TJ North

Monitoring your
vices online
November 17, 2008
Susan Pigg
LIVING REPORTER
As you pour that glass of wine or
two when you get home tonight,
you might want to think about the
price you’re paying for the daily
ritual of taking the edge off.
That drink – which, admit it, is
usually two or three as you ease
into the weekend – costs you about
$2,000 a year. It’s adding up to at
least 100 extra calories a day and,
if you’re an average sized,
50year
old
woman, about 15 pounds of unflattering weight over 12
months.
In the course of a year, you will have downed some 520 drinks and
been under the influence of alcohol 1,161 hours. That means your
throat is often inflamed, your liver and pancreas are under stress
and you are boosting your chances of developing some cancers.
That’s not your doctor talking. That’s checkyourdrinking.net.
If you think you may have a problem, rest assured there are
thousands of others just like you. They’re in cyberspace as well,
doing online selfassessments
and then spending hours in social
networking sites debating with likeminded
people. Their concerns?
Is there a better way to cope with stress? Do their dark days now
rate as fullfledged
depression? Is their weight off the scales?
There has been a virtual explosion the last few years in socalled
eHealth sites, which help people tackle everything from insomnia to
anxiety attacks and gambling addictions. But, increasingly, they are
being used by companies – usually as part of employee assistance
programs – to boost productivity by reducing absenteeism, sick
days and disability claims.
“None of these programs is meant to replace a physician or offer
(medical) diagnoses,” says Estelle Morrison, director of program
development at Ceridian Canada, which runs employee assistance
programs on behalf of many major Canadian companies. “They are
meant to educate people and make them more self aware
and
knowledgeable so they can go to the right people and get the help
they need.
“We now see employers understanding that if they don’t start to
provide some very important support to their employees, they will
be in quite a mess in the next few years because of aging baby
boomers who are struggling with health issues, in terms of
employee absenteeism, in terms of labour shortages, in terms of
employee absenteeism, in terms of labour shortages, in terms of
(the health effects of) people working 24/7.
“These are issues that are impacting the mental health, the
productivity and the availability of staff – and employers are now
seeing the bottom line
cost of that.”
In the U.S., companies are offering “incentives” – gift cards, running
shoes, healthclub
discounts, cash awards of up to $1,000 – for
employees who undertake “health risk assessment” surveys aimed
at pinpointing and minimizing their risky habits. In Canada, Morrison
says, cash incentives are more seen as “rewarding” bad behaviour,
so “we’ve had a lot of iPods.”
The assessments usually include 50 to 75 questions ranging from
your cultural background to whether you wear seat belts.
“They’re being very, very aggressive in the United States about
getting these kinds of systems in place,” says Dr. David Goldbloom,
a senior medical adviser for Toronto’s Centre for Addiction and
Mental Health.
Goldbloom says he was surprised to see the number and
sophistication of “behavioural health” programs during a recent
healthcare
conference in Arizona. “There were tonnes of examples
of companies that are working very hard to make this more a part
of their workplace, but also competing with each other: who’s got
the healthier workplace?”
Torontobased
V CC
Systems Inc. launched its online behavioural
change programs in Canada in 2000 and now offers its services to
many companies. It also has partnerships with agencies such as the
Canadian Cancer Society, which uses its online smokingcessation
programs, says Rachel Fournier, the company’s director of business
development.
VCC
is one of the few eHealth sites that offer some free behaviour change
surveys and programs around drinking, obesity, anxiety,
smoking and depression, as well as access to its online forums. (Far more comprehensive programs are
available through company assistance programs for employees.)
What makes the programs so popular, say experts, is that they are anonymous and available 24 hours a
day in the privacy of your home. With traditional assistance programs that offer counselling, there is always
the fear the information will leak back to your boss.
Rick H., a recovering alcoholic and drug addict, uses the V CC
site most days, offering personal perspective
and advice online. “I think it’s very helpful to people who are starting off and trying to find a path. It gives
them some tools to get them started, but I don’t think it’s for maintaining long term
sobriety. They tend to
hang around a month and then move on.
“I like to think that some of them make it, but I know, from being a member of Alcoholics Anonymous for
two years, that only about 5 per cent make it to five years sober on the first try.
“But there’s always value if somebody has hope.”
What started as online selfassessments
and expanded into online self help
groups is evolving in a new
generation of eHealth programs. These are so tailored to individual circumstances that they could
significantly reduce at least some serious outcomes, such as, say, drinking or poor diet escalating into
costly diabetes and cardiovascular problems or depression – which costs an average per case of $10,000
and 40 lost days at work – spiralling out of control.
“I think it’s very important that we continue to do research and evaluate the impact of these programs,”
says Dr. David Ahern, a U.S. physician who is doing just that kind of research on behalf of the Boston based
Health e Technologies
Initiative.
“But I am much more of an optimist about the benefits of these programs than the downside. I think they
have tremendous potential to help improve health and the quality of health care.”
The downsides, says Canada eHealth expert Dr. Gunther Eysenbach, include getting people to stick to the
programs, especially if they have to keep tedious daily online logs of their habits and behaviour. There are
also the privacy risks of cyberspace, he notes.
While the smoking programs have proven among the most successful – some research shows about a 10 to
12 per cent quit rate – weight loss is trickier, says Eysenbach.
• Feelingbetternow.com is an
initiative from several Toronto
health and mentalhealth
care
experts.
• Quitnet.com is a popular
smoking cessation site.
• patientslikeme.com is aimed
primarily at information sharing
and to help people connect with
others for support, advice and
inspiration.
• acor.org is the highly
informative Association of Cancer
Online Resources site aimed at
people with rare forms of cancer.
• hcsc.
gc.ca/hcssss/
ehealthesante
has Government of
Canada info on Canadian laws
and regulations plus links to
resources.
• Dr. Gunther Eysenbach runs the
Torontobased
Journal of Medical
Internet Research and has spent
10 years monitoring and studying
the value of online health
initiatives and behavioural
change programs. See jmir.org.
Susan
Pigg
reporter Stuart
Laidlaw explores the
thorniest issues in
medical ethics.
Read Stuart here
The You Docs
Podcast
Beyond the Burn
Read the Star’s series
on Canada’s top burn
docs and their
patients.
Part One
Part Two
Part Three
Living Fit Exercise
Videos
Watch our series of
exercise videos aimed
at improving muscle
strength, bone density
and balance.
Squat with balance
Core bracing
Lunge
Bridge
Side plank
Contact us
Email the editor here.
Ask Dr. Waldman
Dr. Murray Waldman
has been a family
doctor, coroner and
administrator. Read
his advice column or
ask him a question of
your own.
Read him here
“With weight loss, there’s just an intrinsic paradox that you make people sit down at a computer to lose
weight when you should actually be sending them out onto the street to do some exercise.”
A more active intervention is starting to happen, with programs that can now be used on mobile devices
and “smart devices” that, in time, Eysenbach believes, will make it much easier for people to keep track of
behaviour that poses a risk to their health.
He predicts it won’t be long before your car will keep track of how much you have driven and whether you
should, for the sake of your heart, start riding your bike. Or your fridge will be telling you it’s time to stop
snacking.
Or put down that drink.
Toronto Star
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