Assessing Depression Via the Web

Cisco Systems Inc. is testing an outreach program that includes a Web-based assessment to help employees suffering from stress, anxiety, depression and related problems that reduce productivity.

The program relies on WebNeuro, a Web-based tool that helps outreach workers and the employee’s doctor provide appropriate treatment, speakers told the Disability Management Employer Coalition’s 2008 conference.

WebNeuro replaces the common approach of assessing and treating depression, said Roy Sugarman, director of behavioral solutions in Sydney, Australia, for Brain Resource Ltd., which owns WebNeuro.

Typically, doctors treating depression ask a limited number of questions and then prescribe an antidepressant, Sugarman said at the August 10-13 gathering in Denver.

However, by using a 30- to 40-minute WebNeuro screening, which measures general and social cognition, brain-function markers for behavioral-health issues such as depression and anxiety can be determined and shared with the employee’s doctor, Sugarman said.

It helps determine which prescriptions or psychotherapies will best treat specific problems. It can also help establish when a patient does not need medication but would benefit from other assistance, such as wellness coaching, to make them more resilient to stress and anxiety, the speakers said.

WebNeuro, drawing on a database of brain-function tests, is also used to measure how a patient is progressing and whether treatments are helping them.

Cisco’s WebNeuro test follows from health-risk assessments that the San Jose, California-based network technology company began in 2005, when it sought to address rising medical costs by helping employees engage in their health care, says Lisa Jing, human resources manager for integrated health at Cisco.

Cisco’s strategy includes rigorous measurement of factors such as employee health risks, medical-cost drivers, health outcomes and employee presenteeism—or employees who are on the job but not functioning efficiently because of physical or mental health reasons, Jing says.

“We are looking at a broader employee engagement strategy and a broader view of human capital management metrics that give us an indication of how our population is doing and how engaged they are in their work,” Jing says.

Health-risk-assessment data on Cisco’s medical costs revealed that overall company employees are healthy, but their stress is rising and depression drives a substantial amount of health care spending as well as productivity losses, Jing says.

Related problems such as anxiety, sleeplessness and fatigue are issues, she says.

“The big surprise was what we found in the presenteeism area,” Jing says. “The total loss to presenteeism was absolutely startling.”

Nearly 10 percent of Cisco employees complained of anxiety and depression, says Dr. David Whitehouse, chief medical officer for strategy and innovation at OptumHealth Behavioral Solutions, which is based in Golden Valley, Minnesota. Those employees accounted for 40 percent of Cisco’s total lost productivity in 2005.

To help its employees, Cisco partnered with OptumHealth, which in turn partnered with Brain Resource, the speakers said.

OptumHealth, a unit of UnitedHealth Group Inc., trained outreach workers in interviewing skills so they don’t alarm employees whose health-risk assessments reveal they could benefit from help such as that available through the optional WebNeuro tool kit, Whitehouse says.

OptumHealth is also learning lessons along the way, such as it’s best for its outreach workers to make their first contact with employees through e-mail rather than by telephone, allowing employees to decide whether they want to talk about what is bothering them, Whitehouse says.

Cisco’s effort will have final outcome data from its intervention program next spring, Jing says. But so far, the WebNeuro tool has been well-received by Cisco employees who have participated in the outreach program.

Cisco intends to offer the WebNeuro resource to employees at an onsite health center scheduled to open this year, Jing says.