9/12/2018

Can You Heal Me Now?

Telemedicine is here and it’s gaining in popularity

By Jim Bowers

This past decade saw dramatic innovation and disruption in the insurance industry. Workers compensation, which has been around for more than a century, has arguably seen more innovation in the past 10 years than in its first 90-plus years combined.

The workers compensation space has embraced advanced claims management systems, analytics, bots, severity models, artificial intelligence, and digital capabilities. It has also seen significant advances in medical services and technology such as wearables that provide real-time biomechanical analysis and feedback as employees are working, and exoskeleton systems that allow injured workers with spinal cord injuries to walk independently.

Many of you have probably seen a Star Trek episode or movie, and you have probably spoken with your friends and family about how great it would be to have a transporter that could immediately teleport you from work to home or across the world for a vacation in an instant with no driving, traffic jams, or airports. Sadly, teleportation is not yet ready for the workers compensation world, but the next best thing is here: telemedicine. It offers not only convenience, time savings, great medical care, and a great customer experience for your injured worker, but also it can positively impact your bottom line.

According to the National Council on Compensation Insurance (NCCI), about 60 percent of all workers compensation benefits paid are medical benefits, with 40 percent being wage replacement benefits. This is a shift from the past—historically only 40 percent of all benefits have been for medical care. In the last 20 years, NCCI data shows workers compensation medical severity increasing by a staggering 175 percent. During that same period, the cumulative change in the personal health care price index was “only” an increase of 61 percent. The bottom line is this: Pursuant to NCCI research, workers compensation costs are 71 percent higher than general health care costs for the same injury. Cleary, we are ready to embrace a solution that can put a dent in workers compensation medical inflation while also providing a great option for injured workers.

Telemedicine may be the right solution the next time one of your employees is injured on the job. With telemedicine, your injured employee can consult with a physician within minutes. Medical care is available when treatment is needed, and is available 24/7/365. What does your injured employee need in order to complete a telemedicine visit? A private location and a smartphone, tablet, or computer—that’s it.

An effective telemedicine program will include a triage component that serves to evaluate the injury and all relevant factors to determine if telemedicine can deliver the appropriate level of care. Typically, a nurse will gather pertinent information about the occupational injury and medical history, and then, if appropriate, offer telemedicine as an option. If selected by the injured worker, a strong program will support a hassle-free and convenient experience by completing a “warm” transfer to the telemedicine physician while electronically sending pertinent information about the office visit to the physician. Look for a program that also integrates the telemedicine visit with other workers compensation medical and ancillary services, like prescription services, physical therapy services, and durable medical equipment services.

Why Telemedicine?

According to the American Medical Association, up to 70 percent of all patients could be treated virtually with telemedicine. Imagine no wait time and less time away from work. With telemedicine, injured employees can consult with a physician within minutes.

The Centers for Disease Control and Prevention reported that the average emergency room wait time was about 30 minutes and the average treatment time was about 90 minutes. Factor in another 30-60 minutes for travel time and you and your injured worker is looking at about 2.5 hours for a medical visit. The average time for a telemedicine visit can be as little as 15-30 minutes and it is completed at the employer’s site with no travel. Follow-up appointments can be conducted at work, at home, or wherever is convenient (and private) for the injured worker.

Imagine a better experience and increased employee satisfaction, too. According to Kura M.D., a telemedicine contributor at Westfield Insurance, 74 percent of patients in the U.S. would use telemedicine services if given the choice, and 96 percent of employees report that telemedicine saved them time. It is likely that many of your employees utilized telemedicine for general health care in the last few years, and more will do so in the next few years.

What about cost savings? In one study published in Health Affairs, telemedicine costs were found to be 50 percent of normal in-person care and less than five percent of emergency room costs. A Towers Watson report found that telehealth could save U.S. employers up to $6 billion per year if used when applicable instead of receiving care in emergency rooms, clinics, and physician offices.

Convenient and cost-effective health care solutions are fueling the advances in telehealth. Telerehab is another telehealth service gaining traction. Imagine completing your physical or occupational therapy at your worksite or at home with a teletherapist.

According to a recent Mitchell survey, nearly half of all workers compensation executives and professionals said telehealth and telemedicine will have the biggest industry impact in the future, and more than half of those surveyed said it will help contain costs. In addition, telemedicine far outranked other technologies in value to the workers compensation industry going forward. Forty-five percent of respondents picked telemedicine, while artificial intelligence ranked second at 19 percent, followed by mobile technology at 14 percent, wearables at 10 percent, and chatbots at one percent.

One challenge in this rapidly changing environment is that regulation, which is a state-by-state proposition in workers compensation, often does not keep pace with technology and innovation changes. At the end of the day, employers, insurance carriers, regulators, and all stakeholders in the workers compensation space should be advocating for injured workers to obtain the best medical and disability outcomes. We need to work together to be nimble with adopting new innovations and solutions. More insurance carriers, employers, and injured workers will be adopting and using telemedicine in the coming years. Don’t get stuck on hold.



Jim Bowers, CPCU, AIC, is workers compensation claims process leader for Westfield Insurance. He can be reached at jimbowers@westfieldgrp.com.

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