Fit for Duty podcast: Episode 3.

[00.00] Hello and welcome to Fit for Duty — a podcast from Aetna International.

Because we know that organisations — large and small — recognise that their future growth and success depend on their people, so we’re here to help build a healthy, happy, productive workforce.

Fit for Duty brings you insights on some of the biggest health and well-being challenges and those forces shaping the corporate health landscape today. I’m Lorien Norden, global content marketing lead for Aetna International. I’ve spent years having conversations with some of the most fascinating and well-informed clinical, well-being and health care experts out there. And now this new podcast, we’re bringing those thoughts and those insights directly to you, along with strategies you can put into place today to help your employees flourish. Because you know that when your people thrive, your business will too.

We hope you find our discussions interesting but valuable. And if you want to get in touch with us for any reason, please do so via LinkedIn.

[01.02] Today I’m back with Simon Miller, the Senior Director of Customer Proposition here at Aetna. We’re going to be looking at all the factors and influences that will be shaping the corporate health and wellness landscape in the months and years to come and looking at the challenges facing organisation implementing corporate wellness programs.

[01.22] Hi — I’m joined by Simon Miller again. We spoke a couple of weeks ago, and Simon, thanks ever so much for joining me again. And would you like to re-introduce yourself for anyone who missed our first podcast?

Yeah, hi Lorien, great to be back. I’m Simon Miller and I head up our product and proposition development for Aetna International, and obviously a very key part of our proposition for our members is our health and well-being services and support.

[01.50] Great, so why I invited you along today is I really wanted to talk to you about the corporate health and wellness trends that are set to shape the landscape over the next 12-24 months really. So, in terms of corporate health and well-being then, what I really want to understand, Simon, is why are you so passionate about it; why did you get into this field in the first place?

Yeah, I think personal reasons and then also through the observations of the support that we provide for our members. I’ve been involved in the health insurance industry UK and internationally now for 15 years and you know we, as an industry, certainly 10-15 years ago were largely focused on paying bills when stuff goes wrong for people, and we do a wonderful job of supporting people in those moments of need. But I think as an industry if i look back to when I started out we weren’t really doing as much as we could as an industry I think to prevent those risks, to help people understand preventative actions or positive actions shall we say rather than necessarily always prevention but to reduce the impact, to intervene early. And what we certainly weren’t doing was seeing the interconnection, you know in a medical sense we refer to these things as comorbidities but if we look at [it] in a holistic sense the impact of physical health on mental health, the impact of sleep, on diet, the impact all these things have in terms of your susceptibility to disease, immune systems, your ability to recover, all these things are absolutely connected and therefore I think for me, yes, we did a great job of helping people at their moment of needs but there was more we could do to produce a better health outcome for the well, the worried well as well as just for the people who were ill. So from a role perspective that was something I was very passionate about but from a personal perspective I take a lot of pride in trying to be at my best and being at my best, being at my happiest and most energised, being the best dad, husband and boss I can be usually happens those things all come together in terms of my well-being when I’m feeling fit and active, when I’m making time for that, when I’m sleeping well and eating well for example, so just personally I recognise the impact of that. I’m one of those people who will happily preach and share what I can with others looking to take steps in those actions so it’s just something I’m very passionate about personally and fortunately I happen to be working in a role where that’s incredibly important to our customers too in what we do and aim to deliver on and so I’m very lucky in that respect.

[4.42:] So, in terms of ensuring that employees are engaged with their health, that they take advantage of the health and well-being programs that are being put forward by the organisations whilst they are obviously catering to the demand of employees. How can they make sure that employees do take advantage of these programs and do get involved for their own, their own health benefits?

Okay, yes, well in our recent research ourselves, we’ve seen a massive disconnect between what employers think that they provide to employees already and what employees think that they have available to them. As much as a sort of 50% disconnect and even greater in some regions and in some cultures. And I think that’s down to a few things. I think use a good question, are they employers providing the right things for individuals? Recognising that one solution certainly doesn’t fit all. But even beyond that, are they effectively communicating those and delivering those in a way that employees can really understand the support and tools that are available for them, how they’re relevant for them, how to access them, when to use them, what they should expect from them. So, that promotion of those information, that education, is a big challenge. But also delivering those in the right channels at the right time for individuals and making it easy for them to access. And even when that is done, I think there’s a real challenge around what the adoption and engagement levels are from employees. So, you know, even some of the best solutions we’ve seen on say mental health solutions, for example, that employers are providing. You know, at best, you may get 10, 20, 25 percent uptake rate and that’s not a bad thing. It’s just merely a reflection that there is a significant world of need here for individuals, a lot of different solutions. You know, if we look at something like mindfulness for example, you know there are more than 400 mindfulness apps in the app store and for a very good reason. Because a lot of different approaches suit a lot of different needs and requirements. So it’s very hard for an employer to deliver against all those different needs and all those different requirements. And that means coming back to a really strong analysis, gap analysis, knowing your employees, and really investing in the things with the biggest impact for the most people. And that’s as much around positive well-being and for example positive mental health as it is about necessarily addressing mental health illness and treatment.

[04.53] Yes, absolutely and you’re not alone. There are a number of CEOs and industry leaders that are obviously very invested in their health and well-being for exactly the same reason, they know that they perform better and they can support their teams and organisations better as a result. So, as we have grown in understanding as an industry, how is it that investment in corporate wellness is changing and attitudes towards well-being on the same par as sustainability, for example, what are your thoughts on that?

Yeah, we’re certainly having totally different conversations with clients now than we were, as I say when I set out in the industry. When I set out in the industry we had annual reviews with clients around their health insurance expenditure and the focus was just on that, the expenditure, of course that’s still incredibly important, but we’re now speaking to clients who are as much focused on the utilisation and who is utilising in our organisations, making sure that people have access to the support and resources and making the most of that investment and that’s great. And particularly younger audiences, workforces who perhaps aren’t fortunately yet suffering from major, long-term chronic conditions but are dealing with everyday ailments, stress, future risk prevention opportunities and employers really really want to support that. So, I think there’s been a shift in terms of perception of the role health care and health care cover for insurers, so we’ve got a great and different conversation going. I think in terms of well-being specifically, I think we’re seeing a shift from what I would say was perhaps a slight sort of tick the box duty of care role historically around provision of some resources to now recognising the link to not only meeting those requirements which are of course incredibly important as well in terms of risk management and risk prevention, but also in terms of the link through better employee happiness, well-being, engagement and outcomes which means better business outcomes and customer outcomes and so we’re seeing that link, so we obviously still have to justify our return on investment on health and wellbeing initiatives, but I think we’re getting a much more mature conversation now around really understanding what that return on investment actually encompasses. Yes, there’s some hard measures as I think we alluded to in our last conversation — productivity, absenteeism and attraction and retention — but also some of those softer measures around employee happiness, satisfaction, energy. So one of the things I think we’re starting to see now is traditional official employee engagement survey starting to mature as well around asking those questions in a little bit more of an empathetic, understanding and holistic way rather than a traditional net promoter score, net satisfaction score-type of way. So, seeing lots of trends in terms of the drivers. And, fortunately I think we’re also seeing lots of trends in terms of the drivers and fortunately, we’re also seeing lots of advances in terms of the solutions. I think we’re seeing a democratisation of access to healthcare resources through some of the digital technology and enablement that’s out there now, meaning that we can bring cost-effective access to first step, high quality health care to individuals on their terms when they want and how they want. And I’m referring here to things like apps, wearables and at-home health care devices and I think the evolution of those as well means employers aren’t just relying on traditional solutions, albeit very important as they are, things like EAP and access to structured counselling but also now bringing in proactive engagement solutions for those staff and that’s really exciting and I think it’s changed the agenda and conversation and I think employers are recognising that changing the value and assessment value of doing these things within an organisation.

[09.25] No, absolutely and I wanted to touch on something that you mentioned as well. You talked about the gradual change over the last 10-15 years in terms of influence on culture. I know that over the past 12 months, so in 2019, it was predicted that the dimensions of well-being, or social determinants if you like, were predicted to be increasingly well understood and applied. Is that one of the trends that you would agree you saw emerging in the last 12 months, and are there any others?

Yeah, I think that recognition of those social determinants — it’s not the greatest phrase, is it, social determinants in health care, it’s very structured. So what do we actually mean by that? You know, those aspects of connectedness, community, the ability to engage with things that are of value to you, sense of purpose whether it’s coming to work or at home, faith as well, all of those things are I think recognised now a lot more in terms of the contributing fact they make to health outcomes. And there’s been lots of research on that, so I think there’s certainly an acknowledgement of that and particularly given the turbulent world that we’re now in where people are I think questioning their purpose an awful lot more and we’re seeing that transcend through to the decisions people make about who they work for, where they work, what level of aspiration they might have in terms of financial wealth over other factors. And these are all good things, I think, these are good questions to be answered and I think it poses new challenges for employers in terms of being meaningful employers, meaningful brands, doing the right thing and being held accountable to do that, having a genuine, credible social corporate responsibility, even the shift from people wanting to work for social enterprises now and give something back. So, these are the trends we’re seeing in the market that I think are related to that and the more progressive organisations are certainly waking up to that, that might be a bit derogatory ‘waking up’, but I think are certainly now moving and adapting to that, but what we do need to do is make sure that isn’t just boardroom speak, that isn’t just coming from the top as PR marketing value and shareholder value but it is actually extending down to what actually employees do and how they interact within the workplace with their managers and colleagues on a day-to-day basis. So, good trends, good shift, still a long way to go I think in terms of that being universal and certainly for that actually applying throughout the workforce in the actions every day.

[12.28] So, we talked about and you mentioned purpose just now and employees really having a greater sense of purpose and wanting to be connected to organisations with that greater sense of purpose. So, I wanted to understand from you, in terms of employee demand, how do you see that changing and why is it important for organisations to pay attention to employee demand?

Yeah, so ultimately as we all know, we’re at our best when we’re doing something that we believe in, that we’re passionate about, that we’re devoted to and I think that’s what we mean when we talk about sense of purpose. If I come into work each day and don’t really believe in the product that I’m involved in, if I don’t really believe in the values of the organisation, are you likely to get the best out of me — short term or long term? So, I think that comes down to a number of things. I think companies clearly communicating that purpose and being authentic and credible in that and that’s everything in terms of not just being a mission and a vision statement but how a company acts, a culture, a charter, the way it treats suppliers, the way it treats customers and of course how it treats staff as well. So, i think it starts there very much in terms of having an authentic, credible culture, so then if an employee can understand that they can then make a decision about whether they align to that and then as part of that making sure that that translates down to their job, objectives and role definitions and making sure they’re cast within the right role and I think that’s often where sense of purpose comes back to. And so one of the things that quite often we’re called upon for is greater support in behavioural change and, not necessarily in behavioural change relating to specific health or well-being condition per se but to just life change you know life change; having that life coaching support, having a conversation with somebody who can talk to you about what it is you want to achieve, what’s relevant to you, goals, aspirations and actually is what you’re doing aligning with what you’re saying you want to achieve? So that’s actually something we’re proud to have as part of our resources available to our members and I think it’s hugely important to be able to provide access to as people sort of question and define their sense of purpose and make sure they have those life goals aligned to, and ways and paths to achieving those.

[15.12] Yeah, absolutely and I think there is a sense of purpose that is associated with your career and working life and one with your life outside of work. And achieving a work-life balance is increasingly important for people and I think that also ties in, as you said, with that sense of purpose. So, what other trends are we seeing in and around the work-life balance, achieving that overall lifestyle sense of purpose as well for yourself and your family… what are we seeing on that front, and is that of interest, and should it be of interest to organisations?

Absolutely, Lorien, it’s a great point. We’ve all heard about the 24/7 permanently on work culture now that is unfortunately for all the great that technology has done for us it is something that’s manifested and is struggling to switch off when we leave the workplace. So, this divide between work and homelife is not as black and white as that and it is leading to a huge imbalance at times, at all levels, this isn’t just at executive level but front line staff taking customer issues away with them overnight because customers no longer act on a 9-5 basis either. So, this is a significant challenge and you know I think the way, in answer to your question, employers are reacting to that is to re-look at workplace culture, environment and policy. Things like flexible working, recognising that if I am going to require you to work more outside of traditional working hours, then perhaps there’s more flexibility within working hours as well, perhaps to achieve things like your well-being goals within work time, you know have that time to go to the gym that you might have done normally in the evening during core working hours, perhaps when it’s quieter at the gym, on the basis you might be expected to still be on after 5pm with some work issue. So, we’re seeing greater flexibility around that and things around holiday and leave, for example. And I think there are some really interesting examples of companies now that are providing unlimited leave to their workforce on the basis that they obviously believe that their workforce are bought into their sense of purpose in the organisation and want to achieve those goals together and will take leave as and when they need it, on their terms, for their own well-being and support, but are unlikely to actually abuse that. So, that’s a really interesting stage of maturity when a company can get to that sort of stage of trust and alignment between employee values and business values as well. So, really interesting times but, you’re right, increasingly less of a distinction between home and work and therefore an increasing importance to look at work-life balance holistically in terms of policy and culture setting.

[18.30] So you believe that that will continue to influence health and well-being within a company culture over the next 12 months and beyond… What else are we likely to see emerging in the next year or so?

So, in the next year or so, happening right now, I think it’s been really interesting over the past few years on people and organisations focusing an awful lot on end solutions for people at need – which is great, don’t get me wrong, to help people for example in mental health who are diagnosed or are symptom aware. What I think we are seeing is a shift now to actually what I would call sort of positive well-being, or positive mental health, of actually investing much more in terms of up front awareness, education, resilience building. I mean that’s been happening already but I think it’s embedded an awful lot more over the last couple of years and will continue to be so. So I think that will continue to be a trend. I think we’re going to see a lot more emphasis in terms of measurement: what is the impact of this; what are we doing well; what aren’t we doing well. An aggregate potentially anonymised dashboard, but I think where trust builds up I think we’ll also see employees potentially happy to share their data if it will be to better outcomes. So if i share my health data with you, can you direct me and navigate me to more personalised and curated resources? So I think we’ll start to see some interesting conversations and developments around that and, again, that will come back to company culture and trust a lot as to how effective some of that is. So, a shift also to as you referred to earlier recognising the broader dimensions of well-being and health and in particular I think I’ve seen several surveys just over the new year where employers are saying that the most important place they’re looking to place investment is around financial well-being and I think we’ll continue to see some really interesting developments in that space. There’s been some really interesting solutions that have been developed to support financial coaching to both ends of the spectrum — people who struggle to pay bills at the end of the month, to people who are trying to manage investment portfolios in very uncertain and volatile economic climates. So that investment in safeguarding, building and protecting of the future in terms of finance and education around finance, really important, but also practical tools to help with people with day-to-day issues, so for example payday loans through responsible, sustainable providers linked in to salary deduction that can help people get back on track. And that’s particularly important in organisations, if you consider retail for example, what proportion of a retail organisation is actually frontline staff on minimum or not far above minimum wages. So the employer itself and the salary may be the very cause of the health and well-being and stress issues, so to speak, so a real duty of care required around that and a real recognition that if you don’t get control of that, not only does it lead to issues around turnover, absenteeism, presenteeism but manifests in lots of other issues like health and disability claims and illness claims as well, so a real expenditure to an organisation.

[22.09] So, looking at those other areas of well-being, the other dimensions of well-being as well, you’ve mentioned financial, I’d be really keen to understand that from an internationally globally mobile expat perspective as well. Some of the issues that you mentioned there, potentially around minimum wage, aren’t necessarily going to impact the globally mobile out there, so how does that financial well-being and how do those services then differ for an international employee base?

Yeah, it’s a really good point. A typically more affluent, more senior globally mobile audience are less likely to be facing those challenges, as you say. However, even then I’d say the nature of expats and certainly the people we’re seeing enquiring around international private health insurance is changing significantly as well so an increasing amount of sole traders or gig workers, as they’re often referred to now, freelancers, who aren’t necessarily millennials but might be retirees or shall we say retirees from the corporate career, who are now consulting and freelancing. So these people have similar sort of challenges, you know they rely on the contracts that they have which are usually short term and those can mean a lot of peaks and troughs in terms of financial dependency and they’re trying to manage small businesses, their own businesses at the same time, so I think we’re seeing a different face of expats in that sense. But also our audience also includes inpats as well, you know people working for organisations in the sub-continent for example, particularly in the technology sector who will be sent on assignments contracts for 6, 9, 12 months or 18 months to the U.S. or to the UK or wherever that might be and they’re doing that to earn money for themselves but also sending money back home as well. So I don’t think we should just think of the expat as the traditional high-flyer who is sent to the Hong Kong banking sector or whatever that has been, I know we’re not, but there’s a lot of different dynamics and needs going on in there and a lot of different challenges for individuals and for organisations to deal with.

[24.37:] Another aspect of the dimensions of health and well-being that i wanted to talk about is social connectedness and the relationship between social connectedness and corporate health and well-being programmes for expats (again, sticking with the expat theme). We did talk about it in our previous podcast, but I just wanted to understand what the future holds in terms of organisations helping their employees maintain that connectedness as they move, work and travel and live abroad. What are your thoughts on that, Simon?

Yeah, this is so important Lorien. There’s loads of studies and lots of surveys out there now, we can’t deny that human relationships are at the core of well-being and quality human relationships… it’s not necessarily the volume (how many people I’m connected with) although there are some correlations there, but around the depth of those relationships, and meaningful relationships, the frequency of contact and you know I think not just in the workplace but in the world in general now, that is increasingly absent, you know, we rely on technology for short conversations but gone is the sit down and write a letter, the opening up conversation and that’s having a real impact in and outside of the workplace and you’ll be well aware of obviously particularly within the younger generation and the dependency on sometimes somewhat superficial or artificial conversations and relationships through social media platforms etc. So, this is a real issue and it’s highlighted as one of the key threats to health and well-being moving forwards. In terms of the international workplace, of course, obviously that remote nature of one’s role and working in communities and environments where I might not have that natural connectedness to people like me, people who I can open up to and discuss my thoughts and feelings with in a natural, conversational way is a real challenge and we know that that is absolutely at the core of mental health and mental well-being, you know, that ability to have that open conversation and that simple question of ‘how are you today?’. And, doing that over the phone and doing that over email is, as we know, not the same thing. So, these are real challenges within the workplace, I think acknowledging those and then designing your manager training, your expat training and some of the resources available around it are extremely important.

[27.28] Simon, you mentioned about assessments and risk assessments earlier, and in terms of holistic health and well-being for individuals through using technology as a means to help an international workforce succeed and employees succeed in their assignments. What are the trends that we’re likely to see emerging in the next 12 months with regards to technology and helping people stay healthy and well?

There has been a fantastic wave of health tech and digital health innovation and there’s some fantastic solutions out there. But, within the workplace, the adoption of those is nowhere near the rates that we’d all like that to be and the drop-off rates of those digital solutions are very high within that. Now, I think part of the challenge with that is that there are just so many different solutions suited to so many different people’s needs that personal preference will always rule with this, and it’s going to be very hard for an employer to pick the right solution that's going to be the right thing for the majority of people. So, i think what we’re probably going to be likely to see is how some of these things come together in sort of ecosystems where the core service is not necessarily the tool but is the services, whether that be human, bot, app, whatever that happens to be that helps understand you and guide you to personal health care pathways and almost sort of prescribe solutions, tools, support to help you based on a really sort of detailed understanding of your goals, your aspirations, your holistic desires and holistic health needs as well as taking advantage of leveraging your data, obviously with your consent to do so. So I think we’re going to see some of these things starting to come together now in aggregated solutions into what I refer as ecosystems and also coming back together with physical solutions. So I don’t think it’s digital or physical, it’s digital and physical we should be aiming for, and I think the developments within tele health environments like our own vHealth solution are trying to bring those things together for professional support that can then hand off into appropriate solutions that might not always be drugs or treatments or in a clinical setting like a hospital is the key development I think we’re all sort of working towards and making some good progress on.

[30.42] So, you’re potentially talking about an environment in which you maybe have a digital entry point that then hands you over and conducts the triage, hands you over into the care of a human being for that personal touch and whether that personal touch comes remotely or in close proximity, in a face-to-face environment. So is that what you mean by the phy-digital evolution?

Yeah, wherever that starting point may be, and that will be different for different people, I think that’s the important thing, not everyone’s going to come through an app or a digital triage, not everybody’s going to come through a pharmacy or a GP conversation, so it’s got to be something that’s fairly flexible. But in principle, yes, a journey, a pathway that engages people and then signposts based on data based on tailored outcomes into appropriate solutions which may be self-help or it may be inter-professional support but I think also then beyond the professional support what I’m referring to is I think we’re going to start to see a shift to that professional support also prescribing self-help and at-home solutions and things like digital therapeutics which I think is a great thing if that reduces dependency on medications and the addictive nature of some of those, if it bring down health care costs. Now that I think isn’t right for everybody and therefore the important part is having that health professional support within that. But in the U.S., for example, with Aetna it’s been great to see within CVS we’re working with companies like Sleepio who have clinically validated sleep therapeutic programmes and we’ve been able to prescribe that as part of your benefits, whereas traditionally insurance benefits might only look to cover what we would look at as traditional treatments in physical locations, settings and medications so we’re now recognising that as an important part of the health care solution. Another example with Aetna in the U.S. at that engagement level is our pilot with Apple at the moment through Aetna Attain and this is really, really exciting because it’s combining both an engagement platform for people to use the Apple Watch or even earn an Apple Watch and monitor and track their activity through all the capabilities that Apple bring but also to do that with combining data - with their consent - from their pharmacy and health care records so that we can provide these really personalised nudges. For example we can see that you’ve missed a prescription or vaccination check or check-up and direct them back into services like our CVS pharmacies to get them back and keep them back on track. And this is really, really important in terms of adherence. And you can imagine, you know, as that data set builds and as there’s greater consent in sharing that data where this can go to… If I was able to log on my watch how I’m feeling today in the mood tracking, you know, is that something that we can then intervene with when there are dips in terms of then prescribing some of these programmes that we have available in a really personalised and targeted way. So, I think the solutions are out there but the bit that needs to evolve and what I’m referring to here is those pathways, those journeys, those member experiences that put the right solution into the right person’s hands at the right time.

[34.31] It’s quite a challenge for organisations really to understand which route to provide for employees and how to really help them navigate that health and wellness menu of options… What do you see as the biggest challenge facing organisations in trying to implement and cater to some of these emerging trends?

Errm, I think it depends on where they are on the maturity curve already. I mean if you’ve already passed the point of your board, your organisation recognising the importance of investing in this space and not necessarily being totally ROI-driven but more holistically driven around why we do the things that we do, then I think that gives somebody whose responsible for internal programmes a lot of different leeway to somebody whose at a more immature stage, shall we say, where they’re justifying why we need to do the things we do in the first place. So I think it will be different things for different organisations but I think there are some good frameworks out there that people can use to sort of score and assess where they’re at in the maturity curve. You know, if you look within mental health in the UK, the MIND charity, for example, provide a very robust framework, the MIND Index that helps understand where we sit on that index in terms of our mental health support and development and quite often what comes out of those is actually it isn’t necessarily about prioritising investing in new tools, it’s about culture, training, leadership, policy, return-to-work policy, for example, it’s about having the right conversations in the workplace and creating the right working conditions and environments and giving people the tools for the job, upskilling them in basic things like time management… If you haven’t got basic time management training, you may well be stressed if there are high demands on you in your role. So, quite often I think it helps gather focus and these are perhaps the important foundations we need to get in place first, and focus on for the biggest impact, not neglecting the tools that need to then be there to help and support people who are identified with symptoms of an illness, but then making sure beyond that that we put the right tools in the right place for the right people.

[37.03] We’ve circled back to mental health again, and quite rightly so. I’d be really interested to talk to you a little bit about how a growing understanding of the difference between mental health and mental illness is really shaping workplace policies, in terms of sick days and doctor’s notes. What are your thoughts on how that is going to continue to evolve for organisations?

I mean it’s wonderful that we’ve now got this heightened awareness of the impact, the recent Deloitte report that came out in January 2020 around mental health in the workplace shed some fantastic statistics on starting to measure the impact on absenteeism and presenteeism, for example. So I think we’ve got a much greater awareness now of what this impact is on the workplace and therefore what are some of the things causing that as well. I think that within that report it alluded to that there are 15% of people (albeit I think a UK sample) in the workplace who do actually have symptoms of an existing mental health condition. And perhaps that number is not that surprising, but does that number correlate with the number of people who are using the services that are available to them, the EAPs that are available to them, does it correlate to the health claims data that you’re seeing coming through, probably not, so there’s a disconnect there. So why is there a disconnect there? Is it about people feeling confident or confidential when using those resources, are they worried about the stigma, are they worried about the impact on maybe keeping a job or getting a promotion if they disclose this. So I think we’ve made some great progress, but a real challenge around that now, a recognition of the numbers but not necessarily a recognition of the disconnect and addressing it in a way that employees feel confident about. So, that’s probably where I’d say we’re at the moment, Lorien, but at least we’re now getting that recognition.

[39.14] And I was also wanting to talk to you about trends that are potentially going to fade out. We’ve talked quite a lot about trends that are really growing and strengthening in the marketplace but in terms of the landscape, what do we see that is potentially fading out of the more traditional approaches to health and well-being within a corporate environment?

Really good question, Lorien. I wouldn’t say necessarily fading out but evolving, so a few things that I can see now, things like there’s very, very low adoption of traditional health risk assessments. And that’s a real challenge because although they are designed to be very evidence-based and clinically validated and therefore they might feel at times long, structured and a little bit cold in their approach, but they are evidence-based. But, if people aren’t completing those then they’re useless, so how do you start to engage people in some sort of survey, some tool that isn’t skewed, that is clinically validated to really help you understand that risk within your organisation and the opportunity and for the individual as well. So I think that’s something that’s under challenge and will need to evolve but needs to evolve in a clinically evidence-based, validated way. So, that’s one thing. I think the other thing that’s actually, I say come and gone, it’s still very much here but the maturity now in terms of how people are looking at the value of things like wearable devices and step tracking. Understandably a great flurry in the industry around that and the arbitrary 10K steps was a great nudge to people in terms of taking proactive steps and I’m sure for a lot of people even if they’re still not using the devices, have changed their habits — and that’s great. But I think wearables have so much more capability to provide more personalised support if we can overcome concerns around data security, data privacy and particularly obviously within the workplace. So i think that’s something that’s going to need to evolve, but fantastic opportunities ahead if we can overcome some of those concerns around how my data is protected and who am I sharing it with and that trust piece, and the ability also to delete my data if I move on as well.

[41.57] No, so I was just going to say in terms of that evolution and technology, what is it that you’re specifically going to be working and focusing on in the 12 months ahead? How do you see those two coming together to support your customer base?

Yeah, so we’ve been approached and looking into and investigating some really exciting partner tools, some of those digital, some physical and some digital and physical and there’s some really exciting pilots going on in Aetna in the U.S. with various partners (people like Sleepio). And then some very targeted solutions to specific segments and cohorts like pre- and post-partum risks for new and expectant mothers, partnerships with companies like Avia, for example, and their digital therapeutic programmes. So, some really interesting programmes that are going on to look at structured data analysis to really look at outcomes and lasting change from that. So, we’re looking at those and working with those; we’ve already got some partnerships onboard and tools available to the customer in that sense, things like myStrength — digital health resilience and stress and anxiety programmes. But I think one of the biggest issues for me is how we create the right engagement, promotion and communication mechanisms to help people navigate into those tools rather than necessarily at the moment bundling lots more tools in there. So one of the things we’ve been looking at is how do we start to simplify the communication of the resources that are available to people and help them understand how this program differs from that program and what might be right for me at the right stage at the right time because there is an awful lot of noise out there and I think there’s just a real risk of the people who are really in need switching off and the people taking advantage of these solutions are potentially the already health-engaged. Not to say that they’re not deriving benefit but they may well already have derived benefit from other solutions already. So, how do we reach those people who are not engaged or have just switched off because it’s just all been too complicated or too big a leap or too big a step? So, that’s really what’s driving me at the moment.

[44.18] We understand from recent surveys that we’ve undertaken across the world that there is a significant gap, I think we alluded to it earlier, between what it is that employers are providing in terms of health and wellness benefits and how they would rate that as ‘good’, I think it’s 70% and potentially only 23% of employees are actually in agreement with that quality assessment of those health and well-being benefits. So, as the year continues to evolve and as your plans in terms of customer proposition continue to evolve, what are the top three pieces of advice that you could give to organisations out there to really focus on and keep an eye out for as we move into 2021 in fact?

Yeah, so I suggest in relation to that statistic that you provide there, Lorien, which was fascinating, on that disconnect on what employees believe they have or offer or what employees think they have. I think just some very basic things like a fundamental audit of all the things that you have available to you as an employer and that your employees have access to first of all. So, for example employee assistant programs are an incredibly valuable resource but potentially an employee might have access to two or three of those between life assurance provider, health insurance provider through the workplace and maybe even through some of the occupational health teams within the workplace, so it might not be that the solutions aren’t there but that becomes incredibly confusing to an employee about what to use and where and particularly when they’re in an international environment where what they had back at the base office or headquarters might be very different to what’s available in the regions or they might still have access to it, should I use this app, that app, how do I get a hold of this, what I am eligible for, what are my family eligible for? So I think the first thing would be an audit — centrally and regionally — of all the things that are available to my staff and just taking that step back and saying OK, well how’s this been communicated, how’s it accessed, how do they reach these, how are we measuring it, and to understand that I’d say the second thing having done that audit then is to survey and speak to and listen to your staff. Understand their understanding of what’s available to them. Do they know what they’ve got? If they do know what they’ve got, do they know how to access it? If they know how to access it, have they used it? If they’ve used it, is it any good? If they haven’t used it, why not, is it not relevant, what’s it solving for and what’s it not solving for? So, some very simple approaches to just listening to the demand. And then following that you can start to understand the gaps and what might be the most important things to address next and how much of a segmented approach is needed for that and whether that’s something you need to solve for yourself or whether you can start to leverage partnerships with your providers, like your health insurers or life insurers to get them to help solve that with you. So, I’d probably say if I were in an employer’s shoes those are three very basic, and perhaps obvious steps, but clearly some of our data is suggesting that’s not always being done effectively in all regions, certainly.

[47.40] Very valuable advice there Simon, thank you ever so much. So I think that what we really should be doing is to reconnect in a couple of weeks’ time and potentially dig into some of these areas of interest and some of these trends in a little bit more detail. I could quite happily keep talking about this for hours but I think i will let you go for today and say thank you ever so much and we will speak again soon.

Thanks Lorien, it’s been a pleasure.

Thank you.

For those who don’t know us, Aetna International is a global health and wellness benefits provider. But, we’re more than just an insurance safety net; our skill lies in delivering the tools, services and resources that help drive health care costs down and people’s physical and mental health and well-being up. This is something that’s important to our corporate clients and self-funded members alike. That’s why we currently serve almost 900,000 members around the world — from Shanghai to Seattle. Ultimately, we believe that when people thrive, their work and personal endeavours thrive too. For more information about us, you can visit AetnaInternational.com.

We hope you enjoyed today’s episode. Join us again soon, when I’ll be speaking with Dr Sneh Khemka, Vice President of Population Health Solutions and vHealth here at Aetna. Ahead of World No Tobacco Day on 31^st May, Sneh and I will be taking the opportunity to talk about global trends around tobacco use and vaping, public health policies, and the impact of COVID-19 on people’s attitudes and behaviours towards smoking.