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HR Magazine, January 2005 - HR Technology - Doc in a Box

Dawn S. Onley  1/1/2005
 

HR Magazine, January 2005Vol. 50, No. 1

Wellness specialists credit health-monitoring kiosks with saving time, money and lives.

Automated health screening stations at Frank Fuentes' workplace are helping keep him off blood pressure medication and out of the doctor's office.

Fuentes, an office equipment coordinator at American Honda Motor Co. in Torrance, Calif., credits the noninvasive, computerized monitoring stations with giving him and other Honda employees the key to managing their own health: timely information.

Fuentes says he has used the screening stations consistently over the past decade to monitor his blood pressure and to get alerts when he has picked up weight. "I was on medication once before. They told me I couldn't get off it until I lost weight," Fuentes says, adding that he checks his blood pressure every few days now at one of the stations. "By doing the reading, I can tell whether I need to exercise."

Computerized Screening Inc. (CSI) of Sparks, Nev., sells the Health Station used by American Honda and other employers to help employees like Fuentes get fast health assessments at their worksites.

American Honda has used the stations for more than 10 years. Workers in the security department requested that the machines be installed in the workplace after seeing how they were used in supermarkets.

American Honda safety specialist John Duehring says that at first the company leased the kiosks, but they proved to be such a major hit, with thousands of uses each month, that officials decided to purchase them to complement a corporate wellness structure that includes an on-site fitness center, wellness seminars and free exercise classes. Honda now owns 11 Health Stations spread across more than half a dozen major facilities and plans to buy nine more stations, Duehring says. Employees use the stations in cafeterias and break rooms.

Touch-Screen Testing
The Health Station comes in basic and advanced models and measures users' blood pressure, heart rate and weight noninvasively. To use the machines, employees sit down at what resembles a combination workbench and mini-entertainment center with touch-screen computers that will walk users through a variety of tests.

To measure blood pressure, users put their arms into a standard blood pressure cuff and rest their elbows on a table in front of them. In some models, a scale built into the seat measures weight. Health Stations, depending on the options purchased, also can monitor other signs such as spirometry, the measurement of lung strength and capacity used by physicians treating breathing issues such as asthma.

Other tests, driven by question-and-answer sessions with the computers, look at users' lifestyles and health choices, such as their level of exercise or smoking habits. The answers help the station generate a personalized health risk appraisal, which places users in government-defined health risk categories.

Bob Sullivan, CSI's executive vice president, says an upgraded version offers enhanced features including Internet links, through a secure server, to let users reach their health care providers or pharmacists on the web. This model also features a drug encyclopedia and a database that ensures medications are compatible. Some models include connectivity that allows videoconferencing right at the station. Stored in the stations are hundreds of health tips and educational videos on everything from alternative medications to nutritional supplements and herbal remedies.

The stations contain customized information on local health care providers including physicians, hospitals and crisis centers.

Use of the Health Station is "completely patient driven," Sullivan says. "The patient is involved in his own health care. This is giving people the ability to understand what their health status is."

Prices for Health Station models range from the Model 3K at $3,495 to the Model 6K at $6,995. Options, such as more tests and information databases, vary depending on the employer's needs, Sullivan says. CSI has 3,500 stations in workplaces, supermarkets and other locations across the United States and Canada. According to the 26-year-old company, its health-monitoring stations are in about 60 percent of Fortune 500 companies.

There is at least one other manufacturer of such health monitoring machines. Medical Screening Services Inc. of Niles, Ill., markets its Vita-Stat health stations, which measure blood pressure, heart rate and weight, calculate body mass, and provide educational information on hypertension, exercise, weight and diet.

Fuentes says he likes being able to monitor his blood pressure. But he says he wishes his company machine gave users a weekly or monthly tip on what they should eat as well as on new medical discoveries.

Some employees are skeptical of the station's readings, Fuentes adds. "Some of the people are not aware that the machine gives you a true reading. People are a little apprehensive about trying to use it. They can have high blood pressure without knowing it."

Keeping Data Private
CSI's Health Stations also allow users to establish their personal medical records in the station's system. The user can bring in records of doctor's visits, hospitalizations or prescription drug use and load that data into some models. Employees need not worry that their bosses could peruse their personal medical information, Sullivan notes. The Health Insurance Portability and Accountability Act (HIPAA) requires increased security for employee health information and imposes criminal and civil penalties for employers that don't comply. In keeping with HIPAA, Sullivan says, neither employers nor CSI can access employee-specific information. The Health Station encrypts such information, and users can access it only with a personal identification number known solely to the employee.

Employers can choose how their Health Station model stores data, Sullivan adds. Some stations are truly stand-alone, with all data stored at the station at the employer's site, while others store data on servers based at CSI. "But we do nothing with the patient-identified data internally, nor do we have access to it," he says.

Although employers cannot access an employee's individual data from the stations, employers can get aggregate data to see what employee populations are using the monitoring stations and what their health concerns are. Then employers can use that data to develop health programs to address issues identified in the data, according to Sullivan.

For employers who wonder if they might be liable should an employee use a monitoring station and then fall ill, Sullivan notes that each time a CSI Health Station gives a user a measurement such as blood pressure, it also displays a disclaimer that points the user to a physician or health care professional for any follow-up.

Cost-Effective Wellness
About four years ago, a blackjack dealer at the Cal-Neva Resort & Spa in Lake Tahoe, Nev., suffered a heart attack and passed out at work. The dealer survived, but the incident prompted senior wellness officials at the upscale casino and resort to take additional steps to promote employee wellness.

The resort, which had long mandated CPR classes for managers and had external defibrillators on-site, was already proactive about employee health, but after the dealer's heart attack, officials felt they could do even more, says Rick Talbot, Cal-Neva's chief of security and director of employee wellness and safety. Cal-Neva purchased a Health Station to give employees and resort visitors a way to monitor their health.

That move may have prevented another calamity last October when the resort's director of engineering, who felt under the weather, decided to test his heart rate. The director, who suffers from ongoing heart problems, sat down at the Health Station and quickly learned that his heart rate was racing at more than 200 beats per minute.

Cal-Neva is considering purchasing another monitoring station. Talbot, who acknowledges he's in a high-stress job, says he uses the station daily to monitor his own blood pressure and heart rate. About 3,000 users each month access the resort's station. Talbot adds that the station helps not only employees but also resort guests, many of whom are unaccustomed to the high altitude of Lake Tahoe.

"We're at 6,200-feet elevation, and the air's a little thin," Talbot explains. "We get older folks here. I've taken guests, complaining of shortness of breath, to the machine myself."

Sullivan recalls the story of a man at another workplace who was noticeably red in the face and was told by another employee to check his blood pressure at their company's health-monitoring station. When he did, he learned it was off the chart, and he had to have immediate bypass surgery, Sullivan says.

Talbot believes the stations save his employer money and increase productivity, although Cal-Neva doesn't keep statistics on how much it believes it saves due to the stations.

"This is saving health care dollars. Just think of what you save if you save [on] hospitalization for cardiac arrest [if the machine catches heart irregularities before an attack]. It's a real lifesaving possibility," Sullivan says.

While American Honda also doesn't have any metrics in place to measure whether the monitoring stations have helped reduce absenteeism or increase productivity among the workforce of 3,040, Duehring says user feedback shows that employees use the kiosks widely. For example, just at the company's headquarters, there are 1,000 uses of the machine a month. And Duehring says he hears from employees all the time-asking for more machines.

"All we go by is how many people are using the machines," he says. "We know that when we have the machine set up in one area and we move it, we get a lot of phone calls."

AstraZeneca, a pharmaceutical manufacturer headquartered in Wilmington, Del., is another employer using the monitoring stations. Amy Milhorn, senior manager of corporate health services, says the three CSI Health Stations her company owns definitely have saved her and her staff time. Milhorn has three full-time and two part-time nurses on her staff who don't have to do as many blood pressure readings and other tests as they used to.

"Instead of employees coming to the nurses to get readings, they use the machines," Milhorn explains.

"CSI provided the basis for a program that enabled us to cost-effectively reach all employees," says Milhorn, whose company has 5,500 employees. "We provided a complete wellness program to the entire staff of our corporate headquarters at minimal cost and great efficiency. We spent far less than if we hired additional health care practitioners, and [we] reached a much greater number of people in a lesser amount of time."

Dawn S. Onley is a Washington, D.C.-based freelance writer who specializes in technology issues in private-sector and federal workplaces.
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