By Mike Bishop, VP of Product and Technology
In the age of in-home voice assistants and self-driving cars, it can seem like the robot takeover that childhood movies and comics predicted is quickly approaching. Everywhere we turn, articles tout the advancements of artificial intelligence and machine learning, while companies scramble to develop these capabilities. We now ask Alexa to read our kids bedtime stories and interact with chatbots for help on our favorite websites; the influence of these products is no longer a distant thought but an imminent reality.
Yet that thought still nags in the back of our minds: is this the “Big Brother” takeover that Orwell admonished? Technology is now part and parcel to our everyday lives, but what does this mean for our futures?
The world of workers’ compensation is no exception. AI and predictive analytics are two hot topics that have permeated conversations this year. As the applications of these technologies to workers’ compensation claims develop, they may draw the same fear that those futuristic stories did. How might these major technology developments disrupt the workers’ compensation industry?
Let’s first address this: AI is not taking over your job.
In fact, the capabilities of AI and predictive analytics in workers’ compensation are exciting. Although we cannot say for sure that AI will not disrupt and perhaps even reduce the type of jobs, the workers’ compensation industry needs the expertise of the individuals working in it. These technologies have the ability to improve overall outcomes of claims by supporting and enhancing (not replacing) what industry professionals do every day.
In a typical workers’ compensation claim, there are several moving pieces to consider. From the date of injury to ongoing pharmacy, ancillary and financial support, workers’ compensation claims are long and complex. Developing technologies can help streamline and consolidate much of the informational burden, leaving more room for claims professionals to make quality decisions. For instance, claims technologies may provide better insight into what medications an injured worker is receiving and the potential outcome of the claim. This in turn gives better direction as to which claims need greater attention and frees adjusters to focus on proactive steps to improve recoveries.
Additionally, the rapid development of new technology does not mean that machines are taking away from industry professionals. Although machine learning and predictive analytics may provide better predictions for the outcome of a claim, the actual knowledge of an injured worker and the best path to recovery does not come solely from an algorithm. The machine can provide increasingly accurate predictions and suggestions, but it does not hold the expertise of those working in the field day in and day out.
What it comes down to is that workers’ compensation cases are highly personal. Machines may be able to predict what a “typical” person with the same injury, gender, prescriptions, care, etc. would need, but it does not know the individual case. The judgment of industry professionals on what path to recovery is truly best for an individual cannot be replaced; nor can technology replace the personal interactions needed throughout a claim from adjusters, nurse case managers, physicians and pharmacists.
This expertise has helped the industry develop new methods to improve outcomes and experienced professionals have to be the ones to tell the systems what to look for and why. Those in the industry have been able to reduce opioid utilization in states such as Ohio by 59%, costs by over a billion dollars in the past eight years, and compound medication usage by 49%.
Ultimately, technology will enhance our ability to utilize our expertise. It offers the potential to free our workload more and focus on innovative ways to continue to improve these numbers and tackle emerging issues.
The most exciting part of claims technology is that it is not a far-off fantasy. It is already improving the outcomes of claims, from the connecting power of telemedicine to the predictive power of risk scoring. In our next article, we will dive deeper in the possibilities of working with AI and predictive analytics in the workers’ compensation industry. Learn how this evolving technology is connecting the dots in workers’ compensation claims to drive quality decisions and improve overall outcomes.
About Mike Bishop
Mike Bishop is the Vice President of Product and Technology for Mitchell Pharmacy Solutions. He leads the Technical Product Development organization and is responsible for technical product strategy, direction and execution. Bishop has been with Mitchell for 12 years holding various leadership roles in Product Delivery, Operations and Software Development. For more than twenty years, Bishop has worked in Enterprise Software Development with experience ranging from small startups to Fortune 500 companies including Oracle and Siebel.
Bishop holds a Master’s degree in Computer Science from the University of Illinois and an undergraduate degree in Computer Science from Georgia Tech.
About Mitchell ScriptAdvisor
Mitchell ScriptAdvisor, the PBM solution built for the workers’ compensation industry, leverages technology and expertise to connect the ENTIRE claim. From a fully customizable portal experience to industry leading networks and comprehensive clinical management, ScriptAdvisor provides effective, efficient, and successful management of your claims. ScriptAdvisor delivers visibility beyond an individual prescription. It integrates with bill review and managed care solutions for a more holistic approach to claim management. ScriptAdvisor combines all of this with robust analytics and outstanding customer service to empower better outcomes for all. Read more of Mitchell’s thought leadership at mitchell.com/mpower.
Mitchell is a WorkCompWire ad partner.
This is not a paid placement.