High tech to high touch

Pur­due Univer­sity’s Can­dace Shaf­fer takes aim at Type 2 di­a­betes with vir­tual coaches.

Employee Benefit News - - Contents - By Phil Al­bi­nus

Pur­due Univer­sity’s Can­dace Shaf­fer takes aim at Type 2 di­a­betes with vir­tual coaches.

Can­dace Shaf­fer had a real chal­lenge, and the only fix was a vir­tual so­lu­tion.

When she was named di­rec­tor of ben­e­fits for Pur­due Univer­sity last Oc­to­ber, Shaf­fer was tasked with two pri­or­i­ties: tack­ling chronic diseases, and im­prov­ing the ac­cess of care to the state col­lege’s 12,000 fac­ulty and staffers on three cam­puses in four lo­ca­tions, with ex­ten­sion pro­grams in all of In­di­ana’s 92 coun­ties.

It was a chal­lenge that re­quired new part­ner­ships, cut­ting-edge tools and novel ways of tack­ling a prob­lem. From high tech to high touch, the Pur­due grad­u­ate and em­ployee ben­e­fits vet­eran — and EBN’s Ben­e­fits Lead­er­ship in Health­care win­ner — is poised to see the re­sults of her vi­sion.

Af­ter be­ing pro­moted to ben­e­fit di­rec­tor fol­low­ing her stint as in­terim di­rec­tor, Shaf­fer’s first tar­get was Type 2 di­a­betes. “It’s one of our top chronic diseases in preva­lence and cost,” she says.

Shaf­fer and her team of around 25 ben­e­fits pro­fes­sion­als de­ter­mined that Type 2 di­a­betes was one of the eas­ier chronic diseases to ad­dress be­cause of the mul­ti­tude of health pro­grams that ad­dress the con­di­tion through diet, ex­er­cise and life­style change.

“There are lots of [so­lu­tions] out there, so it seemed it might be eas­i­est to start to tackle and then move on,” she says.

Af­ter re­view­ing sev­eral health plans that at­tempt to re­duce the risk of Type 2 di­a­betes, her ben­e­fits team part­nered with Virta Health to pro­vide on­line coach­ing to fac­ulty and staff mem­bers. Virta Health aims to re­verse the dis­ease with­out the use of drugs or surgery, re­ly­ing on vir­tual coach­ing to spur pro­gram par­tic­i­pants into healthy habits.

Type 2 di­a­bet­ics and pre-di­a­betic in­di­vid­u­als who are in­ter­ested are ad­vised to ad­here to a ke­to­genic-based diet (low in carbs, high in pro­tein). They re­ceive a scale, lit­er­a­ture and nu­tri­tion guides and other sup­plies to help them tran­si­tion to that way of eat­ing, she says.

Par­tic­i­pants can in­ter­act with a Virta Health coach via tele­phone, mo­bile app or Skype. “You get as­signed a coach who works with you on mak­ing that shift in life­style, and then [you] work on main­tain­ing that life­style,” she says. “The fo­cus was Type 2 di­a­betes or pre-di­a­betic with a cer­tain BMI.”

Ac­cord­ing to Virta Health, who nom­i­nated Shaf­fer for the Benny Award, when Pur­due signed up for the pro­gram, its plan was clin­i­cally sound but not yet com­mer­cially proven. So far, Shaf­fer is hear­ing that the re­sults have been pos­i­tive and promis­ing.

Of those Pur­due em­ploy­ees who en­rolled in the Virta Health pro­gram, 43% of the high/very high risk di­a­bet­ics have im­proved risk com­par­ing higher than those not en­gaged at 35%. Thirty-six per­cent of those with a BMI greater than 30 in 2017 have de­creased their BMI cat­e­gory in 2018, and 45% of par­tic­i­pants with an un­con­trolled blood pres­sure in 2017 have de­creased their BP into a con­trolled range in 2018.

“What we’ve got­ten back from em­ploy­ees and Virta is that it’s go­ing well,” Shaf­fer says. “Peo­ple are ex­cited and they’re get­ting health­ier.”

Shaf­fer and her team are not stop­ping at Type 2 di­a­betes. They are mak­ing plans to im­prove fac­ulty and staff ac­cess to men­tal health ser­vices as well.

“We have em­ployee as­sis­tance pro­gram sys­tem-wide and that doesn’t seem to be a prob­lem,” she says. “The prob­lem is [with] folks who need longer-term coun­sel­ing. There seems to be a shortage in most of the com­mu­ni­ties where our em­ploy­ees live with their fam­i­lies.”

Shaf­fer, who grad­u­ated from Pur­due with a bach­e­lor’s de­gree in child de­vel­op­ment and a mas­ter’s in fam­ily stud­ies, notes that men­tal health ser­vices have been a grow­ing con­cern for the state col­lege’s stu­dent pop­u­la­tion, which is cov­ered by a sep­a­rate pro­gram.

“Is there any­thing to do to­gether to try to get at men­tal health as a whole? This is some­thing that we’re try­ing to do, and we’re just now start­ing to fig­ure that out,” she says.

Shaf­fer’s sec­ond ma­jor ini­tia­tive was im­prov­ing the pri­mary cam­pus’ on­site clinic. Start­ing last July, the univer­sity part­nered with One to One Health, a physi­cian-led health­care fa­cil­ity man­age­ment provider based in Chat­tanooga, to op­er­ate the Center for Healthy Liv­ing fa­cil­ity on its West Lafayette cam­pus.

Em­ployee en­gage­ment with the clinic has in­creased, and One to One Health has added ad­di­tional well­ness pro­grams. Clinic med­i­cal per­son­nel in­ter­act and con­sult with the em­ployee’s pri­mary physi­cian to co­or­di­nate care and di­ag­noses. Just as im­por­tantly, the newly en­er­gized clinic now ac­cepts walk-ins.

“Be­fore, if you didn’t have an ap­point­ment, it was a cou­ple days be­fore you could get one. One to One Health’s man­age­ment has fig­ured out how to take in walk-ins,” says Shaf­fer, adding that the school is look­ing to ex­pand the clinic’s hours and of­fer train-the-trainer well­ness pro­grams.

Ca­pac­ity from the first quar­ter of 2018 im­proved more than 30% year over year, driv­ing a bet­ter than 90% sat­is­fac­tion rate among pa­tients. These re­sults and the pos­i­tive feed­back have spurred Shaf­fer to of­fer Pur­due em­ploy­ees tele­care op­tions in all of the Hoosier State’s 92 coun­ties.

“We still want them to be able to have ac­cess to that coach­ing re­la­tion­ship if they’re will­ing to do that, and so they can now do tele­phonic coach­ing, too,” she says.

Shaf­fer and her team are con­stantly check­ing the re­sults of their ini­tia­tives, whether it’s a new clinic man­age­ment group, the Type 2 di­a­betes pro­gram or the school’s HSA, FSA and other well­ness plans.

“Just be­cause you im­ple­ment some­thing doesn’t mean you stop. We’re al­ways check­ing and recheck­ing and au­dit­ing. If per­for­mance guar­an­tees are ap­pli­ca­ble with some ven­dors, we are mak­ing sure that they’re do­ing their part,” she says. “We get con­stant feed­back from em­ploy­ees and from our own in­ter­nal staff, so it’s an ever-mov­ing process.”

One of the chal­lenges in de­liv­er­ing in­no­va­tive health­care ser­vices is not just cre­at­ing the pro­grams, but also in in­form­ing fac­ulty and staff that they are up and run­ning and avail­able. As in a cor­po­ra­tion with mul­ti­ple satel­lite of­fices, some Pur­due Univer­sity plan par­tic­i­pants are of­ten un­aware that cer­tain ser­vices are avail­able in the first place. Telling Pur­due em­ploy­ees that they have ac­cess to fam­ily-friendly ben­e­fits, in­clud­ing pre- and post-natal care, that they have four op­tions for flex­i­ble work ar­range­ments, plus paid parental leave as well as flex­i­ble spend­ing ac­counts and health sav­ings ac­counts is a full-time job.

“We have [em­ploy­ees] com­ing straight from high school or col­lege at 18 or 22 all the way to ac­tive em­ploy­ees who are in their 70s and 80s,” she says, not­ing that ben­e­fits com­mu­ni­ca­tion and ed­u­ca­tion is key.

When asked what she loves most about her job, Shaf­fer says it’s work­ing with her team.

“We hold each other ac­count­able. We’re very trans­par­ent and hon­est about what’s work­ing and what’s not work­ing, and noth­ing gets left off the ta­ble. You can put any sug­ges­tion out there,” she says. “When you have that at­ti­tude, you can do lots of great things. We’ve been able to do a lot in the last few years, since I’ve had the op­por­tu­nity to have this po­si­tion. It def­i­nitely would not be pos­si­ble with­out all those folks.”

“Just be­cause you im­ple­ment some­thing doesn’t mean you stop. We’re al­ways check­ing and recheck­ing and au­dit­ing.”

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