Cisco Connects Integration and Prevention to Keep Young Workforce Healthy

When a small group of computer scientists from Stanford University founded the hightech company Cisco in 1984, they envisioned changing the way people connected by using the Internet. Today the Cisco mantra “Connected to the human network,” resounds around the world as the company helps people communicate and collaborate in business, education, government, healthcare, entertainment, and philanthropic settings.

This connection theme is also reflected in the way Cisco’s health management team operates. Cisco is leading the way for a highly integrated approach to improved health for employees and their families, always with the understanding that mental health is a major component of overall health.

To give some examples of Cisco’s integrated approach, internal departments are connected with external health vendors, healthcare services with mental health services, and the disease management program with prevention.

Cisco has grown rapidly to global proportions. In order to recruit and retain its highly skilled employees and protect its valuable people assets, Lisa Jing, M.A., Human Resources Manager, told Mental HealthWorks that the company has incorporated a strong compensation and benefits package with an emphasis on preventive health. Cisco’s young workforce, as expected, is quite healthy compared with many companies with older employees. The purpose of the integrated health management program is to keep its employees healthy as they age.

Establishing an Internal Health Management Team

In 2005, Cisco hired Pamela Hymel, M.D., as its first medical director. She pulled together a five-person internal health management team, including Jing. Hymel charged the team with the task of developing an integrated approach to keep healthy people healthy, mitigate the risk of those with health problems, and overhaul disability management.

HealthConnections

One of the team’s innovations was development of a comprehensive integrated approach named HealthConnections. It sends a branded image of health messages to employees with information about program components and helps support shifts in individual and cultural thinking and behaving.

HealthConnections includes quarterly broadcasts—called “HealthConnections Live”—that feature health experts, public service announcements shown on Cisco’s internal television network, and audio programs available for download. According to Jing, these programs have been popular and provide a venue for covering potentially sensitive issues, such as stress and depression.

Last year Cisco received a Best Employer for a Healthy Lifestyle Gold Award from the National Business Group on Health (NBGH) for its HealthConnections program. NBGH also gave Cisco two Behavioral Health Awards that year: one for its autism benefit and one for its participation in a study about the negative impact of stress, anxiety, depression or sleeplessness on productivity and wellness.

Cisco's HRA

A major component of HealthConnections is assessing and stratifying the status of employee health. Cisco has partnered with WebMD and Matria for the content of its health risk assessment (HRA) and engaged Ingenix and Human Capital Management Services to analyze the data and track risks. The HRA includes questions on depression, anxiety, and bipolar disorder, as well as productivity questions from the World Health Organization Health and Work Performance Questionnaire (HPQ).

The World Health Organization Health and Work Performance Questionnaire (HPQ) is a self-report instrument designed to estimate the workplace costs of health problems in terms of reduced job performance, sickness absence, and work-related accidents and injuries.— R.C. Kessler et al. described the HPQ in the Journal of Occupational and Environmental Medicine (JOEM) in February 2003. See also the report by Kessler et al. about using the HPQ to evaluate indirect workplace costs in the June 2004 issue of JOEM.

Participants are stratified, and follow-up or referrals are offered according to their level of health risk. Those with no or low health risk are directed to WebMD for information on and support of their healthy lifestyles. Those with high risk, say for major depression, are directed to disease management programs provided by Matria.

Cisco’s HRA is offered yearly to employees just before open enrollment begins. By using incentives ($100-$300 discounts on health plan contributions), Cisco increased employee participation in the HRA from 40% in 2005 to 52% in 2006.

Healthy Partners Council

Recognizing that not all health problems can be prevented, Cisco incorporates a unique approach for integrating assessment, employee health education, and a coordinated continuum of healthcare.

Cisco formed the Healthy Partners Council comprising 12 internal departments and 30 outside vendors, called “partners.” The internal partners include human resources, benefits, communications, fitness centers, cafeteria, information technology, and workplace resources. The external partners include the health and dental plans, benefits consultants, fitness providers, and health content specialists.

Each year the Council holds a summit with Cisco’s health management team to review the previous year’s activities and plans for the next year.

Monthly Health Themes

The Council also selects monthly themes from the National Health Observances calendar (see margin note on page 5). “Theme teams” meet two to three months before launching a theme and then hold weekly conference calls to identify the target audience, brainstorm about ways to approach the topic, and decide program elements. Vendors frequently help in sponsoring events.

An example of one month’s theme at Cisco was “Healthy Parent, Healthy Baby.” It included a full-day program of speakers, videos, booths, a fashion show, information on postpartum depression, and an infant massage demonstration. More than 300 employees and spouses attended.

The U.S. National Health Observances calendar (produced by the U.S. National Health Information Center) includes the days, weeks, or months devoted to promoting specific health concerns. For example, February includes Heart Health; October includes Mental Health Screening Day.

Autism Practice

Another focus is Cisco’s integrated approach to childhood autism. When employees identified autism as an area of concern, the health management team worked with parents and their health plans to redesign benefits so that families had access to comprehensive assessment and effective treatment.

Experts in autism provided brown-bag educational seminars, and the health management team began a dialogue with local provider groups. This relationship building prompted families who have autistic children and receive treatment to develop informal networks for sharing information among themselves and with the benefits department. They even identified clinicians who were highly effective in treating children with autism, some of whom now provide therapy at discounted fees to Cisco employees. Jing noted that parents, clinicians, and community groups have all given accolades to the effort.

Partnering with Behavioral Health Vendors

Cisco works closely with its behavioral health partners—United Behavioral Health (UBH) and Cigna Behavioral Health; disease management partner, Matria; and disability management partner, the Reed Group—to develop proactive integrated strategies for early identification of employee absence, employee education, coordinated care, and successful return to work.

Cisco offers a full-service EAP to employees and their dependents, regardless of health plan enrollment, through UBH. The EAP Web site includes extensive online educational resources and selfassessment tools. EAP benefits include eight free counseling sessions per presenting issue. If treatment extends beyond the eight free sessions, the employee or dependent is referred to his or her behavioral health plan. Referrals for legal and financial consultations are also available.

An important feature of the EAP is a consultation service for managers and supervisors to assist them in handling difficult situations related to their manager role. For example, managers may call for integrated coaching and consultation from EAP, behavioral health, and/or disability management services to coordinate a return-towork plan for an employee they supervise.

Measuring Impact

Cisco measures outcomes such as trends in healthcare spending, changes in employee health risks, quality of life indicators, absenteeism, presenteeism, and productivity. It is currently participating in a twoyear study with UBH and Harvard Medical School to compare two types of treatments for depression, anxiety, fatigue, and/or sleep disorders. One group is receiving basic resources through the EAP and the other receives intensive outreach through individual face-to-face and/or telephonic counseling.

“Employers must have a holistic view of employees,” said Jing. “They come to us as a whole package with unique skills and talents, physical and mental needs, and varying levels of motivation. Our challenge is to encourage employees to be healthy and productive and to keep them sharply tuned and interested in the work they are doing. We want each person to feel valued and tied to the business and to his or her own health.”

About Cisco Systems, Inc.

Cisco Systems, Inc., is a worldwide leader in networking and developing communication devices. It has more than 200 offices worldwide and about 57,000 employees. Its U.S. headquarters is based in San Jose, CA.

Nancy Spangler, PhD, OTR/L is a consultant to the Partnership for Workplace Mental Health and the American Psychiatric Association Foundation.

Last Updated: January 2008