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Dr. David Asch of the Perelman School of Medicine and the Wharton School

Workplace wellness clearly incorporates multiple business, social, and health drivers — from financial bottom lines to collective behaviors to healthy outcomes.

David Asch of the Perelman School of Medicine and the Wharton School, University of Pennsylvania recently discussed all of these with the New England Journal of Medicine.

The fascinating discussion can be found here. Asch started by explaining how financial incentives really can work to engage people in healthy behavior. Here are key points:

Wellness programs can work with proper design. When asked for examples, Asch said: “One was a study led by Kevin Volpp and it was really a first of its kind study. He showed that in a workplace setting, in this case it was General Electric, you could triple smoking cessation rates if you added a financial incentive. So that’s something that works, and actually in a later study done, published just last year by Scott Halpern, he showed something very similar in an even larger study — in this case with CVS employees — that rewarding employees for quitting smoking helps more of those employees quit… So that’s clear evidence that in some cases, really straight up financial incentives can get people to engage in healthy behavior.”

Asch also discussed what he calls “automated hovering,” and the opportunities to impact behavior outside of medical visits.

Asch said: “The general idea is that much of what really determines people’s health outcomes really happens outside of office visits. So even if you’re a patient with a chronic illness, you might spend only a few hours a year in front of a doctor, but you’ll spend, if you do the math, about 5 thousand waking hours a year doing everything else. And I think a lot of us recognize that it’s during those 5 thousand hours when so much of your health is determined. It’s what you eat, whether you exercise, whether you take your medications. Those are things that happen out of you, and doctors don’t know what their patients are doing during those 5 thousand hours. Even if they did, they wouldn’t really have great ways to intervene.”

“But now we have all sorts of ways to connect with people. Nearly everyone has a cell phone with them, and increasingly that cell phone is a smartphone, and there are Fitbits and other wearable devices.”

Concludes Asch: “We also know a lot more about how to motivate behavior. So it’s not just observing what people do, but because the field of behavioral economics has really taken off, I think we know a lot more about how to intervene so we can pair our monitoring, our automated hovering of patients, with messages or instructions or other forms of encouragement. And of course, new payment models that put hospitals or health systems at financial risk for the outcomes of their patients create a kind of financial imperative or a motivation to invest in these activities.”