14 tips to help your company implement wearables in wellness programs

Fitbit, Garmin, and Mio are just a few of the companies offering everyone the chance to keep track of their fitness level throughout the day. Features include tracking steps, sleep and workouts.

Companies, like Target, are finding ways to implement wearable technology into their Wellness Programs. The programs, a part of employee benefits packages, can help lower healthcare costs, reduce absenteeism and increase productivity.

Implementing the wearable technology is a viable option, but without proper implementation it could create legal challenges.

Experts from various industries came together at Fitbit's recent Captivate 2015 conference and created a list of best practices and lessons learned from their experiences with wellness programs tied to wearables.

James Martin with CIO.com compiled a list of the best tips from those speakers in San Francisco.

Employee wellness plans, privacy and compliance

1) Show employees their personal information is secure

Several speakers emphasized that organizations should show (not tell) employees that health and fitness data is secure.

Some employees initially hesitate to share step counts or other health data with their employers, according to Jim Huffman, senior vice president and head of U.S. Health and Wellness Benefits for Bank of America. These people worry that the information could negatively affect their insurance premiums, chances for promotions or opportunities for raises.

Bank of America is "loud and clear" when it regularly addresses such fears in employee communications and assures staff such information won't be used against them. Buffman said companies have to "prove it," too. In the second year of its wellness program, for example, Bank of America didn't increase health insurance premium rates for any of its U.S. employees, even though the company's own costs rose. Bank of America leaders felt it was important to "pay it forward" and demonstrate to employees that participating in its fitness programs is only beneficial. However, Huffman adds that organizations will "always have a portion of employees who will not share their information."

2) Go above and beyond to protect employee data

Wellness and fitness program managers should "take extraordinary steps" to protect sensitive information collected via wellness programs, Huffman said. He also suggested that companies work closely with HR managers to assure staff that their wellness program teams don't have access to sensitive data, such as employee health insurance claims.

Eric Dreiband, a partner with law firm Jones Day, stressed the importance of maintaining a secure "firewall" between data collected by wearable technology and personnel records. The goal is to keep staff health and fitness data away from supervisors or other decision makers, so that it cannot inadvertently affect employee pay or promotions.

If that data isn't kept separate, and there's an employee complaint, the government could investigate and file a lawsuit, according to Dreiband. The Equal Employment Opportunity Commission sued companies in the past because their wellness programs allegedly violated federal anti-discrimination laws when they coerced people to participate.

3) Stay up to data on relevant regulations

Organizations that use wearables to collect employee data need to be clear on the potential compliance and legal issues related to the Affordable Care Act (ACA), Health Insurance Portability and Accountability Act (HIPAA), and Americans with Disabilities Act (ADA), Dreiband said. Wellness plans that collect medical information, such as heart rate and blood pressure, must be voluntary and may not carry a penalty for non-participation in any way, or they could violate the ADA, for example.

Putting employee fitness data to work

4) Compare anonymous fitness data and business goals

Whenever possible, it's a good idea to tie aggregated, anonymous data from corporate wellness program or fitness challenges to metrics that measure business goals, according to Liz Boehm, experience innovation network director for Vocera, a healthcare communication system vendor.

By combining these data sets, senior management can see how (or if) wellness program engagement helps the company achieve fewer manufacturing errors, lower employee turnover rates, or achieve other business goals. These insights can help keep senior executives bullish on the company's wellness and fitness programs, and convince skeptics the programs are worth the effort and expense.

5) Don't overthink baselines

Companies should avoid getting bogged down when they try to determine baselines for the wellness and fitness program data they want to measure, according to Jennifer Benz, CEO of Benz Communications, which specializes in helping organizations communicate health and wellness programs to employees. (Notable Benz clients include Intuit and Adobe.)

"There's already a lot of great baseline data out there, so you don't have to figure out precisely where your organization is to figure out how to measure improvements."

6) Keep it simple

Companies shouldn't get carried away and try to measure too many things, Benz said.

"Most successful organizations find a couple of metrics to track that are key to their overall business environment," she said.

Wellness programs can often have a "halo effect," as well, giving employees a better sense of their health, according to Benz, which is "something you may not be able to measure, but will be able to see and hear among people in your organization."

Tips for enhanced communication, outreach for fitness programs

7) No silver bullet

There is no single communications channel that's best for raising employee awareness and engagement, according to Benz. So, it's best to embrace multiple channels and formats. Most employees have preferred ways of receiving information, such as viewing online video or reading infographics and email, and the way to reach the largest audience is by using more communication methods.

Ultimately, the goal is "to change wellness behavior, not communications behavior," Boehm said.

Bank of America uses "every form of communications possible" to detail updates, features and benefits related to its wellness program and health challenges, according to Huffman, including the company Intranet, email, "snail mail" sent to employee homes, and team meetings. Before opening each day, Bank of America branches also have "team huddles," which are ideal for communicating information about company wellness programs.

8) Share employees' positive experiences

Several speakers at the San Francisco Fitbit conference said sharing testimonials is an excellent way to engage employees in wellness programs or fitness challenges.

"People love to read stories about their colleagues," Benz said. For example, an 'average Joe' who was a smoker for 20 years successfully completed a cessation program offered by one of Benz's corporate clients. The company highlighted 'Joe's' accomplishment in one of its employee newsletters, and nearly 100 fellow employees emailed him to say the story inspired them to join the program, Benz said. Joe also told his company benefits manager that, after all the recognition he received for quitting, he "definitely can't start smoking again."

Boehm added that organizations should find testimonials from all levels of the company and "keep putting them out there." Employees featured in testimonials can be a wellness program's "best advocates."

9) Focus over generality in communications

Unfortunately, there's no one-size-fits-all approach to effective communication, Boehm said. "The more tailored your communications are (to individual interests), the more engagement you'll get." You're trying to get people to change their behavior, she said. But if your approach is too broad or general, employees might think the message doesn't apply to them.

10) Be timely and proactive

Organizations' communications should be timely and relevant whenever possible, according to Benz. She suggests following the "TaskRabbit model" by striving to make communications "helpful for others" and giving employees information they can act on. For example, if an employee needs an MRI, a company might provide information on affordable facilities that perform the test before the employee makes an appointment.

More tips for successful corporate wellness programs

11) It's not all about the Benjamins

It's never a good idea to depend solely on financial incentives to motivate employees. Many employers choose to increase financial incentives to motivate staff health improvement, but the majority of workers don't take full advantage of the incentives, according LuAnn Heinen, vice president, National Business Group on Health (NBGH).

In 2015, 79 percent of employers will offer monetary health incentives, up from 63 percent five years earlier, according to a 2015 NBGH and Fidelity Investments survey, which Heinen cited. The same survey also found the average maximum incentive amount rose to $693 this year compared to $594 in 2014, while only 47 percent of employees earn the full incentive amount, and 26 percent earn just a portion of the total.

Though important, financial incentives, as well as future health rewards don't always motivate sustainable participation in wellness challenges and fitness programs, Heinen said. The promise of fun, overall better quality of life, and higher energy levels are often more effective motivators, she said.

12) Help employees help themselves

Creativity can go a long way toward giving employees easy options to care for themselves. For example, mindfulness — the act of "being in the moment" —is gaining popularity in corporate wellness programs, according to Heinen. Pitney Bowes, for example, offers five-minute guided meditation for employees over the phone.

13) More physical activity isn't always better

The goal of increasing physical activity isn't always appropriate for all workers. Some workers, such as nurses or employees in packing and shipping departments are always on their feet, so increasing steps isn't necessarily a wise move, Boehm said. Instead, decreasing steps can make these types or workers more efficient in their jobs and "give them energy to focus on what matters most" at work and at home.

14) Cheaters never prosper

Organization shouldn't worry about fitness challenge "cheaters," or people who manipulate their fitness data. Companies that roll out a Fitbit Wellness program can enable or disable employees from manually logging steps, according to Amy McDonough, vice president and general manager, Fitbit Wellness. However, McDonough says Fitbit has "found that with good communications and transparency about how a program ties to incentives and what data is being shared, the majority of employees will be honest and will keep each other honest."


ACA tweaks help small employers, but add confusion

Adjustments to the Affordable Care Act offer some relief for small employer compliance challenges. However, the proposed solutions may create more confusion.
No matter what lies on the horizon for the ACA, an industry expert said, employers and their advisors should not delay in preparing to comply with the law as it already exists.
A lack of resources is said to be causing some small to mid-size employers to lag behind in their understanding of ACA Compliance issues. The government is attempting to make some tweaks to the law to make it more feasible for small to mid-size employees.
For instance, under the Surface Transportation and Veterans Health Care Choice Improvement Act employers can exclude full-time employees who served in the U.S. military and who currently receive veterans' health insurance from the ACA's 50-or-more full-time employee threshold count. The veterans' coverage must either be through Tricare or through the Veterans Affairs Department.
The Protective Affordable Coverage for Employees Act (PACE) also offers some relief by redefining a small group employer from 1 to 50 employees to 1 to 10 employees. The PACE bill maintains the current definition of a small group market and gives states the flexibility to expand the group size.
The Cadillac Tax is also a concern for some employers. A lack of guidance, according to an industry expert, leaves employers and advisers wondering how to avoid the excise tax. The IRS has released proposals that offer some insight into Cadillac tax compliance.
Other concerns for employers and the ACA include a lack of guidance on nondiscrimination, automatic enrollment, quality of care reporting or a new SBC template. Employers have heard little in the way of gudiance from Washington on how to address these issues.

 


Medicare Part D Notices Due October 15

The Creditable Coverage notification requirements for Medicare eligible employees are required by the Centers for Medicare and Medicaid Services (CMS) on October, 15th of each year. 

Plan sponsors whose plans provide prescription drug coverage to Medicare-eligible active employees and dependents, as well as Medicare-eligible retirees and dependents, are required to disclose both to their Medicare-eligible plan members and to the Centers for Medicare & Medicaid Services (CMS), whether their plans qualify as ³creditable coverage² or ³non-creditable² coverage. Creditable coverage is defined by CMS as prescription drug coverage with an actuarial value equal to or exceeding the value of standard Medicare Part D coverage.

This is a friendly reminder that all plan sponsors are required to notify their employees about their creditable coverage status. 
For your convenience, the model notification letters for both credible and non-credible coverage provided by CMS for this year can be found below and are in Word document format.
Most likely you received (or will soon) communications from your health insurance carrier regarding this same issue. These communications most likely inform you that your prescription coverage is creditable or non-creditable. If you did not change your prescriptions coverage in the past year, the creditable coverage status has not changed either. If you have questions regarding the status of your coverage, please contact your health plan insurance carrier or my office.
 
For your convenience, we are attaching the model notification letters for both credible and non-credible coverage provided by CMS for this year in Word document format. Please note these notices are not modified and are the same as last year.
 
Lastly, you are required to notify CMS once per year regarding this status also. For plan years that end in 2007 and beyond, disclosure of creditable coverage status must be provided within 60 days after the beginning date of the plan year for which the entity is providing the disclosure to CMS. This notification may be done online at www.cms.hhs.gov/creditablecoverage/and clicking on "disclosure to CMS" under the heading "Related Links Inside CMS."

What do the ICD-10 codes mean for health providers, employers and HR managers?

After two years of delays, the new ICD-10 codes are live in hospitals across the country.

The tends of thousands of new government-mandated codes describe diseases and hospital procedures in the billing process. The codes are aimed to cover everything that medical professionals may be called on to treat.

Read more codes via @EveryICD10 on Twitter.

How do these codes affect health insurance companies, employers and their human resource departments. Forbes.com contributor Bruce Japsen covers that part of the story.

From erroneous medical bills to denied health services, Americans may need patience grappling with insurance claims beginning today, the much-anticipated launch of tens of thousands of new government-mandated “ICD-10” codes used to describe diseases and hospital procedures in the billing process.

At least one analysis says one in four of the nation’s doctor practices aren’t ready for the transition to  International Classification of Diseases, Tenth Revision, known as “ICD-10.” After two years of delays, medical care providers have to be ready for the conversion to 140,000 new codes that they will use in order to bill government and private insurers.

Health insurance companies, employers and their human resources departments have been working with patients and health plan enrollees, warning of potential problems. Aon Hewitt (AON ), a large employee benefits consultancy, says there is potential for doctors and hospitals to use outdated codes and potentially bill patients for services that could be covered.

“This is a complex conversion that could initially lead to disruptions across the medical field,” said Chris Miles, senior vice president of Aon Hewitt’s health group. “Providers may see overall delays in claims processing, and some individuals may have insurance claims that are denied for services that were provided, but not properly coded.”

The conversion is being required by the Centers for Medicare & Medicaid Services to provide more specificity to the existing coding system. The outgoing ICD-9 codes have limited information about medical conditions and hospital procedures while the new ICD-10 code “sets provide flexibility to accommodate future healthcare needs, facilitating timely electronic processing of claims by reducing requests for additional information to providers,” the Centers for Medicare and Medicaid Services (CMS) has told doctors.

“The impact of the ICD-10 switchover on the healthcare system will not be fully understood until after claims processing begins on Oct. 1,” American Medical Association president Dr. Steven Stack said earlier this week.

But physician groups admit there could be challenged based on surveys they’ve conducted of their colleagues.

Medical Group Management Association president and chief executive Dr. Halee Fischer-Wright said a recent “survey showed 20% or more of physician practices have not received the billing system updates necessary for ICD-10.”

“This could significantly disrupt the submission of patient claims,” Fischer-Wright added.

ICD-10 conversion has been a massive undertaking for private insurers as well since they will use the codes in their claims processing and paying doctors and other providers of medical care.  It has added significant capital expenses to health insurance companies, impacting the likes of Anthem WLP +% (ANTM), Aetna AET -0.93% (AET), Cigna CI -0.75% (CI), Humana HUM +0.06% (HUM) and UnitedHealth Group UNH -1.75% (UNH).

Benefits experts say health plan enrollees could see a delay in authorization for certain tests and procedures if doctors aren’t adequately coding the services. Insurance claims also could be denied.

But the shift to new codes is a good thing overall, particularly as doctors and hospitals move away from fee-for-service medicine to a healthcare system that pays providers based on outcomes and quality.

“Transferring to the new medical claim codes will allow key industry stakeholders to better track and manage diseases, measure the quality of care and evaluate patient outcomes—all of which support the shift toward value-based payment plans,” Miles said.


Technology, interaction, variety: What Millenials look for in a benefits package

Millenials are thinking differently about their company's benefit packages. Understanding what this growing generation in the workforce is looking for could help with your company's recruiting efforts.

A Millenial is someone born after 1980 and the first generation to come of age in the millennium. Pew Research reports this group will number 75 million this year. That's greater than Generation X and Baby Boomers.

But not all Millenials in the workforce are signing up for a benefits package. The Society for Human Resources Management found that just under half of all Millenials consider their overall benefits package to be very important.

Those that find the benefit package important are likely to offer up these answers when asked about employee benefits, according to benefitspro.com.

"I want choice and variety."

Millennials are accustomed to having access to what they want when they want, especially when it comes to information. They want choices and are often offended by a one-size-fits-all approach. Overall, they look for a well-rounded array of benefits, which may mean that a mix of employer-paid products with supplemental and voluntary products will play an increasingly important role for many employers.

"I want customization and control."

Personalization is highly important to millennials. When they’re offered benefits, they expect those benefits to be tailored to their needs. And, they want control over how they spend their money. While giving them plenty of options puts them in the driver’s seat, too many options may paralyze them. Try to strike a healthy balance by considering a choice of plan designs within a product category, or perhaps core/buy-up options.

"I want true simplicity."

Employee benefits shouldn’t be complicated, and communication is the key. Millennials are looking for simple, clear, easy-to-follow steps, which includes systems that are easy to use. It will be to your advantage to recommend working with a carrier who embraces simplicity and offers varying enrollment strategies. This gives you flexibility in recommending the one that’s likely to be most effective.

"I want interaction and collaboration."

Social is the name of the game for the millennial generation. Peer networks play a huge role in decision-making. Employers would be wise to offer ways their employees can interact and network to get information. Blogs are an important way millennials build trust, gather information and connect. Promote them with your clients. They work.

"I want technology, not paper."

Clearly, the biggest difference between millennials and other generations is their use of technology … and their expectation that technology also be important to others with which they interact. They want to use tools that make benefits easier, such as apps and online portals. And they want alternatives to paper. They trust technology.


4 ways to maximize the benefit of your workday breaks

Take a look at your workday. When do you take a break? How long is your break? What do you do on your break? Do you take more than one break? Do you feel recharged after your break?

Those questions were the focus of a study done by 2 Baylor University researchers. Emily Hunter, Ph.D. and Cindy Wu, Ph.D. are associate professors of management in Baylor's Hankamer School of business. The pair surveyed 95 employees between the ages of 22 and 67 over a 5-day workweek. Each person was asked to document each break they took.

Their empirical study - "Give Me a Better Break: Choosing Workday Break Activities to Maximize Resource Recovery" - was recently published in the Journal of Applied Psychology.

The research defined a break as “any period of time, formal or informal, during the workday in which work-relevant tasks are not required or expected, including but not limited to a break for lunch, coffee, personal email or socializing with coworkers, not including bathroom breaks.”

When compiling the total of 959 break surveys, Hunter and Wu were able to provide a greater understanding of workday breaks. Their findings offer suggestions on when, where and how to plan the most beneficial daily escapes when on the clock.

Key findings of the study include:

1) Best time to take a workday break: Mid-morning.

A typical work day may have you counting down to lunch, but the study found an earlier break is more successful in replenishing energy, concentration and motivation.

“We found that when more hours had elapsed since the beginning of the work shift, fewer resources and more symptoms of poor health were reported after a break,” the study says. “Therefore, breaks later in the day seem to be less effective.”

2) What to do on your break: Something you enjoy and not necessarily non-work related.

The study found no evidence that non-work-related activities are more beneficial. Instead, do things choose to do and like to do which could include work-related tasks.

“Finding something on your break that you prefer to do – something that’s not given to you or assigned to you – are the kinds of activities that are going to make your breaks much more restful, provide better recovery and help you come back to work stronger,” Hunter said.

3)"Better Breaks" = Better health, increased job satisfaction

Employee surveys showed those that took mid-morning breaks and did things they preferred led to less somatic symptoms like headaches, eyestrain and lower back pain after the break.

The study also found the employees also experienced increased job satisfaction and a decrease in emotional exhaustion.

4) But how long should the break be?

The study wasn't able to pinpoint an exact length of time for a better workday break, but it did find that more short breaks with associated with higher resources - energy, concentration, and motivation.

“Unlike your cellphone, which popular wisdom tells us should be depleted to zero percent before you charge it fully to 100 percent, people instead need to charge more frequently throughout the day,” Hunter said.

Hunter and Wu believe the results of the study benefit both managers and employees.


10 things to check when planning 2016 health benefit packages

The clock is ticking down to 2016 which means time is running out to dot the 'i' and cross the 't' for your health benefit packages. Employee Benefit Adviser has these tips.

1) Employer shared-responsibility (ESR) strategy: Ensure the intended goal of avoiding or paying ESR assessments for 2016 coverage is supported by coverage offers, administrative and recordkeeping processes, and benefit documents.

2) ESR reporting: Arrange data sources, systems and administrative processes to collect all information about enrollees with minimum essential coverage (MEC), full-time employees, and coverage offers needed for reporting on 2016 coverage. Create a process for correcting any erroneous IRS filings and personal statements.

3) Preventative care: Ensure “non-grandfathered” group health plans comply with the final ACA rules and recent guidance on cost-free preventive services.

4) Other ACA reporting and disclosure requirements: Review delivery operations for summaries of benefits and coverage (SBCs) and watch for revised SBC templates. Prepare for round two of online submission and payment of ACA’s reinsurance fee.

5) Mid-year changes to cafeteria plan elections: Decide whether to permit mid-year changes to cafeteria plan elections for either or both of the status-change events in IRS Notice 2014-55.

6) ACA’s out-of-pocket maximum: Verify that self-only and other (e.g., family) coverage tiers in “non-grandfathered” plans meet ACA’s 2016 out-of-pocket (OOP) limits for in-network care. Confirm that family coverage also satisfies ACA’s self-only OOP limit for each enrollee.

7) Same-sex marriages and domestic partnerships: Assess how the U.S. Supreme Court’s Obergefell v. Hodges ruling that legalizes same-sex marriage nationwide affects your benefit programs and employment policies. Also, consider the decision’s indirect implications for domestic partner coverage.

8) Mental health parity: Check that plan designs and operations provide parity between medical/surgical and mental health/substance use disorder (MH/SUD) coverage. Federal audits of health plans now evaluate compliance with the final Mental Health Parity and Addiction Equity Act (MHPAEA) rules that took effect in 2015. In addition, state legislative activity and litigation around parity issues continue.

9) Wellness: Review employee wellness programs against the proposed Equal Employment Opportunity Commission (EEOC) rules requiring voluntary participation and restricting incentives for completing health risk assessments and/or biomedical screenings. Be prepared to make changes after EEOC finalizes these rules for nondiscriminatory wellness plans under the Americans with Disabilities Act.

10) Fixed-indemnity and supplemental health insurance: Review fixed-indemnity and supplemental health insurance policies to ensure they qualify as excepted benefits under the ACA and the Health Insurance Portability and Accountability Act (HIPAA).


IRS unveils health care page for large employers

Original post by Jeff Stimpsoneba.benefitnews.com

The new ACA Information Center for Applicable Large Employers page on IRS.gov features information and resources for employers of all sizes on how the health care law may affect them if they fit the definition of an applicable large employer.

The page includes such sections as trends and resources for ALEs; how to determine if you are an ALE; and outreach materials including FAQs and links to forms, among other materials.

In 2016, ALEs must file an annual information return and provide a statement to each full-time employee reporting whether the company offered health insurance, and if so, what insurance it offered.

RELATED: How to Avoid ACA Filing Penalties

Companies that will file 250 or more information returns for 2015 must e-file the returns through the ACA Information Reports system. Draft Publication 5165, “Guide for Electronically Filing Affordable Care Act Information Returns,” contains information on the communication procedures, transmission formats, business rules and validation procedures for returns that companies must transmit in 2016.

Although most employers will not be affected, companies should determine if they are an ALE, which comprises an average of at least 50 full-time employees (including full-time equivalents) during 2014. A company with fewer than 50 full-time employees may be an ALE if it shares a common ownership with other employers.


A way to take your wellness program beyond paper

Target is taking its wellness program a step further and giving its more than 300,000 employees access to a FitBit tracker. And to sweeten the deal, all employees participating in the FitBit Wellness Program will have a chance to earn money for the charity of their choice.

Employees can sign up to get the FitBit Zip ($59.95) for free or pay the difference for a more advanced FitBit.

Amy McDonough, vice president and general manager of Fitbit's wellness unit, told eWEEK that the deal with Target is one of the largest company-wide wellness arrangements it has made so far.

"The Target announcement was exciting because they are a strategic retail partner for Fitbit products and also a large employer," McDonough said. "It's a great example of how these larger organizations are really putting wellness at the forefront."

Employees who take advantage of the FitBit offer will be grouped into teams for a monthlong challenge. The winning team will get $1 million to funnel into a charity of their choice, Chief Human Resources Officer Jodee Kozlak told CBS News.

Kozlak added that employees will also receive extra discounts on fruits and vegetables, and healthy grab and go snacks will be featured near cash registers.

RELATED: One compelling reason to participate in a wellness plan


Grab the sanitizer, you'll want it after you read this

The digital age is giving germs a new breeding ground. But a little extra cleaning can narrow the playing field according to this article from forbes.com.

When it comes to germs, the gold standard for grossness is the bacteria brewing in our bathrooms.

A variety of studies and reports over the years have put the average bacteria per square inch on a toilet seat somewhere between 50 and almost 300 for household potties and over 1,000 for the public varieties. Yet our own handheld electronics harbor even more bacteria than that.

Smartphones Your smartphone is home to your photos, music, contacts, productivity apps and odds are at least one game featuring a bird, zombie, fruit or farm. Oh, and there’s something else on your smartphone, too — loads of fecal coliforms. Joining the coliforms are Streptococcus, Staphylococcus aureus and a host of other -ococci.

A 2013 project at the University of Surrey perfectly illustrates the situation.

Bacteriology students made imprints of their phones in Petri dishes, and after three days, they saw examples of many of the aforementioned bacteria — plus one particularly hairy case of Bacillius mycoides. It’s really not surprising that the device that goes everywhere from public transportation to public restrooms to not-so-public germ repositories (aka our own homes) is a hot bed for bacteria.

Even back in 2012, when iPhones only offered us 4.5 inches of germ-covered surface,University of Arizona microbiologist Chuck Gerba found cellphones carried 10 times more bacteria than most toilet seats. In 2013, Mashable put that number much higher, claiming that our phones may boast a whopping 25,107 bacteria per square inch. But your smartphone is just one of the worst offenders, not the only one, as this black-light-enhanced demonstration from British business services group Initial reveals.

Here are four more gadgets to rival any restroom when it comes to germs:

Tablets/e-readers — Just think of them as smartphones with fewer features and more surface area when it comes to the germ load tablets and e-readers pack. One iPad tested by British consumer magazine Which? found 600 units of Staphylococcus aureus alone.

Game controllers — With almost 5 times more bacteria than your toilet seat, your game controller has probably still seen scarier stuff (like that boss faceoff with Sephiroth). Still, E. coli is among the potential offenders.

Keyboards — Your keyboard could be home to anywhere from three times more bacteria than your toilet seat to almost three times that of a public toilet seat. Some studies found 3,000 bacteria per square inch on computer keyboards and 1,600 on the average computer mouse.

Remote controls — While likely cleaner than a public toilet seat, remotes still boast a bit more bacteria than some home-throne estimates with 70 present per square inch.

So how do we handle all of this bacterial buildup?

Step one: Remember the bathroom is no place for a phone (that you don’t want covered in fecal coliforms).

Step two: Wash your hands before handling your devices, or at least use a hand sanitizer.

Step three: Use gadget-friendly wipes to keep your favorite handhelds tidy.

But if you only do one thing, let it be step two. After all, you know what else has more bacteria per square inch than a toilet seat? You do. A lot more.