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Optimizing Health Care Delivery by Integrating Workplace Health Programs

April 25, 2012
Because health in the workplace, health at home and health in communities are interconnected, integrating workplace health programs with other health initiatives could optimize health care delivery, according to a new American College of Occupational and Environmental Medicine (ACOEM) position statement.

"The workplace is organically connected to the home and to the physical communities in which workplaces exist," the authors wrote. "Individuals do not leave the impacts of their personal health risks on the doorstep when they leave for work just as they cannot leave the impacts of their workplace exposures when they return home. Health behaviors extend across multiple environments and cannot be artificially separated."

In particular, the ACOEM position statement stressed that accountable care organizations (ACO) and the patient-centered medical home (PCMH) – two medical trends that focus on team-based care and better patient outcomes – could be more effective if incorporated into workplace health programs. This integration could bring the benefits of ACO and PCMH to millions of American workers and their families.

"In order for ACOs and PCMH to succeed in the long term, all sectors with a stake in health care will need to become better aligned with them – including the employer community, which remains heavily invested in the health outcomes of millions of Americans," said lead author Robert K. McLellan, MD, a former president of ACOEM.

PCMH and ACO

The position statement explains that PCMH "emphasizes the central role of primary care and facilitation of partnerships between patient, physician, family, and other caregivers, is built on a 'whole- person' orientation that envisions care integrated across all elements of the health care system and links hospitals, subspecialty care and nursing homes with a patient's community environment."

ACO, meanwhile, is "a care model that makes physicians and hospitals more accountable in the care system, emphasizing organizational integration and efficiencies coupled with outcome-oriented, performance-based medical strategies to improve the health of populations."

As McLellan pointed out, "The workplace is where millions of Americans spend a major portion of their daily lives, and it makes good sense that it should be an essential element, next to communities and homes, in an integrated system of health anchored by the PCMH and the ACO concepts."

In recent decades, employers have become increasingly proactive as providers of programs and initiatives aimed at keeping their work forces healthier. A growing body of research shows an inextricable link between the health of the work force and the productivity of the work force, and enlightened employers are taking steps in response. From disease prevention programs to on-site and near-site health clinics staffed by a spectrum of health care personnel, they are becoming a more and more influential part of the health care equation.

The position statement, "Optimizing Health Care Delivery by Integrating Workplaces, Homes and Communities: How Occupational and Environmental Medicine can serve as a vital connecting link between Accountable Care Organizations and the Patient Centered Medical Home," was published in the April issue of the Journal of Occupational and Environmental Medicine (JOEM).

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