I am honored to join Dr. Teresa Bartlett, Senior VP for Medical Quality at Sedgwick, and Michael Coupland, CEO and Network Medical Director of Integrated Medical Case Solutions for a session at the Self Insurance Institute of America’s annual National Educational Conference & Expo in October. In the session, Medical Services on Demand: a Look at New Delivery Models, we will explore news ways to deliver medical care to injured workers as quickly as possible.

Through telemedicine, telehealth and on-demand medical services, the workers’ compensation industry is finding ways to deliver medical care faster and more efficiently. The result is earlier interventions, better patient outcomes and lower costs for payers. All three of us will offer perspectives on ways our companies are doing that.

The idea of newer medical delivery options is to bring the best quality care to the patient as soon as possible, regardless of time or distance. In some cases that means using computer links to ‘bring’ the provider to the patient. In others, it means bringing the provider to the patient — at his home, workplace or other venue. And in still others, it can be a hybrid of the two.

One of the best reasons to provide care as soon as possible is to prevent so-called creeping catastrophic claims; those seemingly simple injuries that continue endlessly and render the patient unable to function, let alone work again.

Treating the patient soon after an injury helps decrease the ‘sick role’ mentality, some injured workers develop. They are thinking more along the lines of recovery and getting better vs. being stuck in the rut of an injured person.

PhysNet’s model provides physical therapy where it is most convenient for the injured worker and is focused on return to work. In many cases that means providing PT at the worksite, where we can understand the job tasks involved and structure our treatment based on them.

In other cases the PT can be done at the injured worker’s home until he is ambulatory. Even if the PT is initially done in the home, it is still focused on returning the patient to work.

The biggest benefit is the one-on-one care. We want to make sure it is not just basic care, but is one-on-one, hands on and functional.

Telemedicine

Advances in technology now allow medical care to be provided in ways not thought possible just a few years ago. In addition to providing access to medical care for injured workers in rural areas, these newer medical delivery options can also overcome language and transportation barriers and allow for multiple providers to be involved in a single session

Michael Coupland, for example, is using telemedicine to allow injured workers to be treated by a physical therapist and psychologist in cases where one is warranted. His company has a HIPAA compliant Web enabled video system, so the patient can use a computer, tablet or smart phone and is able to talk and be seen by the provider. It allows for face-to-face sessions, but not in person.

This interdisciplinary type of model involves the physical therapist working with the injured worker at his home, and bringing in the psychologist via computer.  In addition to overcoming privacy concerns, it also allows for more focused treatment.

His company began using the system mainly for psychiatry because it’s difficult to get psychiatrists to all locations where they are needed.

Telehealth

Bringing the physician to the patient for a face-to-face visit via computer is referred to as telemedicine. Telehealth, another form of mobile medical delivery involves such things as monitoring a patient’s heart rate or blood sugar levels. In that scenario, wifi and Bluetooth enable the information to be immediately uploaded to a physician’s office.

Telehealth also includes coaching from medical providers. One such model is the ‘clinical consultation’ service Sedgwick unveiled nine years ago.

The company provides a nurse right at the point of a potential injury, who walks the injured worker through a triage of questions to put their minds at ease. The result may be that the injured worker does not require care and there is some self-care he can do to prevent it from becoming an injury. In other cases the person does need medical attention, in which case Sedgwick expedites the care either to a provider directly or through telemedicine, where they can be linked directly with an occupational health provider.

The Future

Those delivering medical care see a wide open future in terms of new models evolving. One idea, for example, would allow patients to connect with their providers online for follow up visits, rather than having to go to an office and wait.

There really is no limit in terms of delivering medical care to injured workers in the future. I look forward to working with Dr. Bartlett and Mr. Coupland on this session and hearing their ideas. I hope you can join us.

The conference takes place Oct. 8 – 10 at the JW Marriott Desert Ridge Resort & Spa in Phoenix. For more information, visit www.siia.org/i4a/pages/index.cfm?pageID=6336.