His­tor­i­cally, human resource depart­ments have not had the toolkit to develop the most human resource of all – our brains. What are some large employ­ers and insur­ers doing to apply emerg­ing sci­ence and best prac­tices in this domain, via well­ness and train­ing ini­tia­tives, and HR benefits? - Chair: Andrew Lee, Vice Pres­i­dent at Aetna, YGL Class of 2011 - Hyong Un, Head of Employee Assis­tance Pro­grams at Aetna - Evian Gor­don, Exec­u­tive Chair­man of Brain Resource - David Nill, Chief Med­ical Offi­cer at Cerner Corporation This session took place at the 2013 SharpBrains Virtual Summit: http://sharpbrains.com/summit-2013/agenda/

1. How can organizations maximize the
resilience and productivity of their
human resources?

2. Chaired by: Andrew Lee,
Vice President of Aetna, YGL Class of 2011
Hyong Un,
Head of Employee Assistance Programs at Aetna
Evian Gordon,
Executive Chairman of Brain Resource
David Nill,
Chief Medical Officer at Cerner Corporation
How can organizations maximize the resilience
and productivity of their human resources?

3. Hyong Un,
Head of Employee
Assistance Programs at Aetna
How can organizations maximize the resilience
and productivity of their human resources?

4. AETNA RESOURCES FOR LIVING.
Brain health and resiliency
in the workplace
September 2013

5. AETNA RESOURCES FOR LIVING.
Stress Today
5

6. AETNA RESOURCES FOR LIVING.
If you are feeling stressed, you are not alone
Over 1/2 of Americans self-report that they are “struggling” with life today
and 1/3 state their average stress level as “extreme”.
Source: Gallup-Healthways Well-being Index 2010
Financial Challenges
Personal Safety
Headaches
Sick Child
Time to Exercise
Aging ParentsCareer Unease
Teenager’s Homework
Diabetes
Addiction
6

7. AETNA RESOURCES FOR LIVING.
Courtesy of ELIZA CORPORATION
Frequency of life stressors
5

8. AETNA RESOURCES FOR LIVING.
Impact of Stress
0 20 30 40
Lying awake at night
Irritability or anger
Overeating
Fatigue
Lack of motivation
Headaches
Source: The American Psychological Association 2011 Stress in America Survey.
Stress will effect your people’s ability to show
up and focus on their job.
8
7.1 productive days are lost per employee each year due
to stress-related factors.
─ The World Health Organization

9. AETNA RESOURCES FOR LIVING.
Courtesy of ELIZA CORPORATION
Life stressors and productivity
6

10. AETNA RESOURCES FOR LIVING.
Perceived stress and medical cost
Courtesy of Dr. Michael Baime 10

11. AETNA RESOURCES FOR LIVING.
How can we keep our stress level in check?
11
Resilience: (from the Latin word resilo –
to jump back): The capacity to bounce
back from adverse events, adapt and
succeed.
83%of people believe that stress can have a
strong impact on their health in

12. AETNA RESOURCES FOR LIVING.
Resiliency Approaches
12

13. AETNA RESOURCES FOR LIVING.
Resiliency – what does it look like?
Resilient people:
• overcome adversity
• bounce back from setbacks
• thrive under pressure
• maintain emotional stability
• maintain a positive outlook
Developing a highly resilient, change proficient workforce is critical
13
Successfully adapting to difficult or challenging life experiences.

14. AETNA RESOURCES FOR LIVING.
Lifestyle options for healthy brains -
promoting wellbeing in the workplace
1. Healthy nutrition and exercise
2. Work life balance
3. Exercise the brain
4. Practice positive psychology
5. Mindfulness
6. Social networking – friends and
families
* From Sharpbrains. URL to article: http://sharpbrains.com/blog/2007/08/22/10-habits-of-highly-effective-brains/
14

15. AETNA RESOURCES FOR LIVING.
Brain health – the secret to positive change
Neuroplasticity - the ability of the brain to
change even in adulthood- developing new
habits re-wires the brain
Train the brain to:
• Boost memory
• Sustain attention
• Learn from mistakes
• Plan ahead
• Overcome impulses
• Develop a positive outlook
15

16. AETNA RESOURCES FOR LIVING.
The Science of Happiness
Happiness research- a current hot topic!
What makes us happy? Surprising findings and the resiliency
connection from Harvard Business Review 2012.
• Expectations
• Resiliency post trauma or tragedy
• Rich social networks
• Frequency of positive experiences
• “Little things”
• Focus
16

17. AETNA RESOURCES FOR LIVING.
Happy employees have:
• 31% higher productivity
• 37% higher sales
• 3 times the creativity
Based on a meta-analysis of 225 academic studies, Lyubomirsky, King
& Diener
Employees who score highest on social support are:
• 40% more likely to receive a promotion in the
following year
• report significantly higher job satisfaction
• feel 10X more engaged by their jobs than people
who score in the lowest quartile.
Source: Achor research “name of study” date
17

18. AETNA RESOURCES FOR LIVING.
means paying attention
in a particular way
on purpose,
in the present moment,
and nonjudgmentally.
-Jon Kabat-Zinn
Mindfulness
18

19. AETNA RESOURCES FOR LIVING.
Response to stress
This is how most of us typically react…
…and this is the response with mindfulness
19

20. AETNA RESOURCES FOR LIVING.
Meditation changes your brain!
20
MRI scans show increased brain
density in areas of:
• Attention
• Sensory processing
• Learning and memory
• Emotion regulation
• Awareness of self
• Awareness of others’ feelings
and perspectives
Source: Lazar 2005 and Holzel 2010

21. AETNA RESOURCES FOR LIVING.
The impact of mindfulness on stress
Studies show that mindfulness mediation
promotes:
• Empathy
• Decision-making
• Self-awareness
• Flexibility & Creativity
20

22. AETNA RESOURCES FOR LIVING.
Who’s using meditation at work?
• AOL Time Warner
• Apple
• eBay
• Deutsche Bank
• General Mills
• GlaxoSmithKline
• Google
• HBO
• McKinsey & Co
• Nike
• Prentice Hall Publishing
• Proctor & Gamble
• Roche/Genetech
• Yahoo!
23

23. Aetna Inc. 23
23
Employee Assistance Programs as a work place
resiliency tool
Employee
Assistance
Helping members address
work and life issues before
they become large problems
Well-being
Using proactive
engagement solutions,
motivational techniques
and relationship building
to help members
achieve long term
behavior change
Work-life
Providing access to
work-life services along
with coaching or
counseling to help
members achieve work-
life balance
Aetna
Resources for
Living
• Addressing distress and
engagement causing loss of
productivity
 Life stressors - legal and financial
 Family and relationship
 Work place intervention
 Reduce engagement barriers
 Behavior change
 Integration of social network
• Integrating brain health and
mindfulness
• Work place solutions
• Management consultation
• Training
• Crisis debriefing and intervention

24. AETNA RESOURCES FOR LIVING.
Resiliency case study
24

25. AETNA RESOURCES FOR LIVING.
Aetna’s employees
25
At Aetna, we understand that finding the
time to engage in your own health isn’t as
easy as it sounds, so we offer:
• Flexible work time for physical activity
• Two Mind Body Stress Reduction programs
• Viniyoga (Onsite)
• Mindfulness at Work (Virtual)
• Health in small bytes (online classes)
• Healthy Lifestyle Coaching
• Aetna Resources For Living EAP support

26. AETNA RESOURCES FOR LIVING.
Thank You
26

27. Q&A
10 minutes
(Included in session
recording)

28. Evian Gordon,
Executive Chairman of
Brain Resource
How can organizations maximize the resilience
and productivity of their human resources?

29. Employee Resilience and Peak Performance
 Dr. Evian Gordon PhD., MD.
 Chairman of Brain Resource Inc.

30. Overview of Resilience Training
30
 What is Resilience?
 Corporate Impact of a Non-Resilient Workforce
 A Brain Health Approach to Resilience (MyBrainSolutions)
 Building Resilience Through Brain Training
 Outcomes
 Q & A

31. What is Resilience?
31
Resilience:
The capacity to bounce back following adverse events, adapt and succeed.
Like many life skills, resilience skills can be learned.
What habits are common in resilient individuals?
Resilience
Stress
Management
Positivity
Social
Skills

32. Impact of Non-Resilient employees
The Problem:
• 69% of employees report work is a significant source of stress and 41% of
workers report they typically feel tensed or stressed out during the workday. 1
• Health care expenditures of workers who report high levels of stress are 46%
greater than workers with low levels of stress (Average $1,700/year).
• The median number of days lost due to anxiety, stress and related disorders is
25 days versus a median of 6 for all other nonfatal injury and illness cases.
The current solution?
•Wellness solutions for physical health are abundant – but what about brain health?
•Employer Assistance Programs are underutilized and remain stigmatized.
•Do not promote brain health and peak performance.
32

33. MyBrainSolutions.com: Assess—Train—Monitor Results
Positivity
Social
Skills
Building Resilience Through Brain Training
Training 20+ times on the exercises/games: significantly improved core brain resilience capacities
Reference: Gordon, E, Palmer, DM, Liu, H, et al. (2013). Online cognitive brain training associated with measurable improvements in cognition and emotional
well-being. Technology and Innovation, 15: 53-62.
Stress
Management

34. Resilience Outcomes of MyBrainSolutions Training
34
Results after a 30-day Resilience training
period in a corporate setting.
Employees experienced significant improvement
in key areas of brain health linked to Resilience
and Peak Performance.

35. Q&A
10 minutes
(Included in session
recording)

36. David Nill,
Chief Medical Officer at
Cerner Corporation
How can organizations maximize the resilience
and productivity of their human resources?

37. © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 37
Health care is too
important
to stay the same.
TM

38. © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 38
Cerner at a Glance
Founded in 1979, based in Kansas City
Revenue 2012 2.7B
Largest standalone healthcare IT company in the world
Associates as of Sept 2013: 13,500+
66% KC Based
17% Outside KC
17% Outside US
Average Tenure/Age: 5/36 Years
Associate Mix:
35% Services
20% IP
14% Clinical
31% Sales & all others
Two on-site clinics, pharmacies, and free fitness centers
Health Plan Spend 2012: $70 Million
Covered Lives in 2012: 17,200
8500 associates
8700 dependents
85% participation rate

39. © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 39
To contribute to the systemic improvement of health
care delivery and the health of communities
Alignment within Cerner
Population Health
• Living Lab
• Driving Cerner’s future

40. © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 40
Cerner Health & Wellness: Core Principles
Align with Cerner’s vision, mission, and culture
Build, support and promote a healthy and productive workforce
Provide comprehensive benefit offerings
Develop innovative and wellness focused benefits
Proactive view of health:
Health and Care
Plan for Health vs. Health Plan
Promote joint accountability and individual engagement:
Education
Tools
Support
Create a ‘Culture of Health’

41. © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 41
Clinics & Pharmacies
Healthe at Cerner
Coordinated Programs and Services
“Get Well” (Clinics, Pharmacies, Preventive Care)
“Manage Well” (Health Benefits, Wellness Incentive Program, Condition Management)
“Stay well” (Fitness, Nutrition, Education, Personal & Team Challenges)
STAY WELL
CONTINUUM
Benefits/Condition Mgmt.
HEALTH CAR
E
MANAGE WELL GET WELL
LIVE WELL

42. © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 42
Why Brain Health?
Only represented 3% of our total spend when looking at
summary claims data
Deeper evaluation shows that in our top 20% of utilizers
over 50% had a co-morbid behavioral diagnosis
Behavioral diagnoses are not typically coded as the primary diagnosis
in medical encounters
Well recognized that a significant amount of risk in this
area is not identified because member has not engaged
Stigma
Denial
Pre-condition – not to a level where a member seeks care

43. © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 43
Connection to Health
Needed a Holistic Approach
We provide health for the body
Fitness Centers - Exercise
Cafeterias - Nutrition
Clinics – Professional Services
Should provide the same for the Mind
Missing component was the exercise component
Message our associates that we need to exercise the mind as well as
the body

44. © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 44
Proactive Behavioral Health Programming
Get Well: Onsite Services
Primary Care Physicians – Onsite Clinics
Therapists at Healthe Clinics
Manage Well: Health Plan Design
Value-based benefit design around anti-depressants and anxiety medications:
generics covered at 100%
Stay Well: Wellness Programming
Brain Resource Partnership: brain training to improve resiliency, decision-making
capabilities and stress management techniques

45. © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 45
Wellness Program: Improvements in Brain Health
The number of Associates who completed a baseline & follow up brain health assessment was 246. The analysis
focused on results where baseline scores where < 1 SD below the mean.
* = Significant at alpha = 0.05; ** = Significant at alpha = 0.01; *** = Significant at alpha = .0001
*** ***
***
0%
10%
20%
30%
40%
50%
60%
70%
80%
Negativity Bias Emotional Resilience Social Skills
% improvement in Self Regulation
***
***
***
0%
10%
20%
30%
40%
50%
60%
70%
80%
DASS Depression DASS Anxiety DASS Stress
% improvement in Feeling
***
***
***
***
***
***
0%
10%
20%
30%
40%
50%
60%
70%
80%
% improvement in Thinking
***
***
0%
10%
20%
30%
40%
50%
60%
70%
80%
Emotion Identification Emotion Bias
% improvement in Emotion

46. © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 46
Wellness Program: Improvements in productivity
The number of Associates who completed a baseline & follow up HPQ Survey was 269. The analysis focused on
results where baseline scores where < 1 SD below the mean.
* = Significant at alpha = 0.05; ** = Significant at alpha = 0.01; *** = Significant at alpha = .0001
HPQ Result t-value p-value
Mean
(baseline)
Mean
(follow up)
Percentage
Improvement
Relative Absenteeism -5.96 0.0000 -0.34 -0.11 69%
Total Productivity -4.97 0.0000 0.68 0.92 34%
***
***
0%
10%
20%
30%
40%
50%
60%
70%
80%
Relative Absenteeism Total Productivity
Percentage Improvement on HPQ Scores

47. © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 47
Wellness Program: What people have said
I thought the brain assessment was
really cool and taught me a lot. I
appreciate the opportunity to stimulate
my brain by using these solutions.
I think the opportunity to
refocus on the challenges
has been helpful. It is very
easy to get into a rut of
negativity and monotony.
This program helps me to
look at things a little
differently.
So far I think all of it is helpful. The
assessment was great and very interesting.
Now I'm working on skills so I can do the
assessment again to see how it changes.
I really like it. I think the description is fairly
accurate, and after just a couple exercises I
could tell a difference in my attitude.
That stupid balancing
the ball game has
defeated me so
far, but as soon as I
figure out [how] to
actually play it, I will
kick its butt.
I enjoyed the assessment because
it gave me insight into how my
brain processes information. So
far, my experiences are positive.
I like the games available. They are fun and
helpful exercises. I like the ability to track
progress that I make.I like it so far. The games are good in that
I can tailor what I need to work on based
on my profile to what games I need to
do...as well as hone the skills that I am
better at..
It's told me a
lot of what I
already
know, but from
some new
perspectives.
The initial assessment was awesome. It tested my brain
through a series of fun and interesting tasks. The games
are fun. The articles are interesting b/c you only rarely
see articles about the brain on websites or even in health
magazines. Overall, [MyBrainSolutions] has got me
hooked.

48. Q&A
10 minutes
(Included in session
recording)

49. © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 49
Sponsors
Partners
Thank You for
Joining Us!

50. © 2012 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 50
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