By: Melissa McGarry, Director, Product Implementation, Coventry
The anywhere, anytime promise of telemedicine is helping propel its growth in group health. Now, that same shiny prospect of unprecedented flexibility is drawing attention in workers’ compensation as a means of meeting the unique challenges facing injured workers.
In our last installment, we defined telemedicine and telehealth as connecting a patient with a health care provider using modes of communication such as phone or video chat. Here, we’ll look at how combining clinical support with technology such as telemedicine can facilitate appropriate care and foster better outcomes.
Technology, cost and demand make the case for virtual visits
The idea of telemedicine isn’t new. For years, clinicians have relied on devices such as remote cardiac monitors to keep watch over patients from afar. But telemedicine is nevertheless unique because it sits at the confluence of several forces: a proliferation of robust mobile and wireless technology, a need to constrain rising health care costs and a desire among consumers and providers alike for convenience and choice.
Workers, younger generations even more so, are accustomed to first turning to their phones when in need of an answer or a good or service. Health care that arrives through technology therefore fits well with consumers’ expectations. In a survey, 67 percent of patients said using telemedicine somewhat or significantly increases their satisfaction with medical care. The report from Software Advice, a research firm, found 21 percent of patients said not having to travel to the doctor’s office was the top benefit of telemedicine. Another one in five identified the ability to obtain care from home as the chief advantage.
Hospitals, health plans and employers are responding to the demand for telehealth. Many now offer some type of virtual visit. There are about 200 telemedicine networks and about 3,500 service sites in the U.S., according to the American Telemedicine Association (ATA).
Large employers now almost universally provide the services as part of their group health benefit plans. The National Business Group on Health (NBGH), which represents mostly large employers, last year predicted 2018 would see 96 percent of big employers making telehealth programs available to their employees in states where the services were allowed. NBGH also reported telehealth utilization is increasing.
Policymakers are taking steps to address these emerging networks. Each state has different telemedicine policies, and the types of services covered, provider requirements, and reimbursements differ for each, as do medical licensing requirements, notes (PDF) the ATA. Some states require physicians to have a telemedicine license.
Establishing a good connection with injured workers
Telemedicine and telehealth services are gaining traction in workers’ compensation. The Official Disability Guidelines (ODG) recognize their use for treating pain, diabetes, back pain, and mental health disorders. Some states have implemented or are developing workers’ compensation regulations that address telemedicine video consultations with a physician. The availability of video consultations with a board-certified physician in workers’ compensation offers injured employees, employers, and payors a number of benefits. These include:
- Accessing treatment on-demand—with 24/7/365 availability
- Reducing unnecessary visits to emergency departments and urgent care facilities—saving time and money
- Maintaining productivity and reducing time away from work
- Boosting employee satisfaction and a sense among workers that employers care for their wellbeing
Reach out and touch someone
One option for integrating telemedicine into workers’ comp is to make the telemedicine provider information available to the adjusters who are providing care alternatives to the injured worker. Adjusters often become the exclusive conduit between the injured worker and the care that the worker receives. Icons indicating which providers have telemedicine capability, displayed in online provider directories, could be the health care equivalent to food photos on the restaurant-reservation service Open Table. Given adjuster workloads, these visual reminders likely will be necessary for telemedicine utilization to increase.
Alternatively, making the service available during the nurse triage process could result in increased telemedicine utilization, when care is needed, at least while the concept of telemedicine remains novel. Using nurse triage to determine the proper course of treatment can offer significant benefits. This is because upwards of half of calls to nurse triage have been known to result in self-care. This means no medical care is received and no medical claim is filed. When an employee with minor injuries decides to seek care, telemedicine could prove particularly useful. A telemedicine video consult could, for example, help confirm whether a wound required stitches or what level of care was needed for a minor burn. A nurse could walk an employee through a series of questions to ensure that a video consultation was appropriate. If the employee agreed, the telemedicine consult could take place via computer, mobile phone, or tablet.
Whether adjuster-referred or via nurse triage, the benefits of telemedicine are clear. Perhaps an employee is in a remote location far from a clinic. A telemedicine consultation could help determine the appropriate action. Or perhaps an injury occurs during a night shift and the only option is to visit an emergency department for an evaluation. A virtual visit could avoid an unnecessary trip to the emergency department. Forgoing the journey would reduce the burden on employees and would save time and reduce costs. Beyond an initial injury, telemedicine can be used to provide follow-up care or to conduct a post-operative visit or even to deliver a second surgical opinion.
Is this what the future looks like?
Telemedicine is likely to continue its expansion, in large part because many consumers want it and because many enjoy the experience. Nearly three in four patients are comfortable communicating with their doctor using technology, according to a 2015 report from the American Hospital Association. A similar proportion of patients say they care more about access to care than the need for physical interactions with their health care providers. Telemedicine can even boost engagement. The Software Advice survey found about half of patients said telemedicine somewhat or significantly increases their involvement in treatment decisions.
In caring for injured workers, there is value in both telemedicine and telehealth programs. Offering telemedicine as an option at the time of injury allows for quick and convenient access to a physician anytime, anywhere. It is particularly appealing to members of younger generations, who have grown up in a tech-filled world and would prefer to not waste time in transit or in waiting rooms. These virtual house calls can go a long way toward reducing or eliminating unnecessary absences from the workplace, lowering medical costs, improving productivity, and increasing employee satisfaction. The possibilities for telemedicine are as exciting as the technology underpinning it. Combining clinical support and technology brings new and profound opportunities to help injured workers recover and return to productivity.
About Melissa McGarry
Melissa McGarry is director of product implementation for Coventry. Melissa has more than 25 years of comprehensive industry experience as a provider of health care services as well as operations, program development, and product management. She holds a Master’s degree in Counselor Education and continues to maintain her licensure as a professional counselor (LPC) in the state of Texas.
Coventry offers workers’ compensation cost- and care-management solutions for employers, insurance carriers and third-party administrators. With roots in both clinical and network services, Coventry leverages more than 30 years of industry experience, knowledge, and data analytics. The company offers an integrated suite of solutions, powered by technology to enhance network development, clinical integration and operational efficiencies at the client desktop, with a focus on total claims cost.
Coventry is a WorkCompWire ad partner.
This is not a paid placement.