The World Wide Web has emerged as the first new mass medium in a generation — arguably the fastest growing new technology in history. One of the biggest motivations for people to use the Internet is to find information about healthcare. "Healthcare is an enormous reason people go online," said Humphrey Taylor, chairman of the polling company Louis Harris & Associates. Taylor's company polls indicate that about two-thirds of adults who accessed the Internet in 1998 sought information about healthcare topics such as depression and cancer. Another top polling company, Intelliquest, Inc., found that about half of all users go online regarding health and personal problems.

It is clear that Internet-based service delivery is not only an ideal complement to traditional employee assistance program (EAP) products, but one that can reduce costs, improve service and reach people who need help but have been reluctant to seek it.

Why Internet-Based Service Makes Sense
In today's workforce, employees are given a greater range of choices as to how, when and where they work. It's vital to provide programs that can offer round-the-clock help beyond crisis intervention and emergency care, accessible from office, home or on the road. Therein lies a key advantage of Web-based service delivery — the ability to extend the hours of employee assistance to 24 hours a day, seven days a week with a minimal increase in operating cost.

The rationale for Internet-based EAP service goes beyond delivering the same information to the same people via a new medium. Providing online resources to seek referral possibilities, check on policy changes and get news on worksite seminars right over the Web minimizes calls, e-mails and visits to EAP staff, resulting in a tremendous savings in time previously spent explaining benefits and distributing materials. Furthermore, an Internet-based EAP service allows employees to seek information on sensitive issues from the privacy of their homes, a route that some users will find more convenient, comfortable and "risk-free" than a visit to a counselor. Moreover, users have confidential passwords, reinforcing their feeling of privacy and security.

The biggest cost reductions, however, come from an Internet presence that serves as a cost-effective adjunct to traditional therapy, providing confidential assistance that might preclude the need for a visit to a therapist or counselor. Make no mistake, the best Internet-based employee assistance services are careful to point out that they do not provide therapy, an experience that hinges on establishing a continuing face-to-face relationship with a psychotherapist. Yet by reaching employees early with interactive programs tailored to their specific situations, a company can help employees get motivated and learn to solve problems before they require a higher level of service.

All that being said, few EAPs have harnessed the Internet's capability in earnest. Yet a Web-based service provides an opportunity for an EAP to differentiate itself in the market by offering a cutting-edge, value-added service that its competitors lack. In partnering with an Internet behavioral health services provider, EAPs experience little or no up-front investment — there are no software or hardware installation concerns and charges typically come on a per-employee-per-month basis.

Internet-Based EAP in Action
Imagine you're an employee at a company called General Widget. You've heard the company is now offering some kind of Internet-based EAP service. You just earned a promotion, and lately you've been feeling frazzled and overwhelmed. So, you give the new icon on your desktop a click.

Your online experience might unfold as follows:
You register as a first-time user, choose a confidential user name and password and are then asked to give yourself a screen name before entering your gender and birth date.

A menu of topics awaits you — from overcoming depression and improving relationships to learning to set goals and managing them more effectively. Since you might not know exactly what's wrong, you click on a link that promises to help you begin a self-assessment.

After being led through a series of questions on eating and drinking habits, sleeping patterns, emotional states, lifestyle aspects and other areas, you get some suggestions and tips for overall improvement. The programmed response might also direct your attention to programs on stress management and coping with change.

Some of the programs provide quick overviews, give basic information on each topic and answer some frequently asked questions, as well as provide direction toward other resources on those topics. Or you may explore topics on a more personal and customized level, with interactive programs that educate you about your concerns and help you build a personalized plan to self-improvement.

After a half-hour you've picked up some good tips on how to deal with stress and some skill-building tools. You've also gained some insight and a comfort level with your recent career change. Before signing off, you can decide whether to plan some time for a more extensive interactive coached program. Or, you can go directly to the referral section of the site and make an appointment with one of General Widget's EAP counselors.

You decide to make an appointment. At this point you're feeling a little better, knowing that the first steps have been taken toward coping with the recent changes in your life.

What Do Internet Services Offer?
In this emerging industry there is already an array of service providers available. To get a feel for what's possible, let's look at some of the products offered by one specific firm. This company got its start three years ago and now offers services to EAPs and managed behavioral healthcare companies covering over 40 million Americans.

The site's basic offerings include:

• Referral and Benefit Information — Online access to information about an employee's referral options, including referral telephone numbers, claims information, referral procedures and more.
• Library of Topical Information — Straightforward information on a wide range of health and personal development areas.
• Self-assessments — Single-session, 15- to 20-minute programs that ask questions, summarize responses and provide recommendations for addressing specific problem areas.
• Personal Plan Programs — Single-session, 20- to 30-minute programs designed to provide tools with which the user can improve his or her situation. Each program includes online exercises, personalized feedback and a plan for practicing new skills.
• Coached Series Programs — Multi-session programs with individual coaching from a licensed mental health professional. Coached programs include 5 to 10 individual sessions, each with an optional homework assignment.
• Live Chat Support Groups — Private chat rooms for people who want to discuss specific health and personal development issues.
• Message Boards — If users can't be online to participate in the live chat support groups, they can join online discussions via message boards.
• An Online Magazine — This particular company produces its own behavioral health magazine, a credible, authoritative source for news about staying healthy, succeeding at work, and getting more out of life.

Also included on the Internet is an operations site that allows an EAP to customize and manage all aspects of the system for its customers. For example, an EAP staff member can view all of the employers that it has enrolled, sorted either alphabetically, by size, by state, by salesperson or by account manager. Then it can perform a host of administrative activities; the entire site can be co-branded with the EAP's identity, allowing for seamless integration of the system with an EAP's own Web presence, and the site provides simple, step-by-step online training for EAP personnel on every aspect of the system.

Resources for Behavioral Health Professionals
In addition to the above offerings, this site increased its presence in February 2000 with a comprehensive resource to give behavioral health professionals the online tools they need to manage all aspects of their clinical practice and professional lives.

The new version will provide:

• Practice Management Tools — Everything professionals need for the administration of their practices will be made available at the click of a finger — 24 hours a day, seven days a week.
• Personal & Professional Development — Instant ability to connect to peers and experts to get the latest research. It is a place to ask questions, share insights and focus on matters important to a professional practice.
• Clinical Information — Practical help in filling out routine forms, keeping track of continuing education credits, searching for employment opportunities, or creating a web page. That's just a sampling.
• Industry News and Information — This site will keep track of critical events and information and pass it along to members.

These are the basics of an Internet system that truly can be adapted to EAP work. As it has in so many other areas of life, the Internet brings a whole new dimension to the EAP.

Excerpted from Behavioral Health Management published September/October 1999

Dr. Richard Flanagan is co-founder and Chief Clinical Officer at Epotec, a leading online behavioral healthcare provider in Wilmington, Delaware. He oversees content development and care delivery of the EpotecConsumer and EpotecProfessional sites. Dr. Flanagan is a member of the American Psychological Association and a past president of the Delaware Psychological Association. He may be contacted by e-mail at: rflanagan@epotec.com or call 302/655-3390.

© 2000 Targeted Publishing Group, Inc. All rights reserved.

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