By Dr. Jacob Lazarovic, Chief Medical Officer, MyAbilities
As I discussed in last week’s post, we now have the technological capability to produce job profiles that describe the functional characteristics of every job type within an organization down to the last detail. Employers can use these for more efficient hiring and training practices, ergonomic improvements aimed at mitigating higher-risk physical demands, and a wide array of preventive and fitness applications, designed to “harden” employees’ capacity to better sustain their current job activities without injury. This allows employers to better manage their valuable human resources, and to do so using state-of-the-art technologies such as video kinematics and artificial intelligence.
Can this technology also help if and when a claim is filed?
Simply put, these technologies are revolutionizing claim and medical management processes. The digital job profile can be quickly developed or selected from an extensive job database, and instantly and securely shared with all stakeholders with secure platform access: claim adjusters, case managers, physicians, physical therapists, etc. This provides a user-friendly, standardized graphic and video depiction of quantitative job demands, replacing inadequate old-school, paper-based job descriptions. Finally the claim team has the accurate physical demand information that has been absent in the past.
Why is this important?
Determinations about return-to-work (RTW), physical restrictions and limitations, maximum medical improvement status, and residual impairment can now be informed by timely and objective metrics, and become more accurate, defensible and easily retrievable.
Platform users also can access automated, online tools, powered by evidence-based research, that systematize claim and medical management decisions. For example:
- Causation analysis. Deciding whether a particular injury or illness is of occupational or non-occupational origin can be difficult, and, unfortunately, errors are often made at this critical point, with costly repercussions. One tool that has been developed uses evidence-based medical research and offers a series of questions that are customized to the most common diagnoses. Entering responses yields an instant scorecard of factors favoring either occ-or non-occ causation, as well as their relative strength. This can either confirm compensability or alert claim adjusters to claims that may require additional scrutiny before being deemed compensable in the applicable benefit program ( workers compensation or disability).
- Psychosocial issues. Another automated tool created out of the latest technologies is the “yellow flag” questionnaire, which consists of a brief series of questions focused on psychosocial issues. It is well accepted in our industry that biological factors alone do not explain wide variations in recovery and RTW among claimants with similar injuries and illnesses. This type of validated tool identifies those individuals with high-risk scores who may benefit from intensified medical management, and a consideration of mitigating psychological interventions. The tool also guides the user toward best-practice therapies based on questionnaire responses and risk level, (such as cognitive behavior therapy).
Finally, there needs to be input from clinicians such as physicians, and physical and occupational therapists to expedite RTW and objective job matching to the claimant’s own job or appropriate modified duties consistent with any impairments. Claim adjusters and case managers are able to electronically send to these clinicians the claimant’s digital job profile and video, along with a user-friendly display of the job’s physical demands for response.
Clinicians can then enter the platform via an email link, and quickly identify whether the claimant is able to perform all the listed demands of the job, or select those demands subject to restrictions and limitations, and their anticipated durations.
This will either confirm the employee’s ability to return to his/her own job, or if not, trigger a job-matching algorithm which immediately identifies suitable jobs consistent with the employee’s post-injury/illness functionality. Job matching may identify a position within his/her current company, or a fit with any of thousands of other digital job profiles housed in the database.
In addition to enhanced claim management and RTW, these platforms achieve administrative efficiencies by streamlining the sharing of information with all linked stakeholders in the process.
In addition to its ground-breaking practical applications for employers and payers, the technology also offers unique opportunities for analytical research into the variables that impact claim outcomes, and the development of industry best-practices.
About Dr. Lazarovic
Dr. Jacob Lazarovic is the Chief Medical Officer at MyAbilities, where he is responsible for the development of advanced, evidence-based clinical applications that enhance the performance and outcomes of claim and medical managers in the multiple market segments the company services.
Prior to his involvement with MyAbilities, Dr. Lazarovic served for 18 years as the Chief Medical Officer at Broadspire/CRAWFORD, a global third-party administrator of workers’ compensation, disability, auto, and medical product liability claims.
In his more than 35-years of medical administration/managed care experience, Dr. Lazarovic has also served as Medical Director at HealthAmerica, a staff model HMO; Medical Director at Blue Cross/Blue Shield of Florida/Health Options; and Vice President for Clinical Affairs at Vivra, Inc.
In these positions, he has been responsible for a wide scope of medical services, including; network and business development and contracting, provider relations, utilization and quality management, medical cost control, and strategic planning. He has conducted and published original research and analytics and has presented at multiple industry conferences.
Dr. Lazarovic is a board-certified family physician, and experienced medical administrator. He completed his medical training and residency at McGill University in Montreal, and subsequently practiced family, emergency, and geriatric medicine while teaching in a residency program. He holds active medical licenses in both the U.S. and Canada.
MyAbilities is a technology company delivering workplace risk mitigation and injury management strategies using Artificial Intelligence (AI) and robust data analytics.
MyAbilities develops software solutions to help employers assess their jobs, identify risk and prevent injuries using proprietary AI, computer vision, analytics, ergonomic risk analysis, and injury prevention strategies. Post-injury, MyAbilities support claim administrators with an evidence-based claim and medical management software for the resolution of injuries and illnesses in workers’ compensation, and disability programs to reduce costs of claims and expedites return-to-work. More information is available at www.myabilities.com.