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Hospitals must address underlying societal issues

August 10th, 2014

by Anthony Cirillo

Earlier this year I attended a World Health Care Congress session on employee health. The head of Comcast's human resources spoke. He offered a different perspective on addressing employees' health.

Comcast focuses less on specific programs to promote employee wellness (benefits, wellness centers) and more on the underlying triggers that cause bad health to manifest.

He cited something I hadn't heard of before. It was Eliza Corporation's Engagement Index. This tool examines life context issues while predicting how those issues impact health, spending and satisfaction--ultimately expanding the definition of health.


The Eliza Engagement Index Vulnerability data shows that approximately 80 percent of individuals want help from their employers and health plans in dealing with financial stress. Nearly all those surveyed (97 percent) want help in managing caregiving-related issues. In examining overall healthcare spending, those with lower vulnerability scores have significantly lower associated medical costs.

So instead of tackling conditions and illnesses, companies like Comcast look at three primary life obstacles: Financial stress, relationship issues and caregiving. These in turn correlate to buffers that enhance life--social support, spirituality and exercise--and three items that can magnify the issue and trigger stress--sleep issues, feeling sad and substance use (not abuse).

You can see how overall societal issues have health impacts that require hospitals to partner with others for the benefit of the community. This goes beyond population health management of chronic disease. The chronic diseases have their roots in these systemic societal issues. And these life obstacles are most likely issues within your own workforce.

Let's circle back to one of the major issues: Caregiving. I was humbled and honored to be a part of The Dementia Action Alliance Thought Leaders Summit in Washington, District of Columbia in June. CCAL, of which I'm a board member, convened 70 of the nation's top leaders in the long-term care supports and services arena. We are concerned that the National Alzheimer's Plan is heavy on cure and light on care. So a big focus of our work centers on person-centered care for people with dementia and their caregivers.

Missing from this table of leaders was the hospital and physician community.

I urge you to read Sandy Halperin's opening remarks to the assembled leaders. Sandy is a friend and he has early onset Alzheimer's. Here is a taste of what he said.

It is time for all of us, including all of the legislators around the country, to put a stop to these repetitive and recurring conversations of information that is all to well-known and acknowledged--and to replace this seemingly endless talk with action-oriented debates and the funding that is needed to best achieve our nation's dementia care and research goals.

Quite frankly, I don't care whether anybody inside or outside of this room is a Democrat, Republican or and Independent (or any other party affiliation). I don't care whether someone agrees or disagrees with Obamacare--this is not about Obamacare, it is about our health, yes everybody's health, with health being at the core of each of our lives, and at the core of our nation's health--and all of the dementias and dementia care must be a primary part of our nation's healthcare focus.

It's time for us declare a war on dementia, on all of its fronts. And this war must revitalize and accelerate what has been accomplished to date.

In a RAND report on long-term care services and supports they note that "persons with dementia experience, on average, more care settings and more transitions between care settings than do older adults with other chronic conditions."

Hospitals must address societal issues beyond the diagnosis and treatment of disease. The hospital industry and the long-term care industry operate in silos. And while some bundled payment experiments try to unite these disparate systems they miss the mark and ignore the real conversation of care that needs to take place.

Want to be part of the Dementia Action Alliance? You should be. Contact me and we can talk:

Anthony Cirillo, is president of Fast Forward Consulting, which specializes in experience management and strategic marketing for healthcare facilities. He also is the expert guide in Assisted Living for


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