advisor to emerging health and wellness companies with innovative solutions for employers and their employees.  With over 15 years of an unusual array of experience including working in the employer, consulting, and health plan environments, she brings a targeted approach to new solutions achieving remarkable results in the employer ecosystem. 

Workplace Health:  Supporting the Disabilities We Can’t See

Workplace Health: Supporting the Disabilities We Can’t See

A couple months ago I attended Disability Allyship: Advocation for Abilities, an event sponsored by Breaking.Glass. This one-day conference was focused on disabilities in the workplace and employees with disabilities. Some employees come to the workplace with a disability, others may develop a disability while working. Some have a disability that we can see, others may have a hidden disabilities.

Being a person who studies health care and its cost, I’ve paid particular attention to the cost of disability. I think sometimes we expect these costs to show up as a worker’s compensation or disability claim. Of course it does, but what about the disability that we just haven’t seen yet. The type that develops from too much sitting, too much typing, and too much stress. Essentially all the challenges that are often put upon our employees everyday.

Years ago, early in my work career, I began to develop pain in my left elbow. The pain was related to all the typing and computer work that I was doing. My elbow would be sore and swollen and I would keep working. I sought the help of doctors who suggested surgery (which I was not interested in pursuing) or simply reducing the amount of work I did (again I wasn’t interested), or begin to lean on alternative support such as voice dictation. The way I chose to NOT help myself at work was by NOT raising my hand to ask for an accommodation such as voice dictation software or a more comfortable desk set-up. I chose instead, to avoid any hint that I may be on the brink of filing a worker’s compensation claim or too weak to do my job. I’d spend my spare time roaming around the office looking for more comfortable chairs that weren’t being used or making a makeshift sit / stand desk out of books and boxes.

Lucky for me after years of just dealing with this pain I connected with a chiropractor and acupuncturist that fixed my elbow within a relatively short period of time. I was lucky.

Recently I met Michelle who was not quite as lucky.  Michelle worked for years and spent many hours on the computer. She was a “go-getter” and loved the work that she was doing. As a result, she worked despite the pain in her arms, wrists, and neck until finally, one day, her arms and fingers completely froze up and she was unable to type another letter! This sent Michelle on a long journey of worker’s compensation, surgeries, disability, and depression.

She eventually was able to work again, with accommodations, which then sent her on a new journey of learning to engage with potential employers when you have a hidden disability. All of this being complicated by her own and other’s opinions and insecurities related to hiring people with disabilities.

So where do the hidden disabilities reside in our populations?  Are we seeing them in our healthcare data? Are we noticing them before they become disabilities?   What about depression, anxiety, back issues, wrists problems? Do we have policies and the culture in place to make it easy for our employees to ask for help?

  • 10% of Americans have a medical condition which could be considered a hidden disability.
  • 96% of people with chronic medical conditions live with a condition that is hidden.
  • 25% of them have some type of activity limitation, ranging from mild to severe.

The cost to an employer for a disability accommodation averages $500. The cost of a disability is much more!

If you’re looking to build a more supportive organization and more well-rounded health approach, here is list of some wonderful resources on disabilities in the workplace. Please also share your own.

Perks: Are They The New Employee Benefit?

Perks: Are They The New Employee Benefit?

Every year I teach a group of graduate human resource students about employee benefits. I begin the first class by asking my students for examples of what they consider to be a “benefit” for employees. I never provide them a definition which allows them to rely on their own experience and background. My students are all adults, having worked for years in many different sectors and sizes of companies. They come from large established corporations, small tech start-ups, and non-profits so, of course, there are varied opinions.

We begin by noting the “benefits” on a wall-size white board. Within a short period of time, the entire board is covered with examples. They range from the more traditional benefits such as medical and life insurance to offerings that we generally think of as perks. Perks such as flexible work weeks, free food, fitness trainers, computer discounts, movie tickets, child care and the list goes on and on. As we continue our discussion, it becomes clear that the differentiating line between benefits and perks has begun to blur. Essentially the board, full of examples, all represent “benefits” that employees would appreciate. The 40 year old married, mother of 3, is thrilled with true flexible time where she can easily leave work mid-day to be with her children. The 25 year old, single guy is excited about the Blue Apron discount so he can improve his cooking skills and eat healthy.

Perks bring ease to our employees’ lives. And ease means, less stressed, healthier, happier, and certainly, more productive employees.Isn’t that the goal of our wellness strategy?Here’s what I found to be the 3 primary usages of perks in organizations that are known as Great Places To Work:

Alignment – The perks are aligned with the population. I’ve found that generally perks become an afterthought in an organization. They have been around for years and often do not align with the existing employee base. Alignment is key in making perks meaningful. Perks such as longer paternity leaves and support for child care will gain a lot of fans within an organization with young parents.

Organization – Generally perks are “all over the place.” They are managed by various groups and frankly, who even knows if most of them still apply. Meaningful perks are managed just like any other program. This allows an organization the ability to keep them fresh, valuable, and take advantage of available upgrades. A valuable by-product is that the perks are better communicated to the employees.

Reporting – I would bet that many of us have perks available and we are completely unsure how often or if the perk is being used. As an example, do we know how many people have taken advantage of that PC discount? Offering perks that allow for reporting and trackingare key. Tracking is a necessary step to ensure that your perks are what your employees care about.

As I’ve worked with organizations and surveyed employees in the design of their wellness strategies, I find that often the things employees remember most are the perks. It’s the “thing” that their employer provided that brought ease and happiness into their lives, often costing the employer very little. So reconsider your perks. They can be meaningful to the success of your organization and a great support to the infrastructure of any wellness program.

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