At the 2017 IAIABC Annual Conference Michele Hibbert-Iaobacci from Mitchell International gave a presentation on how telemedicine can change workers’ compensation.
The need for telemedicine on the healthcare side is highlighted by the shortage of physicians which is continually getting worse. Telemedicine allows patients in both rural and populated areas to easily see doctors. This is something we will see more in group health in the future. Workers’ compensation is lagging in this area.
There are three types of telehealth modalities: Real time consultations, store and forward, and remote monitoring. Store and forward is the most common use right now as this involves transferring patient records electronically between physician offices.
Specialties such as psychiatry and radiology are especially suited for telehealth. The store and forward modality is extremely common in radiology. Psychiatric treatment via telehealth has tremendous promise for many reasons. First, there is a significant shortage of these providers. Second, using telehealth can help people overcome the stigma associated with going to a psychiatric office visit.
Telemedicine can produce cost savings, but not how you would think. The physician visits themselves are not cheaper than seeing a doctor in person. The savings comes from avoiding delays in treatment which extends disability costs and avoiding transportation costs.
Three areas telehealth may improve the workers’ compensation process:
1. Tele triage: Triage nurse would interview the patient, observe the accident site and make recommendations for the next step.
2. Follow up: Follow up visits would enable prescription refills, monitoring of improvement and eliminating travel and out of work expenses.
3. Specialist evaluations: Rather than having long delays to see a specialist the initial evaluation with a specialist could be done via telehealth significantly speeding up the process.
One of the big challenges for telehealth in workers’ compensation is that most states do not have fee schedules set up for such services. This is something states are starting to take a look at.
Risks and limitations:
1. Physician practice regulations restrict ability to consult across state lines.
2. Creation of new regulations, licensing and privacy policies needed.
3. Laws relating to telemedicine vary by state which creates confusion.
4. High start up costs for technology, need for a secure wifi network.
5. Security of data.
6. Use of data for unintended purposes.
8. Technology errors.