Workers' Compensation Eyes Telemedicine As An Option

Cost savings, better access to care, immediate triaging of injuries and faster claims closings are just some of the benefits of telemedicine, according to workers’ compensation experts, who also say its use is growing. Telemedicine could potentially deliver more than $6 billion a year in health care savings to U.S. companies, but only if the technology is widely-adopted, according to a 2014 report by Towers Watson. The Towers Watson analysis points to a maximum potential savings, but even a significantly lower level of use could save hundreds of millions of dollars, according to Dr. Allan Khoury, a senior consultant at Towers Watson

“Achieving this savings requires a shift in patient and physician mindsets, health plan willingness to integrate and reimburse such services, and regulatory support in all states,” Khoury said.

Texas Study

A recent Texas Department of Insurance Workers’ Compensation Research Division study shed light on how it might work. The study, which defines telemedicine as the delivery of medical care and information via telecommunications network, found two areas of the Texas workers’ compensation system that could benefit from telemedicine: the designated doctor and the spinal surgery second opinion processes. In both cases, injured workers must go to doctors other than their treating doctor for second opinion examinations.

But using telemedicine, an injured worker could have access to a designated doctor or second opinion spinal specialist already familiar with the workers’ compensation system. The report indicated some of the benefits could include “greater conformity among second opinions, increased injured worker satisfaction with the process, fewer disputes, and an electronic record of procedures followed.”

Another benefit of telemedicine is that employees working in remote locations could still seek treatment guidance. The TDI report noted that Texas especially could benefit since it is a state that is 80 percent rural and more than half of all Texas claims are filed in counties officially designated as rural.

One drawback of the rural concentration, according to the report, is that these regions may have telecommunications infrastructure limitations. Kim Haugaard, vice president of network and medical operations at Texas Mutual Insurance Co., said earlier this year her company is considering the use of telemedicine. “Texas is a very expansive geographical area, and in many rural areas there are very few or no medical providers to administer medical care,” said Haugaard. “Injured workers may have to travel a significant distance to obtain medical care…telemedicine is an option that we are exploring.”

Jodi Mathy, senior claims consultant at Wisconsin-based HNI, said that while she sees telemedcine being used in general other situations, she doesn’t currently have any clients utilizing telemedicine for workers’ compensation treatment. “I do have many more clients that are engaging 24/7 nurse triage which I think is the baby step before telemedicine. Companies like TriageNow have a smartphone app that allows the injured worker to take pictures and send them to the nurse real-time. We do see telemedicine becoming more popular on the general health side of things.

In fact, HNI makes Anthem’s LiveHealthOnline available for its employees,” said Mathy. Benefits of Online Care According to Haugaard, the benefits of telemedicine include improved access to care in rural areas; fast non-emergency care; improved cost efficiency by reducing non-emergency care delivered by hospitals and a reduction in travel time by triaging an injury for medical severity and referral to the most appropriate level of care. Mathy believes that based on current estimates, there will be a physician shortage in the near future, which could mean more of a role for telemedicine.