Telemedicine Helping with Injured Workers

Telemedicine may have many applications in caring for workers injured on the job.
Telemedicine may have many applications in caring for workers injured on the job.

Telemedicine can be used to treat workers injured on the job, particularly in rural areas, providing quicker evaluation and potentially reducing the costs paid by employers and workers’ compensation insurers.

Telemedicine is remote, virtual interaction among two or more parties, and with modern telecommunications, it has evolved to include face-to-face interactions via video conferencing, and even remote measurement of worker vital signs in cases of on-the-job injury. It is especially useful in cases where workers are in rural areas, without easy access to medical care.

Increasing acceptance of telemedicine, and the realization by employers and insurers of its many benefits are leading more employers and workers’ compensation insurers to consider adopting telemedicine for workers in rural areas. Benefits of telemedicine in these cases include reducing emergency room utilization, reducing or eliminating wait times for workers who need specialist care, and improvement in return-to-work rates.

Types of Telemedicine Exams Used with Remote Workers

With telemedicine, a patient visiting an occupational healthcare provider who needs specialist evaluation could have the specialist consultation on the spot, through a video conference between the occupational healthcare provider and the specialist.

Another example of telemedicine in occupational injury is the evaluation of burns in food service workers. Telehealth nurses, for example, could evaluate symptoms and determine whether a worker needs to see a doctor or whether he can be discharged with home care instructions. Remote imaging technology allows healthcare providers to see burned areas at higher resolution than you would get with a typical video conference using, say, Skype.

Other types of remote worker exams include EKGs, lung function tests, and hearing tests, where test data is sent to physicians in real time. Physicians are paid the same as they would be paid with a comparable in-person visit, and have generally expressed favorable attitudes toward this type of telemedicine.

Why Workers’ Compensation Insurers Like Telemedicine

Telemedicine as a cost control method in workers’ compensation claims is expected to catch on as use of telemedicine increases. When initial assessments and some follow-up assessments can be done over the web or by phone, costs decrease, as do demands for driving long distances for follow-up appointments. There are many other advantages to use of telemedicine in workers’ compensation cases.

After a non-emergency injury in the workplace, telemedicine could expedite initial medical contact. A visual assessment of an injury could take place much sooner after an accident, while details of the incident are still fresh in the employee’s mind. When multiple healthcare providers are needed, telemedicine can facilitate coordination among them, allowing care teams to coordinate patient procedures, decide which doctor should be seen first, and determine which diagnostic tests are most appropriate.

Should a second opinion be requested (or required by an insurer), one can be obtained more quickly and at a lower cost through the use of telemedicine. Some follow-up appointments may be routine enough that they can be done effectively through telemedicine, saving everyone time, and saving patients the cost of transportation (and saving the insurer on reimbursement for transportation if required).

Telemedicine could cut down on the need for in-person follow-up care, and costs associated with it.
Telemedicine could cut down on the need for in-person follow-up care, and costs associated with it.

Once workers return to work, they could obtain follow-up evaluation right from work rather than having to take time off for an in-person office visit. This can be especially appreciated in rural areas where travel to a specialist requires a long drive. Where case workers are assigned after on-the-job injuries, telemedicine allows them to remain in better contact to ensure recovering workers keep up with self-care instructions and have necessary follow-up evaluations.

Obstacles to Telemedicine Use in Workers’ Compensation Cases

Adoption of telemedicine practices in cases of worker injuries isn’t without hurdles. Legal and regulatory obstacles must be considered, and not all states permit the use of telemedicine in workers’ compensation cases. Some workers’ compensation insurers would like to have a network of specialists available for telemedicine referrals, but the variable state licensing issues can be problematic.

Another possible hurdle is fear of medical malpractice liability due to doctors examining patients remotely rather than in person. Right now there is simply not enough hard data to alleviate these fears, although telemedicine is associated with improved patient outcomes. The legal landscape often lags behind advances in technology, so it may be simply a matter of time before telemedicine plays a more prominent role in treatment of injured workers.

Nevada’s Rural Workers and Telemedicine

Nevada’s workers’ compensation rules say that employees injured at work can be reimbursed for out-of-pocket expenses for meals, lodging, and mileage for authorized medical exams, medical treatment, rehabilitation, or retraining that requires more than 20 miles of round-trip travel for services, and the state is trying to gain approval for telemedicine as part of the workers’ compensation treatment process to cut down on the need for travel.

A request by the Nevada Hospital Association for a proposed rule allowing insurers and third party administrators (TPAs) to pay for telemedicine under specific circumstances failed earlier this year, but it may become part of an overhaul of Nevada’s workers’ compensation law in 2015. Aside from two main urban population centers, the state is mostly rural, and telemedicine could be of great help to workers outside the major urban areas.

Apps Designed for Workers’ Compensation Third Party Administrators

Meanwhile, mobile developers are helping workers’ compensation TPAs develop apps designed to improve communication between claims examiners and injured employees. Some will allow employees with multiple claims to use a single interface for all their claim information, and insurers believe that apps can help eliminate gaps in communication that can precipitate lawsuits. Over the long term, app developers may add medical management features including injury-specific educational information, remote monitoring of vital signs, and reminders for appointments and follow-up processes.

Conclusions

Telemedicine is starting to be examined more as an option for helping workers injured on the job. In rural areas, telemedicine could be used by workers’ compensation medical providers to speed delivery of services and improve care coordination, with the ultimate goal of getting employees recovered and back at work quicker.

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