The Right Telemedicine Solution Can Positively Impact Your Workers Compensation Program CCEA Conference – 10/12/18 Ann Schnure Vice President, Telemedicine Operations Concentra Sharon Scott Vice President ESIS Medical Impact SM
The Language of Telehealth The Innovation Defined Telehealth vs. Telemedicine vs. Telerehabilitation Definitions can vary by state and industry organizations. Telehealth Telerehabilitation Telemedicine Telerehabilitation is a Telehealth Telemedicine is a component encompasses a broad component of telemedicine. definition of of telehealth. technology-enabled • Virtual delivery of • Virtual delivery of health care services physical therapy using medical care using that includes medical video conferencing for a video conferencing for live, two-way interaction care, health education, a live, two-way between a patient and a interaction between a and public health physical therapist patient and a medical services. provider Remote patient • monitoring, mobile health, store and forward, telemedicine 2
Telemedicine in the Spotlight Use is accelerating Telehealth Has Been in Use for 60+ Years • U.S. government agencies such as NASA and Department of Veterans Affairs were early adopters Group Health Focus on Delivery and Access • Health plans, health care systems, employers, technology companies • Addressing adoption challenges • High patient satisfaction Workers’ Compensation May Be The Last Frontier 3
What is the Business Problem to Solve? Why are we together today? 4
Workers Compensation Issues Medical Costs Continue to Escalate 40% $35,000 Rising Costs increase $30,000 • Employers pay almost $1 billion $25,000 per week for direct workers’ $20,000 compensation costs 1 $15,000 • Average medical cost per lost-time $10,000 claim has increased over 40% from $5,000 2005 to 2014 2 2005 2014 $0 1-Liberty Mutual 2018 Workplace Safety Index 2-National Council on Compensation Insurance 2015 5
Workers Compensation Issues Emphasis on Prompt Access to Quality Care Providing Convenient Access to Quality Care • Median cost for top 10 outpatient conditions to emergency department is $1,233, with sprains and strains as the 51% 51% most common 2 incre rease • Delays in reporting work-related injuries from 1-2 weeks to 4 weeks after the injury can cause workers’ compensation claim costs to increase by up to 51% 1 6
If Something is a Disruptor, is it a Good Thing? Problems drive innovative solution How Telemedicine and Problems to Solve Telerehabilitation Can Help • Provide convenient access to • Improved access to occupational quality care medicine care • Engage employees in • No travel for the employee and their recovery less time away from work • Minimize impact to worker • Initiate treatment earlier and productivity convenient follow up • Combat rising health care costs • Positive experience and easy to use • Reduce unnecessary emergency department visits 7
If Something is a Disruptor, is it a Good Thing? Problems drive innovative solution Going Mainstream 75% 54% 80% Over 75% of health 54% of workers’ compensation Nearly 80% of large delivery organizations, professionals, such as TPAs employers (defined as such as physician groups and brokers, say telehealth and 1,000 or more employees) and hospitals, use or plan telemedicine will be most use telemedicine and to use telemedicine in the useful in containing health expected to jump to over near future. 1 care costs. 2 90% by 2019. 3 1-Vidyo 2018 survey of health delivery organizations 2-Mitchell and Risk & Insurance magazine 2017 survey of workers’ compensation professionals 3-Willis Towers Watson 2017 Best Practices in Health Care Employer Survey 8
Telemedicine is Telemedicine, Right? The Occupational Health Challenge Telemedicine for workers’ compensation differs from group health • Focuses on work-related injuries and illnesses instead of urgent care or other group health services • Requires clinicians to understand occupational health and the return- to-work process • Impacted by workers’ compensation that vary state by state 9
How Employers are Using Telemedicine Providing Another Way to Access Care Bring care to Provide care to a Type of Care geographically group of employees dispersed • Injury visits when no in-person workforce in health care options • Recheck visits remote locations are in close proximity • Option for patients who missed Access appointments and case closure General access to Care to care for appropriate injuries to eliminate travel to a provider in urban, After-hours suburban, or rural injury care settings 10
What Types of Injuries are Appropriate? Telemedicine Meets Workers Compensation 1 Initial Injury – Rechecks – up to 30% up to 60% Regardless of whether Strains, sprains, initial injury seen contusions, abrasions, in-person or not simple burns, occupational dermatitis 11
What Does a Good Solution Look Like? Winning Programs Distinguish Themselves Technology Clinician Coordinators Communication Platform Network • Greet patients • Patient has clear • HIPAA-compliant • Expertise and • Manage check-in instructions on experience in • Video and audio and check-out return-to-work workers’ process (RTW) process and • Supports workflows compensation home exercise • Confirm • Supports electronic • Embrace program telemedicine medical records telemedicine and appropriate • Employer notified (EMR) technology immediately on • Ensure specific • Actionable • Utilize same EMR RTW to support employer workflow reporting across network for injured worker is followed • 24/7 support continuity of care • TPA/payor/manage • Schedule future • Confirm in-network d care receives appointments, with payor timely clinical including information to telerehabilitation as support care appropriate continuum 12
How is Telemedicine Applicable in Workers Compensation? Access Points to Care Employer NurseLine Direct Patient engages first with Employer provides NurseLine who follows instruction to access care clinical guidelines to and authorization for patient offer telemedicine as to make direct contact with appropriate telemedicine program coordinator and clinician 13
Patient Engagement – Sample : NurseLine to Concentra Telemed Enhanced Workflow Patient is injured at work Nurse offers telemedicine option and Patient uses directions to register with and calls nurse triage emails/texts access instructions to injured Concentra Telemed via website or mobile app. worker and sends report to Concentra Care Coordinator calls if patient Telemed@concentra.com doesn’t appear within 30 minutes. 1 2 3 Doctor reviews patient information and After Concentra Care Coordinator completes Concentra Care Coordinator uses nurse triage conducts patient visit, including evaluation, intake with patient, patient is transferred to report to begin patient check in – thereby diagnosis, and treatment the doctor for assessment and treatment reducing data intake when patient presents on Concentra Telemed 6 5 4 After visit, patient receives paperwork via Patient visit ends with the doctor if care is Concentra Care Coordinator conducts patient secure email. Employer/Payor receive reports completed OR patient will be reconnected with check out - reviewing restrictions and as outlined in current Concentra Care Coordinator scheduling any required follow-ups Concentra account instructions. 7 8 9 14
What About the Patient? Early and Active Participation a Benefit Importance of the Patient Experience • Ease of use = happy patient • Clinician who understands how to manage return-to-work and supports the patient on a positive path • Engaged patient leads to better outcomes What Patients Need • Access to a private space • Computer/tablet/smart phone, internet connection, email address • Driver’s license or ID and authorization to treat 15
What Patients are Saying Willing to see a doctor using video – nearly 70% of adults 1 Patients with telemedicine visits – 90% satisfaction rate 2 More than 50% say telemedicine helps increase their involvement in treatment decisions 3 More than 20% cite “high quality of care” and “don’t have to travel” as benefits of telemedicine 3 1-American Well 2017 Consumer Survey. 2-BMJ Open “Telehealth and Patient Satisfaction: a systemic review and narrative analysis 2017 3-Software Advice 2015 Telemedicine Report. 16
Keys to Success Pre-Planning is Paramount • Identify and engage advocates within your organization Implementation • Leverage existing processes and workflows and Activation • Understand equipment needs and provide a private space • Educate stakeholders in the injury process on what to expect to support the injured worker • Provide resources so injured worker knows how to get to care Importance • Keep stakeholders informed on return-to- of Communication work post visit • Review results – outcomes, satisfaction 17
Success from Telemedicine Tangible Benefits What You Can Expect • Same quality of care as an in-person visit • A highly satisfied patient • Cost savings • Increased productivity – less time away and shorter case duration • Treatment starts faster which may decrease case duration • Avoidance of higher costs of care such as emergency department visit 18
Learnings and Results 19
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