Editor's note: The following is from Timothy Slottow, executive vice president and chief financial officer.

Solving the nation's health care challenges cannot be accomplished solely by providers and the institutions they serve; it will take a major shift in our culture that must involve everyone. In its 2008 annual report, Blue Cross and Blue Shield notes that "growth in consumer engagement — measured by enrollment in consumer driven health plans (CDHPs), utilization of health information, consumer health tools and health management programs to make more informed decisions — are all increasing."

Here on our campus, faculty and staff are beginning to embrace their roles in improving health and well-being, as evidenced by more than 10,000 participants in the third annual Active U physical challenge and the recent sold-out Healthy Choice chef demonstrations, among others. We also have seen considerable savings through increased use of generic prescriptions drugs, showing that our employees are helping to manage costs.

All of this progress is heading us in the right direction, and more participation is needed to truly create a culture of wellness at U-M.

This third and final part of our series of interviews with Robert Winfield, chief health officer, and Laurita Thomas, associate vice present for human resources, focuses on what individuals can do to effect change that not only will help reduce costs but will improve our work and personal lives.

Record: What can individuals do to address this cost issue along with the University?

Thomas: Families can spend time working on their own culture of health. One of the things you can do is read the literature we send to your home and work addresses and talk about healthy lifestyle choices like good nutrition and regular physical activity. Research says families that eat together even a couple of meals a week make wiser choices about their health investments. So make a family commitment to learn more and practice healthy choices. It's going to take family time and more personal investment to make choices that will enrich both individual and community health.

Winfield: I would like to reinforce the idea of encouraging the family to eat well, to keep your daily activities up — taking walks, parking far from your office. And also some factors more directly involved with your health care; knowing your blood pressure, and if it's elevated getting it treated; knowing your cholesterol and if it's elevated taking the advice of your health care provider to make improvements; having your routine mammograms or pap smears, if you're a woman; having colonoscopy screenings after age 50 for men and women; discussing the pros and cons of prostate cancer screening for men; and for both children and adults, keeping immunizations up to date, as immunizations are one of the ways you can better assure that you and your family will stay healthy.

Record: What else can employees do?

Winfield: People can continue to ask their doctors about the availability of generic drugs. The cost difference between generic pricing and brand pricing can be tenfold, and this expense is passed on through our health benefits costs.

Laurita Thomas, associate vice president for Human Resources

Dr. Robert Winfield chief health officer

Over the past five years, the University has been very successful in managing our pharmaceutical costs. For every 1-percent increase in generic use, the employee benefit pool saves half a million dollars. Since the benefit pool is shared by the University and the employees who make contributions to it, that's significant. We have right now one of the highest generic dispensing rates in the country, and that saves money for the University and for the individual through lower co-pays.

Record: Earlier you mentioned the idea of better utilization of services. For example, sometimes we run to the ER with the flu.

Winfield: Certainly we know that inappropriate use of the emergency room is expensive. We also know that it is important to go to the emergency room when you do need it for issues like chest pain or for severe abdominal pains — we need you to go there appropriately. In the near term, you can use sources like the Healthwise Knowledgebase available on the MHealthy Web site to get very useful health information about specific symptoms and conditions. In the longer term, we hope to institute a phone line where you can get advice on whether you should or shouldn't go to the emergency room. And all of the primary care providers affiliated with the University have after-hours on call, so that's one of the immediate ways you can identify whether or not you should be going to the emergency room.

Thomas: I would like to emphasize the value of using the information that our leadership teams have made available on Web sites and other venues. For instance, in the mental health arena, we have learned that one in five of us will experience a mental health challenge in our lifetime. When we're aware of the signs, symptoms or warnings, we are more able to identify a problem and get support. We save cost in the long term and it improves the quality and happiness of our lives.

In the coming months, we'll have access to a new Web site called HealthSense, which will grow over time and offer health information and tips on managing costs. Right now, we also have access to the Healthwise Knowledgebase that Dr. Winfield mentioned, and it's accessible through our own health system's Web site and the Michigan Healthy Community Web site.

Record: Can you explain Healthwise a little more?

U-M faculty members and staff raised $80,000 for the American Heart Association while participating in the 2008 Ann Arbor Heart Walk. (Photo courtesy Ann Arbor Heart Walk)

Winfield: Healthwise is a Web-based tool that will give advice and information on virtually every health condition. For instance, if you have a cold and you wonder whether or not you have a sinus infection, what you can to do is go into the Healthwise Web site and read about the kind of discomfort that comes with sinus infection; what you can do for yourself that might relieve the sinus pain; and when you should go see a health care provider. It contains a huge database of health information and everyone at the University can utilize it at no cost.

In the first part of this series you mentioned the expense of new technology. What can employees do about it, if anything?

Winfield: One of the difficulties with the technology issue in containing health care costs is that the patient or an employee usually doesn't have the information at their fingertips to make a decision and has to trust in the doctor's judgment. Where our employees can make a difference in containing costs involves recognizing that it may be in their best interests to ask for a second opinion about a big procedure, so they can fully understand the pros and cons of proceeding with something or choosing to wait and watch safely.

Thomas: What may seem like a minor action in the workplace can make a significant difference when done over time and by large numbers of people. Things like bringing your lunch to work give you far more control over your nutrition, paying attention to posture can prevent injuries, understanding the signs of emotional stress and seeking help can prevent it from becoming an impairment to daily living. We want to encourage people to think about this and use the resources we have available to us so we raise the level of our health as a community. We're all in this together.

To comment on this series, send an e-mail to HealthSense@umich.edu.