VERSION 3.2.1 - APRIL 2014
HEALTH RISK ASSESSMENT
IMPLEMENTATION GUIDE
Confidential: The contents of this document are confidential and intended solely for the recipient. Reproduction of, or forwarding to anyone not directly sent or given permission to view this document is strictly forbidden.
“GOOD HEALTH AND GOOD SENSE ARE TWO OF LIFE’S GREATEST BLESSINGS.”
— PUBLILIUS SYRUS
CONTENT 04 Employer Group Variance 05 Available Format 05 Availability, Delivery & Language Support 07 Biometric Data 08 Structure 09 Completion Incentive 09 Participation Options 09 Available Reports 13 Delivery Options 15 Contact Us
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LET’S BEGIN
HRA
V3.2.1 HEALTH RISK ASSESSMENT IMPLEMENTATION GUIDE Deployment of the Health Risk Assessment module is designed to allow flexibility between employer groups. The purpose of this document is to outline each available option. This module may be selected as a standalone component or offered in conjunction with other Meliora Modules.
Employer Group Variance Each employer group is able to configure Health Risk Assessment (HRA) deployment to meet their individual needs. It is not necessary for all employer groups under one reseller to maintain the same configuration.
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Available Formats The HRA is available in 2 basic formats, Long Form and Short Form and may be delivered online or paper based. Employer groups can deliver both long and short forms to the same population or subgroup and can switch between long and short forms from year to year. Aggregate reports support both versions within the same population and time period. Format 1. Long Form
The long form assesses current health, including lifestyle behaviors, biometrics,
health status and compliance with recommended preventive health screenings;
chronic conditions; future disease risk, and workplace productivity. 2. Short Form The short form delivers all the functionality required to assess current health, including biometrics, but omits chronic and future disease risk assessments and workplace productivity. The shorter format facilitates completion by populations with low literacy and reduces processing costs of paper assessments.
Availability, Delivery & Language Support This Module can be delivered in both long and short form to the same population or subgroup and can switch between long and short forms year to year. Availability The HRA open and close dates are determined by the employer group. Possible Examples:
1. Full Year (The HRA would be available for the entire Wellness Plan Year)
Open Date: January 1, 2014
Close Date: December 31, 2014 2. Partial Year (The HRA would be available for a portion of the Wellness Plan Year)
Open Date: January 1, 2014
Close Date: March 31, 2014
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Delivery There are several delivery functionalities and options to be considered prior to deployment.
Online or Paper Based (Paper version is not yet available in version 3.2.1)
The primary delivery target is online. A paper-based version of the questionnaire is
also supported, with functions to batch load data from paper forms into the central
database for assessment and reporting. The paper version is completed using bubble
forms in English or Spanish which support standard scanning technologies.
Biometric & Laboratory Results
Results from biometric screenings and laboratory tests many be entered into the HRA
questionnaire by the user. In addition, functions are provided to allow results to be:
• Entered/updated by a health coach
• Entered/ updated by a site administrator
• Batch/loaded from a file
Process Mode
Process Model determines what happens immediately after a participant has
completed all HRA questions and the required timing of biometric and laboratory
results entry into an HRA.
Employer groups electing the Meliora Coaching Module and Meliora HRA Module will
have a Submit/Lock (SL) process model. Employer groups not electing the Meliora
Coaching Module will have a Lock (L) process model.
Completed HRAs will have a status of submitted or locked.
• A submitted HRA may still be updated/changed by the participant.
• A locked HRA is no longer available to be updated/changed by the participant.
A submitted HRA will transition to a locked HRA in one of the following ways:
1. Biometric/lab results are loaded into the Meliora system
• Biometric results dated 120 days prior or 120 after the participant HRA start date can be loaded
into an HRA.
• It takes approximately 24 hours for biometric/lab results loaded in to the Meliora system to be reflected in an HRA and for the HRA to lock.
2. 60 days have passed since the participants HRA Start Date
• If no biometric/lab results are loaded into an HRA within 120 days of the
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participant HRA start date, the HRA will lock.
3. A wellness coach manually locks the HRA
• A wellness coach may edit, lock or unlock and HRA at any point in time.
4. The employer group process model is lock
• Upon completing all HRA questions participants will be asked if they would like
to lock their HRA and alerted that once an HRA is locked question responses
may no longer be changed.
Language Support The HRA questionnaire and participant reports are available in English and Spanish. Both versions use the same data elements, providing a single database for aggregate reporting and review by health coaches.
Biometric Data There are a variety of options regarding the impact of loading biometric data in to an HRA Biometric Data Minimum Requirements Loading biometric data will lock the HRA for participants/employer groups with a process model of Submit/Lock. 1. The default minimum requirements for biometric values to lock an HRA are glucose and total cholesterol. Biometric Value Inclusion Based on the list below each employer group has the ability to determine what values will be loaded into an HRA. Electing not to include a biometric value will remove the value from the HRA and any ability to enter/track the value. Note: Glucose and total cholesterol are required to lock an HRA with biometrics. Available options are as follows:
Height, Weight, Waist, Hip, Body fat, Neck, Blood pressure, Total cholesterol, HDL
cholesterol, LDL cholesterol, Triglycerides, Fasting/no-Fasting glucose, A1c (non-
diabetic or diabetic), PSA, Cotinine
Self-Reported Data Each employer group has the option to accept or deny self-reported biometric values. Allowing self-reported data allows the user to enter biometric values into their HRA. Any verified biometric data loaded into an HRA will override all self-reported data.
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Don’t Know Data
To progress to the next page of questions, all questions on the current page must be
answered. The Don’t Know option allows the user to select. Don’t Know for any given
biometric value and progress to the next page of questions. Example Self-Reported Data & Don’t Know
If the option to allow self-reported data has been enabled, the user is not able
to progress to the next page of HRA questions without providing all biometric
values. Enabling the Don’t Know function allows the user to progress to the next
page of HRA questions without entering all biometric values.
Auto Generated Health Risk Assessment
This option allows an HRA to be created when biometric values are loaded.
Structure The HRA uses evidence based treatment guidelines and disease-risk models from recognized organizations such as the National Institutes of Health and US Prevention Services Task Force to assess participants for current and future health risks. These evidence-based guidelines and models have been developed by independent panels of experts that systematically review the evidence of effectiveness and develop recommendations. Individual Risk Factors Each participant is presented with an assessment of the following individual risk factors: .
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LIFESTYLE BEHAVIORS
BIOMETRICS & LAB RESULTS
PREVENTIVE SCREENINGS
Nutrition Activity Alcohol Tobacco Substance Abuse Stress Motor Vehicle Safety
Weight Waist Circumference Waist to Hip Ratio Body Fat Blood Pressure Total Cholesterol LDL Cholesterol HDL Cholesterol Triglycerides Fasting PSA*Men Only
Physical Examination Blood Pressure Cholesterol* Colonoscopy* Pap Smear* Mammogram* Breast Exam* Flu Shot
*Based on age and gender
CHRONIC CONDITIONS* Arthritis Asthma Back Pain COPD Depression Diabetes Heart Disease Heart Failure Hypertension
FUTURE DISEASE RISK* Arthritis Back Pain Breast Cancer Colorectal Cancer Lung Cancer Skin Cancer COPD Depression Diabetes Heart Disease Heart Failure Hypertension
WORKPLACE PRODUCTIVITY* Self-reported Absenteeism Self-reported Presenteeism
*Available on long form ONLY
Completion Time The Long Form HRA should take between 15 and 20 minutes to complete. The Short Form HRA should take between 10 and 15 minutes to complete.
Completion Incentive This Module may be offered with or without a completion incentive. There is not a set completion incentive, each employer group may select the completion incentive.
Participation Options Participants will be able to complete an HRA based on the Open and Close Dates determined by the employer group.
Available Reports HRA completion will generate reports for both the individual and program administrator. Participant Reports Two reports are available for reporting individual participant data -- the user report and the provider report. These reports are available for each health risk assessment questionnaire
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started. The long- and short-form HRA generate the same participant reports, but the shortform reports do not include any information related to chronic conditions or future disease risk. Participants completing the HRA questionnaire in Spanish will receive a User Report in Spanish. The provider report is always delivered in English. A. User Report
The user report is a personalized report designed for the program participant or
participant. This report details the participant’s health risks and lifestyle behaviors,
together with recommended actions for health improvement. The User Report is
available in HTML for delivery to the screen, as a PDF optimized for printing. 1. Summary Chart
The first part of the report contains a summary table that assesses
the participant’s modifiable risk factors, compliance with recommended
preventive screenings, disease severity and control (for participants with
one or more selected chronic conditions), and future disease risk. The
first section provides summary results, listing a Wellness Score (calculated from
16 modifiable risk factors), Chronic Conditions Impact (if applicable), and
Future Disease Risk.
High risks are shown in red, moderate risks in yellow, and healthy behaviors/
low risks in green. Assessments that cannot be calculated because of
missing data or unknown result are shown in blue. The results of the current
HRA questionnaire are compared to the results of the two previous
questionnaires to show progress over time.
In the online (HTML) version of the report, links are provided within the
summary table to take the user directly to the associated results and
recommendations section.
2. Results and Recommendations
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The second part of the report contains detailed results and recommended
actions for health improvement. This section follows the same order
as the summary table. The results and recommendations section
is highly personalized based on the participant’s assessed health
risks, readiness to change, and responses to individual questions with
the HRA. The report length varies with the age, gender, and health risks of the
participant, but is typically 12-13 pages in the PDF version for the long-form HRA
and 5-6 pages for the short-form.
The results and recommendations section is written in accordance with a Flesch-
Kincaid Grade Level score of 8th grade. The report follows current medical and
health guidelines developed by organizations such as the National Institutes
of Health, the Center for Disease Control and Prevention, the American
Heart Association.
The online (HTML) version of the report supports up to two links within each
subsection of the report to provide the user with direct access to further
information related to the subsection topic. These links are controlled
by an XML file for each HRA configuration. The default XML file provides links
to publicly available web sites from organizations such as the National Institutes
of Health and the American Heart Association. One or more client-specific links
files can be created to access client resources.
Provider Reports
The provider report is designed to give health care providers easy access to the results
of the health risk assessment. The report summarizes the participant’s health risks and
lifestyle behaviors in tabular format
The Provider Report is available as a PDF optimized for printing and in XML format
through web services. The report length varies with the age, gender, and health risks of
the participant, but is typically 2 pages. Administrator Reports
A variety of administrator reports are available to assist with employer group
administration and outcome reporting. 1. HRA Management Reports
Management reports assist program managers with program administration. a.
HRAs by Date
The HRAs by Date report summarizes HRA participation and status for a
selected date range, categorizing HRAs as Started, Submitted or Locked.
The report is delivered as an Excel data table and PDF bar chart.
b.
HRA Listing
The HRA Listing generates a report in Excel format that provides
information about each participant that has started an HRA and
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c.
the status of each HRA. HRA Results
The HRA Results Report provide three presentations of HRA data, each in
Excel format. 4.
5.
6.
1. The Biometrics Results Reports list actual values reported
for body measurements and laboratory tests. The data
is color coded, with self-reported data in red and
data from all other sources (batch loaded, entered
by administrator or health coach) in green. Two reports
are provided, one listing data in Lbs, Ft, Inches and
the other in Kgs Meters.
2. The Lifestyle Readiness to Change Results Report lists
the lifestyle assessment and the readiness-to-change
result for five lifestyle behaviors.
3.
HRA Aggregate Reports
2. HRA Aggregate Reports
HRA Aggregate reports combine results from many HRAs. These reports allow
site administrators to profile a population to determine key health risks and to
measure program outcomes over time.
The HRA database supports aggregate reporting where data has been collected
through multiple questionnaires, including:
• The Spanish language questionnaire.
• The long-form and short-form questionnaires.
• Historical HRA data loaded from third-party vendors.
The number of HRAs assessed is included in each section of a report to provide
meaningful comparisons where all assessments may not be present.
NOTE: Reports do not mask results for small population subgroups as the
reports may be required for internal purposes in addition to being shared
with end clients. Site administrators should determine what level of data
can be shared with end clients where low population size may create privacy
issues. a.
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HRA Population Reports
The HRA Population Reports provide a summary of risk factors for a
selected population at a given time. The HRA Population Reports include
an additional selection page that allows definition of the date range and
HRAs to be reported, together with entry of the total participants in the
population (used for calculating participation rates).
• The Health Risk Summary Report provides a tabular analysis of the
risk factors for a selected population at a given time and is delivered in
Excel format.
• The Population Health Risk Report includes bar charts, data tables, and b.
a narrative explanation of health risks and is delivered as a PDF. HRA Population Trend Reports
The HRA Population Trend Reports compare risk factors for a given
population for two time periods and can be used to measure program
outcomes over time. The reports can be generated for two different data
sets. • The population option includes HRAs for all participants in each time
period, and shows how the risk profile of the group has changed over
time.
• The cohort option includes HRAs for participants with HRAs in both
time periods, allowing the impact of the program on participants to be
measured.
The HRA Population Trend Reports include an additional selection page
that allows definition of the date ranges for each time period and the
HRAs to be reported, together with entry of the total participants in the
population (used for calculating participation rates).
Delivery Option / User Report
The User Report is displayed to the participant on the screen in HTML format. Links within the user report page provide access to the PDF version of the User Report and also to the PDF version of the Provider Report..
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CONTACT
MELIORA TECHNOLOGY
CORPORATE OFFICE 600 West 6th Street Suite 150 Fort Worth, Tx 76102 Phone 877 282 3044
Meliora Technology is the industry’s premier provider of technology solutions for workplace health management programs, including the development and implementation of customized, web based health management software. We also offer a wide range of tools and services that streamline the benefits administration process, including an online benefits enrollment and administration system, EDI data exchange, error resolution and more.
Fax 877 667 2994
email: info@melioratech.com www.melioratech.com
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