The Power of Telemedicine in Workers’ Comp white paper by Peter Rousmaniere

The Power of Telemedicine in Workers’ Comp American healthcare is rapidly adopting telemedicine technology to overcome doctor shortage, improve quality of care, and reduce cost of care. Telemedicine brings special benefits to managing work injuries, from the moment of accident through recovery and return to work. Consumer Health Connections describes here how workers’ compensation claims payers can best make use of the technology. “Telemedicine” is interchangeable with “telehealth.” Both refer to remote communications between patient and healthcare professional including live video meetings, remote patient monitoring, alerts, reminders and other messaging of health information. The technology is spreading rapidly among group health insurers and large employers for personal health issues. In workers’ comp we will see a different cast of characters, likely different applications, and an even stronger value proposition than is made in general health. Let’s start with a few scenarios which reflect how telemedicine will evolve in the next few years. These scenarios can occur in any jurisdiction today.

at the moment of injury: empathy and 100% accuracy Lifting boxes in a shipping room, Tony experiences sharp cramps in his lower back. Tony’s supervisor alerts the personnel manager, who opens up an app on her mobile device, and alerts the workers’ comp carrier. By the time she has walked to the accident site, a triage nurse, Sonia, appears in a virtual clinic waiting room on the device. Tony is handed the device; he and the nurse make eye contact. Sonia expresses her concern for Tony and asks if she can try to help him get the right medical care ASAP. She and Tony talk about his symptoms. With Tony’s approval, the session’s audio and video is recorded and stored. Sonia recommends how Tony can best be treated—self care at the worksite, with a follow-up call from her the next day. Sonia can suspend recording when Tony wants to discuss personal health issues that may be unrelated to the injury. During the session Sonia completes the FROI and the claims system is automatically populated. Sonia has also recorded Tony’s verbal consent for release of medical information.

doctor can see you now, 24/7 Hugo is driving his freight truck across the country in February, and at 11 PM on Sunday night he suffers a shoulder bruises and a head laceration after falling from his cab upon ice at a rest stop outside Wichita, Kansas. He opens an app on his smart phone and within seconds is in face-to-face conversation with a triage nurse. The nurse quickly brings into the conversation Dr. Reed. Hugo and the doctor talk; the doctor recommends that Hugo go to an emergency department ten miles away. The nurse arranges for transportation and alerts the ED. At 8 AM on Monday, another nurse contacts Hugo on his smartphone; the adjuster finds the claim on her system when she arrives to work.

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checking up on evelyn while on transitional duty Laura, a case manager for a claims payer, calls Evelyn’s smart phone. Evelyn is recovering from a burn on her right hand, which happened while working in a food processing plant. (Most workers recover while back at work.) She is back at the worksite, at modified duty. Laura is concerned because Evelyn’s diabetes can complicate the wound’s healing. Alerted before by a text message, Evelyn has stepped into a room at the plant reserved for medical and other sensitive meetings. The room is a virtual clinic, stocked with scopes and other simple diagnostic devices. Laura looks at the hand with one of the scopes through webcam, and finds that the wound is healing well. Laura forwards to the physician at the occupational medicine clinic who treated Evelyn the audio/ video record plus the pertinent ODG guidelines. If warranted, the doctor could participate in this virtual encounter at the virtual clinic.

The State of Telemedicine Today In 2015 nearly half of employers offered telemedicine services, up from 28% in 2013, and nearly 90% could offer them by 2018.1 This rapid expansion is simple to explain: telemedicine appeals to patients, medical providers, and insurers. In general health, employers find that telemedicine offers a unique opportunity to improve medical care. For instance, people get treatment immediately and conveniently for relatively minor ailments. Healthcare utilization drops. Even when clinic visits may be useful, the number of these visits declines over the course of treatment. According to the American Medical Association, 70% of clinic encounters can be successfully performed through telemedicine without a physical visit to a clinic. Through auditing and accreditations, regulators and medical associations have analyzed the technology to help in removing barriers. The technology is HIPAA compliant. Several vendors market turnkey telemedicine platforms for use in general health. Consumer Health Connections has a customized solution for workers’ comp, available today on the Cloud, including conferencing, automatic messaging, smooth interface with claims and state databases, and fast preparation of mandated documents. Adoption in the practice of medicine for personal health issues will take time. While telemedicine has been used for years in some settings, the general population in America doesn’t expect it when they need it. It’s up to employers, insurers, and medical providers to introduce to patients the convenience and other benefits of the technology. In workers’ comp, claims payers are in the driver’s seat for putting the technology to use.

1. Willis Towers Watson, based on Washington Business Group on Health 2015 survey.

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opportunities in workers’ comp Telemedicine in workers’ comp is best viewed as a platform, upon which functions to serve the workers’ comp community operate. A highly fragmented process of injury response, treatment and RTW converts to a unified, accurate and efficient system using a single platform on the Cloud. The result is pleasing to worker, adjuster, case manager, doctor, and employer.

the current landscape

disrupting the current landscape

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Telemedicine is actually more useful in workers’ comp than it is in general personal health, one reason we anticipate its rapid adoption now that its acceptance in personal health is fairly well under way. When deployed correctly, the technology delivers sharp improvements in compensability determination, medical management, and return to work. Our first scenario above underscores the high value of responding immediately to a work injury. Work incidents deserve immediate attention but not necessarily expensive medical care. A third or more incidents don’t even need a visit to a medical clinic. Very few need emergency department care. However light or severe the injury, the worker wants professional attention and, when she gets it, will respond positively throughout the course of recovery. Telemedicine delivers the clinician right to the worker, at the worksite or in the field, 24/7. It also ensures 100% accuracy in recording information about the worker, the incident, and triage recommendations while a triage professional solves what kind of response is appropriate. There will never be a need to go back to re-construct what happened from imperfect memories. Next, consider the virtual team nature of injury management. The technology is ideally suited to how work injury response involves a virtual team of practicing clinician, case manager, adjuster and employer. Telemedicine brings the parties together in conferences, and keeps the parties in touch by automated distribution of documents, automated messaging including alerts, and shared workspace accessible any time. Access is governed by authorization controls.

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key take-aways Telemedicine is spreading rapidly among group health insurers and large employers for general health. Its value proposition is even stronger for workers’ comp. The technology is available today, customized for application in workers’ comp. Most regulatory barriers, where they existed, have been removed.

a checklist of applications initial triage. Best routing of medical care, economic use of medical and personnel resources, strengthening of worker advocacy. ongoing care while on disability. Promotes worker engagement, progress review, goalsetting, and patient education. Example: pain management. return to work. More transparency to modified duty assignments, gradual restoration of full duty capability. use of platform for other than medical treatment. Virtual conferences on protocols for injury response and RTW planning, involving adjuster, nurse, med clinic, and employer. Conduct educational sessions with invited parties.

about chc

chc vision

CHC is a technology solutions organization influencing the quality of care through telehealth, eliminating gaps in the current process, and challenging workers’ compensation issues head on.

CHC is committed to market-disrupting telehealth solutions that continuously improve workers’ compensation healthcare delivery. Our determination and drive will significantly impact the health of businesses and patients.

chctelehealth.com | 855.242.1373 Copyright © 2016 Consumer Health Connections, LLC., All rights reserved.

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