Guideline to A Successful

Worksite Wellness Program

8th December , 2014

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Delivering a successful wellness program

Contents
1 Back ground ...............................................................................................................................3
2 Introduction to Wellness.............................................................................................................3
2.1 Wellness Model ..................................................................................................................3
2.2 Best practice criteria............................................................................................................4
3 Wellness Committee...................................................................................................................4
3.1 Planning..............................................................................................................................4
3.2 Promoting ...........................................................................................................................4
3.3 Implementing .....................................................................................................................5
4 Selecting a Vendor ......................................................................................................................5
4.1 Vendor Selection Criteria .....................................................................................................5
5 Program Design ..........................................................................................................................6
5.1 Health Screening .................................................................................................................6
5.2 Health Risk Assessment .......................................................................................................6
5.2.1 Components .......................................................................................................................... 7
5.3 Comparator.........................................................................................................................9
5.4 Personalised Coaching for HRA .......................................................................................... 10
5.5 Corporate Dashboard and Analytics ................................................................................... 10
5.6 Annual Engagement .......................................................................................................... 10
5.6.1 Access to Online Content..................................................................................................... 10
5.6.2 Health Tips .......................................................................................................................... 11
5.6.3 Health Newsletters .............................................................................................................. 11
5.6.4 Medical Encyclopedia .......................................................................................................... 12
5.6.5 Ask Expert............................................................................................................................ 12
5.6.6 Doc ‘Round the Clock........................................................................................................... 13
5.7 Health Support Program for ‘At Risk Employees’ ................................................................ 13
6 Indicative Pricing ...................................................................................................................... 14
7 Annexure ................................................................................................................................. 15
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1 Back ground
This document details a guideline to deliver a successful worksite wellness program to a large corporation
with employees spread across multiple locations.

2 Introduction to Wellness
• A comprehensive best practice wellness program involves all employees, deals with all major health
risks, offers choices, and provides periodic evaluation of its results. A comprehensive best practice
program emphasizes follow-up and offers support for the employee. Studies have shown this
approach to be highly successful.

2.1 Wellness Model

• A robust wellness program is the one which will enable employees to take more active role in
managing their health and wellness. It is based on the following methodology:

• Assessment: The first step in the wellness program is to assess Employee’s state of health.
• Improvement: Programs to improve employee’s health on an ongoing
• Management: Where there are employees who are afflicted with disease, they would need disease
management programs
• Educate: Ongoing educational programs
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2.2 Best practice criteria

• An annual plan for wellness is a useful management tool and some of the best practice criteria
include -
o Employ features and incentives that are consistent with the organization’s core mission,
goals, operations, and administrative structures.
o Operate at multiple levels, simultaneously addressing individual and policy in the
organisation
o Target the most important health-care issues among the employee population.
o Engage and tailor diverse components to the unique needs and concerns of individuals.
o Achieve high rates of engagement and participation, both in the short and long term, in a
defined “core program.”
o Achieve successful health outcomes

3 Wellness Committee
• Wellness committees are important in that they create a sense of ownership in the program and
facilitate various tasks involved in wellness programming at the workplace.
• The committee should be composed of a cross-section of employees representing various
occupations, levels, locations and subgroups with the organization.

3.1 Planning

• Planning the program can include:

o Finding space for activities
o Planning and organizing worksite-wide events such as contests
o Reviewing reports prepared by the program staff and making recommendations

3.2 Promoting

• Promoting the program can include:

o Recruiting workers to take part in screening, health improvement programs, and events
o Encouraging workers to take part in follow-up counseling
o Organizing promotional strategies using newsletters, signs, bulletin boards, computers, and
other media available within the workplace
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3.3 Implementing

• Helping to implement the program can include:

o Helping to conduct worksite-wide activities
o Acting as wellness mentors to fellow employees

4 Selecting a Vendor
• Wellness is a complex subject and in selecting a vendor to provide a wellness presentation or
program activity, the wellness committee should make a decision based on a number of factors:
o Does the vendor have credentials and experience in the relevant program area?
o Is the program evidence-based to promote wellness?
o Is the vendor available at times convenient for employees?
o Does the vendor have a demonstrated record of reliability in providing programs?

4.1 Vendor Selection Criteria

• When selecting a vendor for a large organization the following criteria would provide a benchmark
o An integrated health management services company with year-long engagement capability
o Ability to service in multi locations and at least have 20 centers in Metros / Tier 1 locations
for comprehensive health check evaluation since a health screening program needs to
provide multiple opportunities for participation
o Has serviced a client with 5000+ employees spread across locations
o Has signed multi-year contracts with clients since wellness is a long term goal
o Has multiple programs including a health risk assessment and disease management program
since the menu approach works best
o The Health risk management tool must not only look at lifestyle factors but also a person’s
family history, health status and biometrics
o Ability to deliver personalised dashboards on all programs to encourage employees to set up
their own personal wellness goals
o Ability to provide coaching services since one of the most successful ways of helping
individuals change and improve is to be coached on an one on one basis
o Ability to service onsite to address participation which is a major concern in all wellness
programs
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5 Program Design
• A best practice Wellness program offers a variety of tools, resources, interventions, and educational
resources to offer something that will appeal to any employee. A two year program can be structured
in the following manner

Year 1 Year 2
Full fledged Health Screening Basic Health Screening
Health Risk Assessment
Health Risk Assessment Comparator
Personalised Coaching on the Personalised Coaching on the
HRA HRA
Annual Engagement including
health tips, newsletter, Ask
Expert and Doc 'Round the
Clock and Medical Health Coaching for At Risk
Encyclopedia Individuals

Annual Engagement including

Analytics Dashboards at the
Corporate Level
health tips, newsletter, Ask
Expert and Doc 'Round the
Clock and Medical Encyclopedia
Analytics Dashboards at the
Corporate Level

• The section below will provide a snapshot of these program offerings as provided by Vidal Health.

5.1 Health Screening

• The backbone of wellness programming at the worksite is health screening. It is the first major
activity a company should do when starting a wellness program.

• This is a program that will provide inputs to prevent lifestyle diseases such as diabetes, hypertension,
heart disease and cancers.
• In year one, an extensive screening can be done followed by a simpler one in Year 2. Please see
Annexure for details of the health screening components.

5.2 Health Risk Assessment

• A Health Risk Assessment (HRA) is frequently used in conjunction with a health screening. An HRA is a
computerized assessment tool, which looks at an individual’s family history, health status, and
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lifestyle along with the biometrics from the health screening. An HRA seeks to identify precursors
associated with illness
• Vidal would offer its proprietary Healthex methodology for the employees.
• Healthex is a clinically validated health assessment methodology – customized for the Indian market
– and developed by Milliman Consulting – Vidal’s Knowledge Partner. Milliman is an internationally
renowned clinical and health management actuarial consulting company.

5.2.1 Components
• The Healthex program has the following components:
o An online Clinical Assessment Program (CAP)
o Telephonic health coaching session with a doctor
o Telephonic nutrition coaching session
• The graphic below shows the workflow for employees:

In the above flow:

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o At the start of the program, employees would be sent an invitation email and welcome kit
with a link to the online Clinical Assessment Program (CAP) to be completed. The CAP
assesses each employee on 14 dimensions – including personal medical history, biometrics,
family history, current diet, physical activity patterns, work life balance, emotional health etc.
This online questionnaire is important as it helps provide a full health risk profile of the
employee.
o Once the questionnaire is completed, the values form the biometric screening is also
incorporated.
o The graphic below shows a sample of the User Mypage with the summary of the Healthex
report

- The score on the top of the page is the Healthex score. The employee would be able to see his profile
in terms of key metrics in the “My Health Profile” panel.

- The top right panel shows the “at risk” current health status for a number of common diseases in
India. This helps the employee understand the interplay of family history and lifestyle factors - both
of which contribute to the “at risk” status
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- The bottom left panel shows specific aspects of the employees’ health where he/she is doing things
right.

- The bottom right panel shows the “Health Road Map”. This is a customized road map which shows
the path to the target Healthex score for the employee.

5.3 Comparator
• In the second year, a detailed comparator with the previous score and risk ratings will be provided to
track improvements or otherwise.
• During the coaching session, the GP will also focus on this.
• A snapshot of the comparator is provided below. The comparator focuses on the below elements –
o Healthex Score
o Biometrics
o Risk Rating of Lifestyle factors
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5.4 Personalised Coaching for HRA

• Programs which incorporated individual counseling / coaching as part of the program process
achieved significantly higher participation rates and achieved greater risk reduction/risk elimination
than standard group programs.
• The results of the biometric screening (i.e. the reports) together with the Healthex score would be
used by the doctor to provide a personalized coaching session. The coaching session is a 20 minute
session, which focuses on reviewing the health profile of the employee and then focuses on the
specific steps of the Health RoadMap to improve the Healthex score.

• A nutritionist will provide a personalized session lasting 15 minutes which focuses on a diet recall and
dietary suggestions based on Healthex.
• The idea in to create a personalized, actionable and measurable health improvement program.

5.5 Corporate Dashboard and Analytics

• One of the big benefits of an HRA is that it can provide an aggregate group report of a company and
can be utilized as an evaluation tool.
• To this effect, Vidal Health would provide a full analytical profile of the employee base. This can be
customised to locations or cadres.

5.6 Annual Engagement

• In guided self-help, the wellness counselors provide support, materials and encouragement to help
employees make life style changes
• Healthy Living promotes healthy lifestyle by creating a culture of wellness through content. Overall
learning is enhanced with innovative and creative ways that are used to deliver information to create
a culture of health.

5.6.1 Access to Online Content

Articles
• Articles are created by the content management team and are updated every month. These are
available to subscribers only.
Health Tools
• These health calculators provides an approximate overview of current status of health condition
across areas like:

Diet

Fitness
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Lifestyle
Find facility
• This provides access to a vast database of hospitals, diagnostic centers and specialists from the Vidal
network.

5.6.2 Health Tips

• “Tip of the Day” – is a short (less than 20 words); graphically illustrated email which is sent to
employees every morning – which has small pieces of information about maintaining on-going wellness.
Sample of this is included below.
• Close to 250 tips will be sent in a year.

5.6.3 Health Newsletters

• The Health Newsletter – HealthMatters – is a monthly publication which provides information on all
five areas of wellness – Diet, Exercise, Lifestyle, Health and Stress Management. These articles are
research backed and are meant to provide in-depth understanding to employees.
• 12 monthly newsletters will be sent in a year.
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5.6.4 Medical Encyclopedia

• Medical Encyclopedia helps manage health better with most credible and comprehensive collection
of information on wellness. It offers easy access to research based information written in simple
language on everything from diseases, lab tests, surgeries, injuries, first aid, exercise, nutrition and
much more.

• This web based service provides volumes of health information which included A-Z look up, search
and navigation of favorite topics
o Reference of health care articles written in simple language, videos, illustrations and animations.
o Detailed medical case studies, complementary and alternative medicine information is available.

5.6.5 Ask Expert

• Vidal will provide its ‘Ask Expert’ email based query facility to the employees of GE India.

• Facility available for queries related to

Diet and Nutrition

Stress and Work Life Balance

• The query facility is manned by internal or empanelled experts in the field of Nutrition / behavioral
sciences.

• The email based queries are answered within one working day.
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5.6.6 Doc ‘Round the Clock

• Vidal would provide Doc 'Round The Clock - a 24x7 instant helpline that provides quick assessment of
an individual’s health-related symptoms. With this service, GE India employees will have direct access
to a qualified doctor over the phone.
• Key features are:
o 24x7 Telephonic Medical Guide
o Available Across India
o Simple Question & Answer Based Tool
• Symptom-Based Intelligence System.

5.7 Health Support Program for ‘At Risk Employees’

• A health support program must do the following once the At Risk individuals are identified -
o Review employees’ health risks and make sure the employees understand them.
o Contact employees who have health risks.
o Counsel employees on a one-on-one basis, helping them set goals, solve problems, and get
expert help when they need it.
o Help employees follow their treatment and make lifestyle and health behavior changes.
o Recruit employees into health improvement programs, such as weight loss and smoking
cessation.
• Vidal Health presents a comprehensive support program for employees who are at risk of high
cholesterol or diabetes. Program design includes the following:

• Following are the program components:

o Enrolment and User sensitization
o Baseline clinical tests and Initial counseling - note that the baseline readings would be from
the annual health check.
o Follow up counseling via the phone
o Review of base line tests at the end of the program. The base line tests are as below and are
dependent on the risk category

Tests for health coaching program

FBS PPBS
Lipid profile
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o End of program dashboard

• Counseling details :
o Telephonic calls would be made on a regular basis to registered employees and their
progress and compliance will be tracked
o Sample call schema has been shown below for the telephonic counseling

At Risk Population
Call 1: Confirmation of handover profile / Intro / Rapport
Building and Disease Information / why they’ve been chosen
for the program (what risk factors and combination) and what
will the program will do.
Call 2: Disease Progression and how to manage /
Complications of disease
Call 3: Diet review
Call 5: Exercise & Physical Acty
Call 6: Stress Mgt
Call 6: Obesity
Call 7: Eating out – weekend diets / Festival diets
Call 8: Co – Morbidities: Dyslipidaemia & CVD
Call 9: Annual review – Drug / Diet / Exercise.

6 Indicative Pricing
• It is important to realize that keeping healthy employees healthy provides the greatest opportunity
to make gains in productivity.
• Best practice programs make provisions to triage at-risk employees but provide services to maintain
and support healthy employees.
• Such a solution will be both cost effective as well as cost beneficial.
• The table below provides an indicative pricing for such as program -
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Year one Program Price per life in Rs.

With prescribed mandatory tests as in Annexure
7.1 4000 - 4500
With prescribed mandatory and optional tests as in
Annexure 7.1 7000 - 7500
Year 2 Program Price per life in Rs.
With health check as prescribed in Annexure 7.2 1500 - 2000
Health Coaching Program for At Risk Program will
be priced additionally 2000 - 2500

• The proposed product structure and pricing including workflows if any, are indicative, and are for
discussion only.

7 Annexure

7.1 Extensive Health Screening

Male Female
CBC CBC
ESR ESR
Diabetic Profile (Fasting Blood Sugar Diabetic Profile (Fasting Blood Sugar
and Post lunch sugar) and Post lunch sugar)
Urine Test Urine Test
Stool Test Stool Test
Lipid Profile Lipid Profile
Renal Profile Renal Profile
Liver Profile Liver Profile
X-ray Chest (PA) X-ray Chest (PA)
TMT TMT
Thyroid Stimulating Hormone (TSH) Thyroid Stimulating Hormone (TSH)
USG - Whole Abdomen USG - Whole Abdomen
Prostate Specific Antigen PAP Smear
Additional Test - Male Additional Test - Female
Dexa Bone Densitometry Dexa Bone Densitometry
Mammography
25 OH test (Vit D) 25 OH test (Vit D)
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7.2 Basic Health Screening

Male / Female
HAEMOGRAM
• Haemoglobin
• P.C.V
• R.B.C
• MCHC, MCV, MCH
• Total W.B.C.
• Differential Count
• E.S.R
• Peripheral Smear
• Platelet Count
BIOCHEMICAL PARAMETERS:
• Fasting & PP Blood sugar
• Creatinine
LIPID PROFILE:
GENERAL TESTS:
• Complete Urine analysis
• E.C.G. (Resting)
• X-Ray (Chest)