[Editor’s Note: This is the first of a two-part series examining wellness in the 21st century. In this month’s issue, we will set forth the key issues wellness professionals believe will dominate their profession in the new millennium. Next month, we’ll explore the strategies they are implementing today as they lay the foundation for tomorrow.]

Technology with a personal touch will drive 21st century wellness

Smaller staffs, greater impact in the cards for in-house professionals

Part of the New Year’s resolutions for many wellness professionals involves doing long-range planning, which calls for a strategic vision that extends into the new millennium. Employee Health & Fitness polled fitness experts and readers to find out the driving issues as we approach the 21st century. Our findings: Health promotion professionals predict an increasing dependence on technology in the new millennium. However, they warn, this shift must be coupled with a renewed dedication to consistent, employee-friendly communications.

"We must come up with techniques that use more technology," says Dick Robson, FAWHP, MBA, MEd, president and CEO of American Corporate Health Programs Inc. (ACHP), a full-service fitness and wellness company in Exton, PA. However, adds Robson, who is also the incoming president of the Northbrook, IL-based Association for Worksite Health Promotion (AWHP), "It is critical that we maintain the personal touch in whatever way possible, as we communicate our messages to the program participants."

"More creative work situations," such as working at home, will also require more computer-based and telephonic health promotion programs, says Joan Cantwell, MA, COHNS, manager of the employee health & wellness program for Chicago-based Quaker Oats Co. "Will we be able to create programs that ensure the people who work in remote sites can get same level of quality programs?" she asks. "Even now, we are dealing with the isolation of people who are on the Internet all [of the] time."

"In the new millennium, the big thing will be using technology for wellness — for several reasons," predicts Wayne Burton, MD, corporate medical director of Chicago-based BANKONE, which was recently formed by the merger of BancOne and First Chicago NBD. "Corporations will become larger through mergers and acquisitions [Burton now oversees the health of nearly 100,000 employees], but the populations will become much more dispersed," he said. "Also, we will see an increasing number employees working from a road or home setting. We will have to have wellness programs that meet their time needs — be it Internet, intranet, video, or some other form of media."

Other predictions offered by experts interviewed by Employee Health & Fitness include the following:

• A growing emphasis on the mental health and wellness of employees and their families.

• Greater integration with managed care.

• The extension of wellness programming to the entire family unit.

• A major consolidation in the industry, with only a handful of national vendors surviving.

• A growing role for genetics and biotechnology. We will be able to identify more individuals who are predisposed to a specific disease, and begin the process of intervention much earlier.

• Professional organizations will become more important in terms of assisting wellness professionals, making certain that those who provide wellness services and programs are of the highest quality.

• Companies of the future will rely more heavily on intellectual assets.

(Wellness expert Larry Chapman offers his own personalized set of predictions. See box, p. 3.)

Technology with a human touch

Will it be possible to deliver a growing percentage of programs through technology while maintaining a human touch? Robson insists that it will — and it must.

"Certainly in the next ten years, we will be targeting our interventions much better than we have historically," he predicts. "At the same time, we will be faced with a more dispersed and diverse workforce, so intervention techniques or methodology will have to be accommodated to reaching people wherever they work."

Robson says this will be accomplished through three major forms of technology:

1. High-risk telephonic intervention: This consists of outbound phone calls placed by what Robson calls "Content experts." These are professionals who are certified or licensed in a wide variety of areas — registered dietitians, health educators, respiratory therapists, certified diabetes educators, and so forth — who have specific content expertise. "They will be calling the individual to work specifically on a particular intervention — high blood pressure, asthma, weight or stress management, and so forth," Robson says. "Over time, a sense of trust is created. If they are trained in behavioral techniques, these content experts will be able to empathize with the employee, and show a caring attitude even over the phone, which will help the employee in overcoming whatever issue they are facing."

2. Customized interactive systems: These computer-based systems entail having employees answer a series of questions that are completely customized to their lifestyle and their likes and dislikes. "The reports and materials will [be customized] at your educational level, geared to the kinds of foods you like, and the activities you are likely to participate in — with multiple alternatives," explains Robson. "Instead of a prescription for exercise or nutrition that is completely foreign to you, it will be based on the ethnicity and cultural components of wherever it is that you live. For example, if you live in New York you may get suggestions on how to order from a deli — but that just wouldn’t fly in Nashville."

3. Interactive voice response systems (IVRs): Presently, IVRs are very expensive, says Robson. An IVR allows the participant to be walked through a flow diagram’ by dialing up and speaking into a handset system. As the individual answers certain questions, the answer tree’ ultimately leads them to the most appropriate action or behavior change. Such "trees" are commonly printed today as a component of self-care programs, for example. Based on each answer, the employee is given a new set of options until they arrive at a final recommendation, such as "call your primary physician."

It’s a small world

The emphasis on a more "humanistic" wellness will spill over into how employees see themselves in the world, Cantwell predicts.

"Holistic health will include looking at how the environment affects us," she says. "We will all have to become more global thinkers in terms of health care,’ not only in terms of traditional label reading, but in looking at how things like TV ads affect people — how culture affects their health." (For more on holistic wellness, see story, p. 4.)

While wellness professionals should continue to emphasize individual behaviors, "we must also become more concerned about how we are doing as a community, as a country, as a world. As global citizens, we should become more concerned with global health — what things cause cancer, how we should buy produce, and so on," says Cantwell. "We’ve even seen how weather influences and affects people’s health."

A changing role for professionals

The next millennium will also bring dramatic changes in the role of wellness professionals, say observers. "The in-house wellness coordinator will be more of a manager, as opposed to having a number of staff under them," Robson predicts. "They will be responsible for working with outside vendors to make certain program components get delivered in the way they are supposed to. Large, in-house staffs will go the way of the dinosaur."

Cantwell also sees a similar shift. "We will almost be consultants to our employees," she says. "I see us moving toward being great vendor managers — looking at the needs of our business. Also, people like myself will be more internal consultants and advocates — building the business case for the programs, and making sure they are well-documented."

Will the total number of wellness professionals gradually shrink? Cantwell is not so sure. "Maybe they will be the vendors," she offers. "I feel more entrepreneurship is definitely happening."

As the role of the wellness manager changes, it will also be viewed as being more critical, Robson asserts. "From a strategic point of view — given the fact that corporations have pretty much seen all of the savings they will ever see through managed care and other types of savings that come through tinkering with the [health care] system — we must now address issues where the rubber meets the road. What can we do to provide people with opportunities to learn skills and have the tools they need to make changes and better manage their health or their chronic illness?"


Joan Cantwell, Employee Health & Wellness Program, Quaker Oats Company, 321 North Clark Street, Suite 163, Chicago, IL 60610. Telephone: (312) 222-8548. Fax: (312) 222-2733. E-mail: /g+joan/s+cantwell/o=usgpserv@mhs-quaker.attmail.com.

Wayne Burton, BANKONE, 1 First National Plaza, Suite 0006, Chicago, IL 60670. Telephone: (312) 732-6434. Fax: (312) 336-0029.

Dick Robson, American Corporate Health Programs Inc., 559 West Uwchlan Avenue, Suite 220, Exton, PA 19341. Telephone: (610) 594-2111. Fax: (610) 594-9079. E-mail: achpinc@aol.com.