Firms go wireless with wellness apps

Some employers are turning to wireless technology, such as cell phone applications that track physical fitness activities, to enhance their wellness efforts.

As more employees rely on iPhones, BlackBerrys and other smartphones to communicate at work and at home, some employers are launching pilot projects to help workers use the devices to better manage their health.

At Baptist Health in Little Rock, Ark., many employees who had trouble managing chronic conditions weren't signing up for the employee wellness program, said Paula Suter, director of Baptist's Center of Excellence for Chronic Care Management. So the health system began testing a new model of care targeting workers with frequent hospitalizations or emergency room visits for poor management of diabetes, heart failure, asthma or chronic obstructive pulmonary disease.

Baptist offered incentives for signing up, including reduced medication costs, a fitness center membership and free glucose meters and strips. Each of the 43 participants was given access to either a BlackBerry or a Bluetooth-enabled MedApps mobile wireless health monitoring system for transmitting blood pressure, blood glucose readings or other health data to a central network for nurse health coaches to assess.

Each device has its pros and cons, although younger employees loved getting feedback on their phone via Raleigh, N.C.-based Confidant Inc.'s diabetes management application, Ms. Suter said. With either technology, preliminary findings suggest diabetic employees are getting better control of their blood sugar, hemoglobin A1c and cholesterol levels.

“I think that the biggest benefit is that the nurse gets to see information in real time, and then usually if there's an issue, she's going to call them and do a more in-depth assessment over the phone,” Ms. Suter said.

Participation in workplace wellness and disease management programs traditionally has been limited, and sustaining participants' interest over time is a challenge. Some experts believe the growing popularity of mobile applications may energize those efforts.

“The benefit is, you have a feedback loop and it's interactive, so you're not just kind of writing stuff in a journal and hoping for the best,” said Fraser Edward, manager of market development for health care at Waterloo, Ontario-based Research In Motion Ltd., a developer of wireless solutions for BlackBerrys. “You're actively getting feedback from some kind of health coach in the background.”

Robert McCray, chairman of the Wireless-Life Sciences Alliance in San Diego, credits the ubiquity of cell phones, their power to compute and communicate, and the emergence of small, inexpensive, remote sensors that can synchronize with cell phones with creating the perfect environment for the programs.

“Out of all that, some of us are optimistic that we are going to be able to actually crack the toughest part of disease management, and that is to influence people's behavior,” he said.

The cell phone has “considerable potential value” to employer wellness programs, said LuAnn Heinen, vp of the Institute on the Costs and Health Effects of Obesity at the Washington-based National Business Group on Health, although she doesn't believe the technology will motivate people who lack the desire to change. “I think it will make it easier for someone who is motivated,” she said.

The most visible health and fitness applications, or “apps,” are those that phone manufacturers and service providers are offering for individual download. Apple Inc.'s iPhone App Store, for example, lists dozens of apps, including programs that track calories consumed and burned, act as a personal fitness trainer, and help smokers quit.

“There's no filter on the quality of those apps,” cautioned Vivian Distler, research manager with the Institute for the Future's Health Horizons Program in Palo Alto, Calif. But many are free or relatively inexpensive, starting at $1 or $2, “so it is not a big deal to try an app out, see if it works for you and, if not, move on to the next one,” she said.

Some disease management and wellness vendors are building wireless applications into their programs, with no additional fee for mobile access.

Sensei Inc., a Humana Inc. company based in Boca Raton, Fla., has developed a weight-loss program that works like a virtual dietician and weight-loss coach. Users plug in their dietary preferences and receive customized menus, shopping lists and tailored advice by cell phone and desktop. Robert Schwarzberg, Sensei's president and chief executive officer, said the program encourages individuals to make healthier choices “one meal at a time.”

A 2008 pilot with Humana's workforce led to numerous system updates, and now three employers are testing the revamped program.

Being able to offer the program on a wide range of cell phones is a distinct advantage, he said, because not every employee has access to a desktop computer, and that's particularly true for truck drivers, sales people and employees in other types of distributed workforces.

“It's very hard to get them engaged in a health and wellness program of any kind,” Dr. Schwarzberg said.

At RedBrick Health Corp., a Minneapolis-based health services company that develops tools to assist members of consumer-driven health plans, an activity-tracker application is in the works. Members will be able to track calories burned, steps taken and miles logged while engaged in physical activity like gardening, walking or riding a bike, said Abir Sen, the company's co-founder and chief strategy officer. The app is slated for rollout in early 2010 and initially will be available only on the iPhone.

OptumHealth Inc., a UnitedHealth Group Inc. company that provides services to improve health quality and lower benefit costs, is eyeing mobile applications as a way to interact and set goals with consumers, said Karl Ulfers, vp of OptumHealth Care Solutions in Golden Valley, Minn. The company is looking to capture individuals' day-to-day weight and activity levels, for example.

Medical device and technology companies are developing systems that link a biometric device to a cell phone.

WellDoc Inc., a Baltimore-based health care company that develops technology-based health solutions, is testing applications that provide real-time feedback on patients' blood glucose readings via most cell phones.

A randomized clinical trial of the system involving 225 members of CareFirst BlueCross BlueShield is in the works.

Results aren't in yet, but in an earlier pilot involving 30 patients, those in the intervention group achieved, on average, a two-point drop in their hemoglobin A1c within 90 days, noted WellDoc CEO Ryan Sisko.

It's estimated that every percentage-point drop in A1c blood test results reduces the risk of diabetic-related complications, including eye, kidney and nerve damage, by 40%, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

SymCare Personalized Health Solutions Inc., a Johnson & Johnson affiliate, is taking a more conservative approach with the use of wireless technology. Its inTouch diabetes management system, cleared by the U.S. Food and Drug Administration in April, wirelessly transmits a patient's blood glucose readings from a meter to a secure Web site.

Using proprietary algorithms to identify trends, the company shares the results with the patient, the patient's doctor and his or her nurse coach. To protect patient privacy, the cell phone never retains sensitive medical data, said Eric Compton, general manager at SymCare in West Chester, Pa.

People leave their phones in planes and taxis, he reasoned, and they wouldn't want a stranger or co-worker accessing that information. Patients, however, may elect to receive feedback from their caregivers by text message if they wish, he added.

So far, few employers are interested in wireless, two-way connectivity, noted Michael Canning, a principal in Deloitte Consulting L.L.P.'s Health Plans Practice in Boston. But that easily could change as results of pilot projects roll in.

“I just think it's going to take more time to see if you can actually affect behavior change,” he said.

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