I attended a webinar recently where the focus was managing musculoskeletal (MSK) claims for successful outcomes. Not surprisingly, telemedicine was a big component.
This is an emerging issue about which I’ve already blogged. I was interviewed in 2020 for a cover article on telemedicine published in the July/August issue of Claims magazine, a top-tier publication for lawyers, claims executives and others in the healthcare space. In it, I note that telemedicine can enhance treatment outcomes, saying that
…injured parties in remote locations could benefit from some level of medical assessment…and patients could conceivably have access to specialists, no matter how remote.
In the Claims article, I also state that for injured workers — including those with MSK concerns — early assessment and triage of required care via telemedicine can help. As I note about early assessments, they “…allow for the employers to assist with management and initiate internal protocols. It also sets a positive rapport between employer and employee who are working toward recovery.”
During the pandemic, these issues have taken on a heightened importance. For starters, the workers comp and claims numbers show a significant upward trend. Here’s what the industry has seen since three bellwether started covering claims for COVID due to work-related exposure.
- Massachusetts — 5,030 claims, 734 denied and 69 in dispute
- California — 50,592 claims, 25% denied
- Florida — 3807 claims, 1695 denied
Approximately 15% of cases have significant symptoms and 5% get hospitalized.
Tele-rehab is a promising treatment pathway. Its advantages include limits to exposure for at-risk family members, promotion of self-sufficiency, and improved continuity of care for injured workers on quarantine. In addition, the virtual technology affords more convenient access to care for rural and remote areas with fewer transportation issues.
These advantages are consistent with what providers observe worldwide. According to the International Journal of Environmental Research and Public Health Patient Perspective, improving access to services with reduced need for transportation is one of six major takeaways. Developing a strong therapeutic relationship with a therapist while maintaining a sense of personal space is another, coupled with the completion of tele-rehabilitation with in-person visits and providing standardized yet tailored and challenging exercise programs using tele-rehabilitation. Finally, there’s an increasingly perceived ease-of-use of tele-rehabilitation equipment and an ongoing sense of support.
Ultimately, however, it’s a mixed bag…
- It can be cost-effective and for those who are unable to get to traditional visits, it can be impactful
- It’s not “hands on.” So, many treatments, imaging tests or blood work cannot be completed
- Some assessments — such as ROM and functional testing — are restricted
- Information can be easily shared among providers, though personal health data transmission remains a concern
- In-person instruction for treatments — such as exercise or dressing changes — may be initially required and then advanced to Telerehab
- Smart devices provide a wealth of health information
- Patient skepticism is a possibility as they interact with physicians/rehabilitators (1)
- Patient and employer feedback is needed for improving approaches and methods (1)