Communicating With Your Doctor On Facebook May Be The Future Of Healthcare
Originally posted by Carolyn Gregoire on June 20, 2015 on huffingtonpost.com.
We communicate with our friends, our families and our coworkers via email and Facebook, and apparently, most Americans also wish that they could keep in touch with their health care providers this way.
A national survey of 2,252 pharmacy customers conducted by Johns Hopkins University's Bloomberg School of Public Health highlights the gap between what patients want from their health care providers in terms of communication and engagement, and what they're actually getting.
"This study tells us that for most patients, healthcare isn’t quite ready for the future," Joy Lee, a post-doctoral fellow at the university, told The Huffington Post.
In fact, there's something of a patient engagement paradox in healthcare, Lee said.
"On the one hand, doctors, policymakers, and researchers often talk about the need to engage patients," she explained. On the other hand, many patients are already engaged -- in Facebook and other online communities. Yet instead of embracing this connection, medicine is preoccupied with confidentiality and drawing professional boundaries.
Fifty-seven percent of respondents -- who were generally educated, healthy and regular users of Facebook -- said that they were very interested in using Facebook and email to communicate with their physicians and to manage their health. More than half of respondents also said that they wanted to use their physicians' websites to access health information.
More than a third said that they already communicated with their doctors via email, and 18 percent said they connected with their doctors on Facebook, a surprising finding considering that many health care providers have rules barring this mode of interaction with patients due to privacy concerns and ethical guidelines for physicians.
Young adults -- as well as caregivers, patients with chronic conditions, and regular Facebook users -- were more likely to communicate with their doctors via email and Facebook.
Lee emphasized that of course, it's critical to safeguard patient information. But "Health care organizations need to figure out how to take advantage of resources like Facebook," she added.
They're already on the way. As part of the growing telehealth movement, many doctors and health care organizations have electronic systems that patients can use for things like messaging, accessing test results and personal information, and health tracking.
"Many patients are interested in [these services] but few are actually using them -- possibly because patients don’t know they’re available," Lee said. "Doctors and health care organizations should take steps to publicize and educate patients of these opportunities. Either way, it starts with a conversation between patients and doctors on how they prefer to communicate online."
The study was published this month in the Journal of General Internal Medicine.
Most Cyber Attacks Due to Trick Emails, Errors, Not Sophisticated Hacking
Originally posted by Joseph Menn on April 14, 2015 on insurancejournal.com.
When a cyber security breach hits the news, those most closely involved often have incentive to play up the sophistication of the attack.
If hackers are portrayed as well-funded geniuses, victims look less vulnerable, security firms can flog their products and services, and government officials can push for tougher regulation or seek more money for cyber defenses.
But two deeply researched reports being released this week underscore the less-heralded truth: the vast majority of hacking attacks are successful because employees click on links in tainted emails, companies fail to apply available patches to known software flaws, or technicians do not configure systems properly.
These conclusions will be in the minds of executives attending the world’s largest technology security conference next week in San Francisco, a conference named after lead sponsor RSA, the security division of EMC Corp.
In the best-known annual study of data breaches, a report from Verizon Communications Inc. to be released on Wednesday found that more than two-thirds of the 290 electronic espionage cases it learned about in 2014 involved phishing, the security industry’s term for trick emails.
Because so many people click on tainted links or attachments, sending phishing emails to just 10 employees will get hackers inside corporate gates 90 percent of the time, Verizon found.
“There’s an overarching pattern,” said Verizon scientist Bob Rudis. Attackers use phishing to install malware and steal credentials from employees, then they use those credentials to roam through networks and access programs and files, he said.
Verizon’s report includes its own business investigations and data from 70 other contributors, including law enforcement. It found that while major new vulnerabilities such as Heartbleed are being used by hackers within hours of their announcement, more attacks last year exploited patchable vulnerabilities dating from 2007, 2010, 2011, 2012 and 2013.
Another annual cyber report, to be released on Tuesday by Symantec Corp., found that state-sponsored spies also used phishing techniques because they work and because the less-sophisticated approach drew less scrutiny from defenders.
Once inside a system, however, the spies turned fancy, writing customized software to evade detection by whatever security programs the target has installed, Symantec said.
“Once I’m in, I can do what I need to,” said Robert Shaker, an incident response manager at Symantec. The report drew on data from 57 million sensors in 157 countries and territories.
Another troubling trend Symantec found involves the use of “ransomware,” in which hackers encrypt a computer’s files and promise to release them only if the user pays a ransom. (Some 80 percent of the time, they do not decrypt the files even then.)
The new twist comes from hackers who encrypt files, including those inside critical infrastructure facilities, but do not ask for anything. The mystery is why: Shaker said it is not clear whether the attackers are securing the information for resale to other spies or potential saboteurs, or whether they plan on making their own demands in the future.
RSA Conference
At next week’s RSA Conference, protecting critical infrastructure systems under increasing attack will be a major theme. Another theme will be the need for more sharing of “intelligence” about emerging threats – between the public and private sectors, within the security industry, and within certain industries.
While many of the biggest breaches of the past two years involved retailers, the healthcare industry has figured heavily in recent months. Former FBI futurist Marc Goodman said that both spies and organized criminals are likely at work, the former seeking leverage to use in recruiting informants and the latter looking to cash in on medical and insurance fraud.
Verizon’s researchers said that to be most effective, information-sharing would have to be essentially in real time, from machine to machine, and cross multiple sectors, a daunting proposition.
Insurance
Another section of the Verizon report could help security executives make the case for bigger budgets. The researchers produced the first analysis of the actual costs of breaches derived from insurance claims, instead of survey data.
Verizon said the best indicator of the cost of an incident is the number of records compromised, and that the cost rises logarithmically, flattening as the size of the breach rises.
According to the new Verizon model, the loss of 100,000 records should cost roughly $475,000 on average, while 100 million lost records should cost about $8.85 million.
Though the harder data will be welcome to number-crunchers, spending more money cannot guarantee complete protection against attacks.
The RSA Conference floor will feature vendors touting next-generation security products and anomaly-spotting big-data analytics. But few will actually promise that they can stop someone from clicking on a tainted email and letting a hacker in.
Anatomy of a Hack
Originally posted by Zurich American Insurance Company.
Once hackers set their sights on a target with access to sensitive company information, attacks may ensue from multiple directions – in the office, at home or on the move. Anatomy of a Hack describes what you and your company can do to help limit exposures.
The risk of having sensitive company data lost and stolen has grown exponentially over the last few years, largely due to the increased use of the Internet and the interconnectedness of everything we do. As the likelihood of a data breach continually escalates, so does the cost.
Read more here.
Check out the “Anatomy of a Hack” infographic here.
Copyright © 2015 Zurich American Insurance Company
Personalized Employee Training Plans: Have You Joined This Trend?
Originally posted January 8, 2015 by Bridget Miller on HR Daily Advisor.
Did you know that many organizations are opting to create training programs for employees that are more personalized rather than generic or role-based? These training plans take into account not only the role the individual is training for but also the individual’s future goals and any gaps in that person’s skill set.
Assessing individual skill levels through testing;This trend is made possible because of technology. Today, there are dozens of online platforms that can handle every aspect of training, including:
- Outlining what training courses are needed for each role (and each individual) throughout the organization;
- Tracking which courses have been completed by each individual employee;
- Monitoring compliance for any training session that is legally mandated;
- Showing employees what training sessions are available within the organization;
- Storing actual training documents, such as presentations, handouts, and more;
- Testing learner knowledge after a training session through post-tests to ensure the session was effective;
- Allowing individuals to search for specific types of training and other resources;
- Allowing individuals to take training courses in the format they prefer (in some instances), whether that be in-person, online, or even on a mobile device;
- Providing immediate access to online training and informal resources;
- Allowing employees to comment on content and interact with one another and with trainers;
- Providing training certificates for course completions; and
- Providing reports with any of the above information, plus much more.
Technology enables all of these actions; it is up to the organization to decide which aspects to focus on and utilize as they set up their system.
Why Create Personalized Training Plans?
You may be thinking that this sounds like a lot of effort and expense—and if it’s done haphazardly, it could be. But if personalized training plans are implemented as part of a larger focus on training and productivity improvements, there’s no reason they cannot be a win-win for both employers and employees.
Here are a few of the benefits for employers:
- Fewer skills shortages, because employees get trained in what they need;
- More satisfied employees who feel that their employer is investing in their development, which leads to increased morale and retention;
- Increased productivity from employees who are properly trained for their roles and who are brought up to speed more quickly;
- Less wasted time for unnecessary training (i.e., when employees are put through training simply because it’s required, not because they need it);
- The organization can be more competitive with employees who have skill sets closely aligned with their roles;
- The organization can gain a reputation as an employer that cares about employee development, which can lead to better-qualified applicants;
- Higher customer satisfaction, because employees are well-trained in how to serve the customer best;
- Better employee retention of training materials, because employees can take training in smaller chunks at their own discretion—the learning is reinforced more frequently over time; and
- More employees will benefit from training if they have the option to take it in a format that is best suited to their learning style. The training has the potential to be more effective when personalized, even if the same content is covered across all employees.
How Can Personalized Employee Training Plans Be Implemented?
Even if you’re already on board with the idea of implementing personalized training plans for employees, it can be daunting to think about how to implement it in practice. There are quite a few ways to do it, so each employer can opt to customize their implementation in a way that works best for them. Here are just a few examples:
- Incorporate training and employee development into the performance management system so that it can be paired with employee goals.
- Convert some training to online versions to allow employees to take additional training sessions as their time allows. Obviously, this is not possible for every type of training, but it can be useful in many cases and can often be used for portions of courses even when it cannot be used for the full course. For example, if an employee needs to attend a live training session on a particular topic, online options could still be used to provide pre-reading, handouts, and pre-tests to assess skill levels in advance of the session.
- Implement a learning management system (LMS) that will assist in tracking training needs. This could also allow employees to pick and choose optional training sessions to attend, especially if some of those options are available online rather than only through live courses.
Has your organization begun to implement more personalized training options? What methods did you use? What are your next steps?
In 2020, Workers Will Decide Health Benefits
Originally posted by Bill Toland February 09, 2014 on https://insurancenewsnet.com
By the end of the decade, the majority of American workers will be selecting their health benefits from an online menu of plans and paying for those benefits with a stipend from their employer, according to experts in the field.
If and when that day comes, it would mark a major shift for the nation's health care apparatus and a reversal of the method by which health insurance has been furnished to American workers for decades -- through a defined-benefits plan selected by an employer.
In 2020, private health "exchanges" will be the predominant way that health care benefits are delivered in this country, said Eric Grossman, a senior partner at Mercer and the exchange business leader in his company's benefits division.Mercer, based in New York with an office in Pittsburgh, is a global human resources, benefits and financial services consultant.
Mr. Grossman, like many other experts in the field, likens the transition in health insurance to the ongoing transition in retirement planning -- where once the "defined-benefit" pension was commonplace, now many companies offer "defined contributions" which employees can steer to a 401(k) or an investment mix of their choice.
That transition took two decades, but now, for anyone under the age of 35, employer-subsidized retirement -- where it still exists, that is -- generally means a defined contribution.
"Our prediction in health care is that a similar transition will happen, [but] it will happen more quickly," Mr. Grossman said.
Private health insurance exchanges -- some of which already exist -- work like this: Instead of an employer negotiating a standard benefits plan or two for its employees, companies instead make a defined cash contribution to employee accounts. Employees then use the cash to select from a menu of a half-dozen or so health plans, with varying price levels of coverage.
Exchanges are set up and managed by health insurers (such as Highmark), benefits consultants (such as Mercer), traditional benefits brokers and online brokers. Plans included in exchanges can be a mix of plans from regional and national insurers, depending on who is the sponsor. A Highmark exchange would offer only its own plans, for example, while a Mercer exchange would offer plans from several companies.
Businesses have dozens of plans to choose from within the exchange "universe" -- health as well as dental, vision and others -- but that list is whittled down to a handful before the plans are finally offered to employee groups.
These are called private, or closed, exchanges because the policies are available only to company employees -- not to the population at large, as is the case with the national and state-based marketplaces that came online Oct. 1 as part of the Affordable Care Act.
Right now, said Bill Brown, Highmark's manager of digital distribution, national marketplace penetration for private exchanges is about 3 percent and adoption rate among Highmark's client base is about the same. Large companies with more than 250 employees have been particularly cautious.
Highmark began offering large employers access to its "MyBenefits" exchanges Jan. 1.
"There's a lot of interest," Mr. Brown said. "But they're not ready to jump."
That's partly because, despite the 401(k) analogy, there's not much immediate cost savings in a health exchange, particularly for large groups. When big employers moved away from pensions and toward defined contributions, the point was to reduce immediate retirement costs and unload a major financial liability going forward. Today, less than 30 percent of Fortune 100 companies offer a defined-benefit retirement plan to new salaried employees.
But with health exchanges, big, self-insured employers that now pay all of their own medical claims will continue to do so. The impetus to move to an exchange, at least among larger employers, won't come from claims savings but rather the opportunity to offer a wider array of health plans to employees and to offload some of the benefits administration now handled by human resources departments.
The real savings will come for fully-insured small-and-mid-sized groups, Mr. Brown said.
They'll be able to offer far more variety to employees, and the entire process will happen online. "It really streamlines administration," he said.
If they "move onto [the] exchange, they get five medical options, four dental, four vision" plans, he said. Employees can choose the plan that is best for them and their family.
While the pension analogy is the one most commonly used to describe the shift, Mr. Brown said a comparison to the world of retail shopping might be more appropriate. Where once customers went to a store and were able to select from whatever the store had in stock, now they can go to Amazon.comand buy anything.
A decade or so ago, people might have been skeptical of the online shopping process, but not anymore -- at least, not in retail.
Mr. Brown believes that will be proven true in health insurance: 14 years ago, Highmark test-launched an online ("paperless," the press release described it) defined-contribution platform called BlueChoice. "It kind of fizzled out. Nobody was ready at that time."
But they soon will be. Part of it is just the ubiquity of the Internet. Part of it is getting used to health care as a retail market. And part of it, said Mr. Grossman of Mercer, is getting people to separate work from health insurance. If people don't buy auto or mortgage insurance through their employers, why do they get health insurance that way?
"The mindset for decades was, for most people, 'My employer provides it,' " Mr. Grossman said, and employers have done so, and continue to do so, for competitive reasons. Employer-sponsored health insurance became the norm in the U.S. following World War II, driven by recruiting needs and labor unions.
That era is ending, and Mercer is of the opinion that the "employee is in the best position to decide the best plan," Mr. Grossman said.
Mr. Brown predicted that in the next 18 months, up to 40 percent of small employers will be offering benefits through some kind of exchange and up to a quarter of midsized companies will do the same.
"The one thing I'm waiting for is someone really big to make a move [to exchanges] -- Walmart, McDonald's," Mr. Brown said. "That's the tipping point. And the entire market is going to start to switch."
Manage chronic diseases with smartphones and smart-tech inhalers
Originally posted November 5, 2013 by Kathleen Koster on benefitnews.com
If people with chronic conditions only spend about an hour a year with their physician, how can they stay adherent with medication and their disease education for the 8,759 hours they’re outside the doctor’s office? The most promising answer is through mobile devices.
Health plan providers and plan sponsors can use mobile devices to monitor and engage participants with notifications, such as medication reminders, when it is most convenient for them. Backsliders know where they are failing through self-monitoring in real time and coaches monitoring their results can intervene when necessary.
“People need to be thinking about lifestyle choices when they're living life. People don't live their life at a desk," says David Bjork, president of Telcare, Inc. He adds that lifestyle changes occur in the "between" moments, such as before and after work, during lunch or at home. Disease management programs and outreach need to encourage healthy behavior at all times.
Bjork insists that the current disease management strategy and methodology need to evolve; most of today’s programs identify people who are most expensive in claims data last year and manages them in order to save money for the future. However, he says, employers need to look at diseases from the wide mouth of the funnel and help people earlier before they escalate into high-risk categories and become high health plan utilizers.
Mobile technology is no different, says Bjork. Mobile outreach is deployed to focus on the most expensive, high-risk patients in a population. New solutions have emerged that collect data from more patients and track a wide range of peoples’ activity, biometric data or clinical metrics. And he believes more will come.
“The problem is that disease management as we know it has failed,” said Jonathan C. Javitt, MD, CEO and chief medical officer at Telcare, Inc. during a presentation at the Care Continuum Alliance Forum in Scottsdale, Ariz. These antiquated outreach programs too often identify the high-cost individuals from last year without taking into account who will be high cost this year or the year after that. He believes mobile solves this problem by engaging everyone in a population and can monitor and intervene with people in real-time before they become high risk.
Bjork agrees that tier-models focusing on certain diagnosis groups with high levels of utilization are missing an opportunity because certain disease states or condition states are left completely unguarded. For instance, disease management programs that focus on diabetes should also target obesity since that often leads to diabetes.
Mobile solutions for diabetes allow individuals to manage their blood sugar levels by sharing blood glucose levels through the cloud to the care management coach or vendor can monitor their levels behind the scenes. Mobile outreach can help manage pre-diabetes and weight as well by tracking a participant’s activity.
Carolina Advanced Health uses an online database to collect participant metrics and monitor them in a team-based approach with nutrition experts, care managers and pharmacists through disease registries. Participants self-collect their glucose levels through a mobile platform, which sends the data to health professionals. If the care team notices a blip in blood glucose levels after lunchtime, a nutritionist can call the patient immediately and ask them about their activity and meals that day to determine what caused the increase. The system educates the patient while monitoring their health metrics in real-time.
Self-management can get good results, explained Thomas Warcup, medical director at Carolina Advanced Health, but “when you add a team you get greater results because you’re watching the data on a real-time basis.”
Bjork believes mobile outreach like this is just the beginning. He predicts the mobile outreach for diabetes will fan out to managing other diseases. For example, blood pressure levels, asthma, and weight will all be observed in a more mobile way.
"We will start having methodologies for monitoring people in their own settings to manage behavior and intervene early on and not wait for the first episode to occur," he says.
One smart-tech inhaler gathers data whenever a patient uses it, helping understand what triggers an asthma attack and how to avoid one. Propeller Health’s inhaler shows when and where the patient uses it and combines this data with weather information (such as wind and UV index) as well as traffic information. With this data, they can map a city for an asthmatic patient so they can avoid bad air locations and prevent potential asthma attacks.
Employers turn to tech for wellness
Source: https://www.benefitspro.com
By Amanda McGrory-Dixon
More employers are relying on new technologies to promote health engagement and attain targeted employee behavior changes, according to a new study by Buck Consultants and WorldatWork.
Specifically, 62 percent of respondents report using gamification and believe it is most effective, and 31 percent of respondents say they are likely to implement gamification in the next year. Fifty percent of respondents use social networking, though there are concerns over personal privacy. Another 36 percent of respondents use mobile technology, which is the least used, but 40 percent of respondents say they expect to rely on mobile technology in the future.
Additionally, 73 percent of respondents say they have implemented health engagement strategies, measure communication effective have a health engagement strategy in place and measurement of communication effectiveness, but return on investment could use more help.
While roughly half of respondents say mobile technology will be the most prevalent technology used by employers in the next two years, only 11 percent of respondents report measuring ROI on mobile apps and social media platforms, and 21 percent of respondents say they measure ROI on gamification.
“The lack of measurement is due, in part, to the fact that many companies are using third parties, such as health insurers and wellness program vendors, to handle various aspects of their wellness programs,” says Lenny Sanicola, CBP, senior benefits practice leader of WorldatWork. “These companies should direct their vendors to better engage employees and to collaborate on measuring effectiveness.”
The survey reveals that the largest obstacle from keeping respondents using these technologies is budgeting at 71 percent for gamification, 73 percent for mobile technology and 68 percent for social networking. Respondents also say lack of senior management support and no effectiveness measurements are barriers for these technologies. When it comes to social media, 43 percent of respondents say they have blocked some or all sites from employees’ computers.
“Today’s health care benefits require individuals to absorb an increasing share of expanding health care costs,” says Scot Marcotte, managing director of talent and human resources solutions at Buck Consulting. “Technology offers unprecedented ways for employers to motivate and enable employees to become more effective health care consumers. But employers need to better understand what drives their workers to make the desired changes.”
Want to know what 2025 will look like?
BY KATHRYN MAYER
- Many needs, many models. This scenario is a natural extension of health care as many Americans know it. The scenario forecasts a shortage of primary care physicians, increased emphasis on disease prevention, growth in electronic medical recordkeeping, a shift from employee-based insurance to health insurance exchanges, and growing disparities in access to and quality of primary care based on income and where people live.
- Lost decade, lost health. This scenario forecasts a shortage of primary care physicians, declining income for practicing physicians and more uninsured patients, some of whom resort to black market care and unreliable online advice. Patients with good insurance have access to great care enhanced by advanced technology
- Primary care that works for all. This scenario assumes nearly universal health care coverage, with 85 percent of patients using integrated systems staffed by collaborative teams of health care providers, including physician assistants, nurse practitioners and health coaches who work closely with patients. Seeking to provide better care at lower cost while improving the health of the population they serve, primary care teams join with community partners to address factors that affect a community’s health, including employment, educational attainment, housing, transportation, and access to fruits and vegetables.
- Consumer is boss. Under this scenario, four of 10 patients opt for consumer-directed health plans, which include catastrophic insurance with high deductibles. For the most part, savvy consumers use advanced technologies, including noninvasive bio-monitors, as well as wellness and disease management apps, to stay healthy. Large vendors offer free avatar-based health coaching to consumers who purchase other integrated health products and services. Consumers shop for the best doctor and buy on the basis of high quality and low price.
Read why flexible benefits don’t always have to be online
By Steve Hemsley
Whether it is reading books on a Kindle or buying groceries online, the technology industry has long proclaimed we are heading for a paperless society.
When it comes to communicating and then administering something as important as flexible benefits, HR directors can find it hard to resist the temptation to switch to an online solution.
From a time-saving point of view, changing to a web-based system should make perfect sense, because one of the reasons for dumping paper is to shift some of the back office admin work onto the employee. And why wouldn't someone want to spend some of their free time looking at an online benefits portal? After all, 85% of employees rate benefits as 'important' or 'very important', according to the CIPD.
Yet any benefits program is only successful if it engages staff by making it clear what is being given, why, how benefits will work and when new ones will be introduced.
Charles Cotton, adviser for performance and reward at the CIPD, says at first glance technology may appear to make schemes easier to administer and communicate - and in some cases cheaper. But, he argues, HRDs must think carefully before committing to what could be a hefty, long-term investment.
"Ultimately, an employer must consider how having flexible benefits supports what it is trying to achieve and what it needs from its employees," says Cotton. "If the benefits scheme is relatively simple, then paper is perfectly fine and the HR team will not gain anything from switching to online. In fact, data can go missing or be incorrectly inputted and the HRD must decide if he or she is happy for the information sent electronically to be accessed by a third party." Even when paper folders are consigned to history, there still remains an administrative burden. The HR team must study and respond to the data reports being generated, for example.
Traditionally, HR has worked closely with the payroll and the internal communications teams to communicate flexible benefits.
A switch to online can complicate the working relationship, because the IT department and a third party technology provider become involved.
HRDs can also underestimate how long it will take to implement a technology solution (up to six months) and the ongoing costs involved during the length of a web-based contract (often three years or more).
Claire St Louis, HRD at digital marketing agency Essence, whose clients include Google and eBay, agrees with the CIPD and urges HRDs not to rush into technology for technology's sake.
She says technology can be a barrier to some staff understanding and engaging with the benefits on offer, especially in companies where employees do not work in front of computers, are on the road, on the shop floor or in various manual roles.
"Many companies wrap themselves up in HR processes, ultimately forgetting the reason why they are doing them," says St Louis. "Benefits are there to retain, motivate, attract and maintain competiveness and, in many cases, people-based internal communications and paper administration is still the right way to go."
Kuljit Kaur, head of business development at the Voucher Shop, says organizations must certainly not ignore the importance of internal communications and the power of having HR staff and specialists available to explain how and why particular benefits exist.
"People are naturally cynical and think there must be a catch when it comes to benefits. A more 'people-based' approach allows you to communicate why this is not the case," says Kaur. "Using real people as advocates of particular benefits to talk to other staff face-to-face works better than just sending an email telling people to log on to a website to view benefits. Technology assumes people will make the effort to find out more."
Even Matt Waller, CEO at online provider Benefex, accepts that for some organizations a paper system can be cheaper, remove reliance on involving third parties and enable more control internally. But, he points out that an online option allows data to be centralized and makes it easier to communicate benefits to large numbers of employees.
"For businesses that want a flexible benefit or total reward scheme to reach as many people as possible in the most time- and cost-efficient way, technology has to be the way forward," he says. "Benefit selection errors can be corrected more quickly and paper document hell is avoided when informing payroll and benefit providers."
Matt Duffy, head of online benefits at Lorica Consulting, backs him up, although he agrees that technology is not right for every organization. "Online is a simpler solution for an increasing number of companies, although when setting up a flex scheme there is less of a build phase with paper," he says. "However, what actually takes the time is devising the rules and working out who is eligible and what the rules are. Companies still have to do this, even with a paper system."
In reality, this is not a black and white issue between paper and internal communications or online. Most organizations now adopt a multi-channel approach, supporting an online system with various forms of offline communication.
Even at technology giant Telefónica O2, paper has not been abandoned completely. It supports its tailored online benefits system with leaflets posted to an employee's home address. There are also benefits roadshows.
Telefónica rewards manager Kirsty Read says offline communication uses simple messaging to draw people into the website, where they can discover more detailed information on complex areas such as salary sacrifice and tax.
"We have actually re-introduced the paper leaflet after a five years' absence," says Read. "Staff told us they wanted a range of different communications relating to benefits. If they receive a leaflet at home, they can start to think about their benefits and discuss them with their family."
A multi-channel approach is supported by Thomsons Online Benefits' MD, Chris Bruce. "This is about ensuring that even with an online solution, staff can still talk to real people at workshops and clinics and read paper benefit guides alongside the online content," he says.
While it can make sense for larger employers to move online, many SMEs are concerned about the cost of the technology and perceive it as complex."
Julia Turney, head of benefits management at Jelf Group, says a flexible benefits system can certainly work without technology, particularly in small companies that have simple salary exchange benefits without complicated calculations.
"The administration side of things tends to be the deciding factor for companies moving to an online system, but technology alone will not engage staff with benefits, even if it makes the HR department's job easier," says Turney.
Benefits consultancy Mercer has teamed up with software firm Sage Employee Benefits to develop packages for organizations with fewer than 100 staff. SMEs are offered an online portal, but employers still have access to Mercer's specialist advisers.
"Technology is not always the answer," says Matthew Forrest, head of services at Sage UK. "Many SMEs want to offer benefits and can do so with paper-based and telephone support. This product allows owners of small businesses to manage a flexible benefits package at an affordable price, shaped to their needs."
The technology providers' message that online is best does seem to be winning over SMEs, with an increasing number ditching their paper systems. This trend is likely to accelerate as benefits packages become more complex and employers prepare for the phased introduction of auto-enrolment pensions this year.
Law firm D Young has 180 staff in London and Southampton and switched from paper to a predominantly online system in June 2011, with the help of Thomsons Online Benefits. An employee survey in December revealed staff are more aware of the benefits available to them now than they were under the paper system.
"In the first year, we used paper-based marketing to communicate the online benefits system, but in year two we will do this online with an e-brochure," says D Young HR manager, Jennifer Mead.
One company in the process of switching to online is Sumitomo Electric Wiring Systems, based in Staffordshire. Its HR manager, Liz Brown, says the move from paper will take place on 1 April.
"We are introducing flex benefits and felt online was a more efficient and flexible option, as we wanted something people at our different UK sites could access easily," she says. "Until now, a paper system has been adequate for the salary sacrifice and other benefits we offered our 230 staff, because there was not much data to deal with."
The technology companies will vigorously fight their corner to demonstrate that organizations running benefits programs can miss out by not moving online. Savvy HRDs, however, will only switch from paper when the time is right.
Northern Rail: paper trail
Should Northern Rail retain the franchise to run train services across the north of England, it will look to move from a voluntary to a flexible benefits system, but it won't ditch paper.
This 50:50 joint venture between Serco Group and Abellio, formed in 2004, has 4,800 staff scattered across the north, and most employees are drivers, conductors or engineers and do not have access to company computers.
An employee survey in 2009 discovered a low satisfaction rate regarding its benefits scheme, which is a combination of voluntary benefits and an employee assistance plan (EAP), as well as salary sacrifice, free travel and a final salary pension.
Northern Rail compensations and benefits manager Paul Stephens(pictured left) says communication was an issue, so the company introduced a benefits booklet and increased coverage of the scheme in its staff magazine, Your Northern, sent to every worker's home address. There is a telephone helpline and benefits roadshows are held at different depots.
"The culture of our business is paper-based and people still like to receive hard paper copies of anything to do with their job," says Stephens. "The difficulty with a booklet is that things can change and the content can become out of date quickly, but staff like to get paper copies of their total rewards statements, for instance."
Despite its traditions, Northern Rail appreciates the advantages of moving some of the administration online when the flex scheme is introduced and it is working with benefits provider, Personal Group.
Stephens wants to encourage staff to check the internet at home, but many paper aspects - such as the magazine coverage as well as the telephone helpline - will remain.
"We fear we will lose the engagement levels we have generated since 2009 if we move everything online - and we cannot afford to do that," Stephens says.
Hilton Worldwide: engagement online
Sean Thomas, cluster HR director at hotelier Hilton Worldwide, says he could not run the company's benefits scheme without technology. In fact, he says it would be "a nightmare".
He is convinced paper-based schemes will die out within a few years and everything relating to employee benefits will be online, especially in large organizations.
Many of Hilton's thousands of staff globally are young and have an expectation of a technology solution. For the HR team, it makes administration simpler and the reports the online platform generates mean the scheme is more effective, according to Thomas.
"We can see from the click through rates what things people are interested in and what is not so popular and react to that in a timely fashion.
"I believe that without technology, communicating when the benefits window is open would be harder. We send regular emails, although we do support this with posters around the offices."
He says that, as a US-centric organization, the whole group has to adapt to ideas and technology coming out of the US designed to help the business.
"Without this technology, I do believe it would be much harder to communicate our benefits to staff and they would be much less engaged with them."
There can be confusion among employers about whether a flexible or voluntary benefits scheme is right for their organization. A flexible scheme lets employees choose the benefits package that best suits their lifestyle and personal circumstances. They may prefer tax-efficient benefits such as childcare vouchers or to make salary sacrifices to boost their pension.
Flexible or voluntary?
Flex is a good way to bring consistency across a group of companies, as part of a harmonization process, or to tailor benefits to staff if a workforce is diverse.
Staff can usually change their core benefits once a year, during what is known as a 'benefits window' and, whether it is a paper or an online solution, employees can see a menu of benefits and the price of each. They usually receive a 'total rewards statement' outlining their total remuneration.
An employer can make a scheme as flexible as it wants to, so staff feel valued. Ultimately, a well thought out flexible benefits package can help to retain and attract talent.
Companies often add additional voluntary benefits, which are products and services staff can buy, at a discount. The main difference between voluntary benefits - such as retail discounts or gym membership - and flexible benefits is that they are paid for by an employer allowance or benefits pot, or their own salary, through payroll.
Many employers use the tax and national insurance savings gained from introducing salary sacrifice benefits to fund the cost of administering a voluntary benefits discount program.
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