Employee well-being

A safe environment, healthy employees, jobs that can be done without harm or injury—none of these can occur if a corporation reacts to situations only when they arise. By that time, it may be too late.

As with other innovations in the life and work of employees, IBM established a leadership position on workplace safety even before Thomas J. Watson, Jr., issued our first formal policy in 1967. IBM has a proud heritage of excellence in the execution of its occupational health and safety programs that dates back to the very beginnings of the company. IBM history

Our foundation for the management of employee well-being derives from IBM's corporate policy on "Responsibility for Employee Well-being and Product Safety." We turn this policy into action through the IBM Global Practices, which document our global standards for employee safety and well-being. Requirements and standards are universal across all IBM geographies but allow maximum flexibility for efficient implementation in a variety of cultures, work settings and regulatory environments.

Central to our holistic approach to employee well-being is IBM's global health benefits strategy, which focuses on preventive care, healthy lifestyle choices and good healthcare decision making—while providing flexibility to IBM and its employees. This includes:

• Helping employees take responsibility for healthy behavior and become more involved in treatment decisions.
• Enabling informed healthcare decision making by providing information that helps individuals choose health plans that offer optimal value and improve efficiency in the system.
• Providing technology enabled, smart delivery of innovative healthcare services.

Prevention, whether it relates to health problems, workplace accidents and illnesses, or even stress, is an underlying theme in all well-being programs. Examples of IBM's prevention programs range from providing wellness information and tools, health benefits that encourage maintaining a healthy lifestyle, stress reduction resources and workplace accident prevention plans to substituting different chemicals or processes, or even eliminating a process altogether.

In the United States, IBM works with various government agencies to develop and support solutions to the national healthcare challenge, including tax advantaged employment based healthcare accounts, innovative nonemployment-based demonstration projects, healthcare process redesign, universal access, and improved patient safety and healthcare quality.

The GWBS organization has developed strategies and initiatives to combat these issues in an attempt to drive the market to change the way healthcare is purchased, delivered, and consumed.

1. Purchasing healthcare right….going beyond health plan design:

We arm people with the resources needed, including online tools, to help them process information about their healthcare providers, because we believe employees/enrollees are central in making important improvements in the healthcare system. In addition, we engage our health plans to ensure that they are contracting with providers who have demonstrated a commitment to improving quality and adopting measures such as those highlighted by The Business Roundtable’s Leapfrog Group (http://www.leapfroggroup.org/), of which IBM was a founding member.

2. Encouraging community collaboration in delivering care…..the road to eHealth:

Of the many issues plaguing our healthcare system, none are more vital than the ability for providers to access important patient information when they need it to make clinical decisions at the point of care.

IBM is at the forefront of a national movement to transform healthcare and encourage widespread adoption of electronic health records. A key Well-being and Health Benefits strategic objective for 2005 was to provide a positive influence on national healthcare policy. We have numerous IBMers who are participating in national forums and other organizations to advance the agenda for healthcare reform. One of the key agencies we support is the National e-Health initiative, also known as EHI, in Washington, D.C. EHI is a broad coalition of diverse stake holders that are focused on enhancing healthcare quality and safety through the broad application of information technology.

In October of 2005, IBM and eight other IT companies, who have formed the nine company Technology CEO Council (TCC), committed to adopt electronic health records based on open standards. For IBMers in the United States, the company is already meeting that commitment. IBM's active work force in the U.S. has access to a personal health record (PHR) application, a first step toward the kind of networked health that the company is striving to foster. It offers content tailored to personal needs, and is designed to help participants become, and stay, as healthy as possible with a long-term goal of making patient data securely available to healthcare providers such as hospitals and emergency personnel when and where information is needed.

IBM's roll out of PHRs in 2005 came on the heels of the report it delivered that year as part of the TCC. In a TCC commissioned study, 86 percent of U.S. Physicians surveyed said that a healthcare system that adopted information technology such as electronic health records would improve the quality of healthcare patients receive.

The National Digital Medical Archive is one example of this type of system. GWBS team members have been working with other IBM groups to communicate the availability of the National Digital Medical Archive (NDMA). NDMA now allows women to securely record and store personal medical history, participating in an unprecedented national health effort to find a cure for breast cancer and discover better diagnostic tools and treatment options.

GWBS is a catalyst for healthcare change. Through our participation in the National Business Group on Health, we are actively encouraging payers and health plans to adopt health information technology as a condition of business and are striving to have them require their healthcare providers to adopt health information technology as a condition of their business.

GWBS also provides leadership and tools to help communities collaborate. Two of the more noteworthy projects are THINC in New York State and NCHICA in North Carolina. The Taconic Health Information Network and Community (THINC) is the premier community health information exchange project in which we're currently involved. THINC involves multiple hospital systems and multiple laboratories and multiple payers. The project has been highlighted in the Poughkeepsie Journal, Time Magazine, and the New York Times.

Back in 2004, a physician's portal was introduced by THINC, providing the ability for participating doctors to electronically sign their transcriptions of their clinical reports. In 2005 and 2006, an electronic prescribing initiative has been introduced where doctors will create their prescriptions electronically and deliver them directly to the filling pharmacies, thereby eliminating handwritten, paper interfaces. In 2006 and beyond THINC will start to incorporate electronic healthcare records so that the episodes of patients’ healthcare encounters will be recorded into the system electronically and stored so that they can be shared amongst other providers of one’s healthcare.

THINC physicians will have a rich set of health information readily available on each of their patients in electronic format. Your problem list will be readily identified, any recent procedures that you have undergone, your allergies and medications will be clearly delineated, and any results of laboratory tests that have been recently performed will be displayed online. And summaries of any care that one may have received from other participating physicians, so-called "continuity of care" records, will also be an important element of the THINC physician portal. And, starting in 2006, the THINC electronic prescribing portal will allow physicians to create and deliver prescriptions directly to the dispensing pharmacies, eliminating easily misinterpreted handwritten prescriptions.

Another similar community project is NCHICA, or the North Carolina Healthcare Information and Communication Alliance. The value to IBM employees in electronic prescribing is patient safety and reduction of medical errors. This is the key strength of the NCHICA project and our endeavors with THINC in New York State as well.

3. Consumer-provider behavior is key:

Beginning in January 2006, IBM provides financial incentives to employees who elect to participate in a preventive care rebate program designed to help them become better healthcare consumers. In addition to completing an online health risk assessment and taking action toward recommended health screening, employees will be empowered to select and use healthcare providers that have demonstrated a commitment to improving quality of care.

IBM is engaged in provider-incentive initiatives as well. The key message behind paying additional incentives to providers for reengineering their practice and/or adopting information technology is that we recognize that the current incentives for quality and efficiency are misaligned (the current system rewards volume rather than outcome), and it includes rewarding physicians who have been recognized under NCQA’s (National Committee on Quality Assurance) physician practice connection and the new Bridges to Excellence healthcare quality initiative. BTE is a healthcare quality initiative that realigns incentives to physicians for meeting nationally accredited quality measures.

In a move that will improve healthcare in the United States as well as IBM's bottom line, the federal government awarded contracts in November, 2005 to four consortiums, one of which is led by IBM, to help automate health records, accelerating the use of modern computer technology in healthcare. The government's role is to set goals and require that companies link doctors' offices, clinics and hospitals in computer networks using open data standards so that information can be easily shared. Each of the four groups can use different technologies, as long as one local network can pass patient and other health information back and forth to other networks.