Column: Workers' Comp

Telemedicine’s Urgent Questions

By: | April 7, 2017 • 2 min read
Roberto Ceniceros is senior editor at Risk & Insurance® and chair of the National Workers' Compensation and Disability Conference® & Expo. He can be reached at [email protected] Read more of his columns and features.

The often-quoted, “If you build it, they will come,” from the movie “Field of Dreams” isn’t always a guiding principle in workers’ comp product offerings. Emerging products more often follow the marketing principle, “Get buyers to come and pay for it and then we’ll build it.”

It’s not always true. Some vendors carefully develop products before taking them to market. But frequently enough, they’re offered before sellers are ready to meet their big-picture promises.
We’ve seen these scenarios unfold with workers’ comp offerings like predictive modeling and high-performance doctor networks.

On the positive side, the practice spurs innovation. Larger, well-funded employers become early adopters, pushing vendors to improve their offerings. Vendors, meanwhile, gain vital customer feedback on performance.

Are products really capable of something new, or just streamlining existing capabilities, perhaps with a new label?

But the practice puts pressure on purchasers to study what they’re paying for. Is a product really built on a state-of-the-art platform or is it a reworked older system? Are products really capable of something new, or just streamlining existing capabilities, perhaps with a new label?


The growing application of technology means purchasers will need to ask those questions more frequently and spend more time learning. Telemedicine offers an example.

The big-picture promises of telemedicine in workers’ comp — that it will save money, reduce injured worker time away from the job, and improve access to medical care — are still largely somewhere out in the future, although occurring in small doses.

Lessons health care insurers learn about telemedicine will eventually migrate to workers’ comp. But right now, workers’ comp hasn’t even settled on what telemedicine is. Are existing nurse-triage systems using video technology really “telemedicine?”

Nurse-triage services have great value. But shouldn’t telemedicine be something more than a post-injury assessment of whether a worker needs first aid or an emergency room visit?

A more robust definition would encompass using video technology for post-surgical doctor visits, obtaining second opinions on surgery procedures and providing ongoing treatment.

In workers’ comp, those services are still challenging to provide on a broad, multi-state basis. Jurisdictional regulatory hurdles remain. It is also difficult for payers to offer telemedicine options when doctor networks are not prepared to deliver. Conversely, it’s challenging for doctor networks to promise care delivery when they don’t know how much telemedicine demand they might experience.

Despite the challenges, there are reasons for optimism that telemedicine will become available to more injured workers.

But with much of that promise still more buzz than proven capability, product buyers have a lot of questions they will need to ask and have answered. &

More from Risk & Insurance

More from Risk & Insurance

Black Swans

Black Swans: Yes, It Can Happen Here

In this year's Black Swan coverage, we focus on two events: An Atlantic mega-tsunami which would wipe out the East Coast and a killer global pandemic.
By: | July 30, 2018 • 2 min read

One of the most difficult phrases to digest without becoming frustrated or judgmental is the oft-repeated, “I never thought that could happen here.”


Most painfully, we hear it time and time again in the aftermath of the mass school shootings that terrorize this country. Shocked parents and neighbors, viewing the carnage, voice that they can’t believe this happened in their neighborhood.

Not to be mean, but why couldn’t it happen in your neighborhood?

So it is with Black Swans, a phrase describing unforeseen events, made famous by the former trader and acerbic critic of academia Nassim Nicholas Taleb.

We at Risk & Insurance® define these events in insurance terms by saying that they are highly infrequent, yet could cause massive damages. This year, for our annual Black Swan issue, we present two very different scenarios, both of which would leave mass devastation in their wake.

A Mega-Tsunami Is Coming; Can the East Coast Even Prepare?, written by staff writer Autumn Heisler, profiles an Atlantic mega-tsunami, which would wipe out lives and commerce along the East Coast.

On the topic of whether the volcanic island of La Palma, the most northwestern of the Canary Islands, could erupt, split and trigger an Atlantic mega-tsunami, scientists are divided.

Researchers Steven Ward, a geophysicist at UC Santa Cruz, and Simon Day of University College London, say such a thing could happen. Other scientists say Day and Ward are dead wrong; it’s an impossibility.

One of the counter-arguments is backed up by the statement that there has never been an Atlantic mega-tsunami. It’s never happened before and thus, could never happen here. See exhibit “A” above, re: mass school shootings.

Viral Fear: How a Global Pandemic Kills an Economy, written by associate editor Katie Dwyer, depicts a killer global pandemic the likes of which hasn’t been seen in a century.

Tens of millions of people died during the Spanish Flu outbreak of 1918.

Why it could happen again includes the fact that it’s happened before. The science on influenzas, which are constantly mutating, also supports just how dangerous a threat they pose to millions of people beyond the reach of antibiotics.

Should a mutating avian flu, for example, spread widely, we could see a 10 percent drop in GDP, mostly from non-physical business interruption.

As always here, the purpose is to do exactly what insurance modelers and underwriters do; no matter how massive the event, we create scenarios, quantify possible losses and discuss risk mitigation strategies. &

Dan Reynolds is editor-in-chief of Risk & Insurance. He can be reached at [email protected]