Disability

VR in Workers’ Comp

Health care researchers and workers’ comp insurers are discovering the versatility in virtual reality as a new tool for treating patients and training workers.
By: | February 20, 2017 • 5 min read

Virtual reality is fast becoming a useful new workers’ compensation tool.

Health care researchers are testing novel ways to incorporate VR into patient rehabilitation while workers’ comp insurers are using it to better train adjusters and underwriters.

Areas where the application has promise include catastrophic injuries such as spinal cord injuries, phantom limb pain after amputation, severe pain after burns and rehabilitation.

“The industry is starting to use it,” said Zack Craft, vice president, rehab solutions, at One Call Care Management. “It’s being discussed at almost every rehab center out there.

Zack Craft, vice president, rehab solutions, One Call Care Management

“They see workers’ comp as a good area to test the waters; they see this as a funded source,” he said.

So how does a video image displayed on a large screen or headset help treat catastrophic injuries?

VR may help injured employees cope with pain and regain mobility after serious accidents. VR therapy may improve balance and help with motor learning and mobility. Incorporating video games with the therapy might also keep patients engaged and interested in rehabilitation for longer.

Treatment can be individually designed per patient based on the injury.  Biometrics can measure and adjust to how quickly patients are recovering. The development of the technology, though, is still nascent.

“I think we’re still years away from decent guidelines on which technology to use on certain conditions and for how long and what outcomes we can expect,” said Dr. Robert Goldberg, chief medical officer at Healthesystems.

Doctors tried VR in a study to determine if the technology can help in pain relief while changing bandages on significant burns. Results from the first group of patients were promising.

One of the most exciting potential areas for workers’ compensation payers is the way VR might also be used to replace or reduce opioids in the treatment of pain.

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Opioids are a huge cost for payers. That’s because the drugs are so widely prescribed, are addictive and prescription coverage for them can continue for years without remedy.

It is thought VR can help divert the injured worker’s thoughts away from lingering pain and reduce use of addictive painkillers.

“We’re on the cusp of something almost revolutionary if they can manage chronic pain,” Craft said.

“We need to show that the technology works in a way that makes financial sense.” — Zack Craft, vice president, rehab solutions, One Call Care Management

“When your brain is distracted and immersed into a full-body sensory experience it doesn’t focus on pain,” he added.

VR might also offer improved mirroring, a technique already used to help with phantom limb pain. Again, the VR display distracts the patient from focusing on the nerve-ending pain. That may help to rewire the brain to sense less pain and begin to recognize the missing limb.

Currently, VR is most commonly applied to the care of mental health conditions such as depression, post-traumatic stress disorder, autism and ADHD.

Far from the doctor’s office, VR is already playing a big role in workers’ comp as a training tool for employees, underwriters and adjusters, said Mahendra Nambiar, vice president of global insurance solutions and innovations lead at Capgemini.

“The No. 1 way we see VR used in workers’ comp is from the training space,” Nambiar said.

VR can be used to better train workers, such as a forklift operator, how to do a job more safely and avoid injuries, he said. It can also help the adjuster or underwriter learn to do a more consistent job when conducting a workers’ comp safety assessment.

“The uniformity and quality and inspection goes way higher” when VR is used for training, Nambiar said. VR training is often easier and cheaper than instructor-led teaching, he added.

There’s Promise to the Technology

Healthesystems’ Goldberg said he is hopeful about new uses for treating injured employees.

Dr. Robert Goldberg, chief medical officer, Healthesystems

“There’s promise to this technology,” he said.

Yet, there’s reason for concern.

Last year, the Federal Trade Commission fined the creators of the Lumosity “brain training” programs $2 million for deceiving consumers with marketing claims that their games can help users perform better at work and school, and reduce or delay cognitive impairment associated with age.

“Lumosity preyed on consumers’ fears about age-related cognitive decline, suggesting their games could stave off memory loss, dementia, and even Alzheimer’s disease,” said Jessica Rich, director of the FTC’s Bureau of Consumer Protection in a statement.

“But Lumosity simply did not have the science to back up its ads.”

Virtual reality can best be used as medical treatment when evidence-based care is already established, said Skip Rizzo, the director of medical virtual reality at the Institute for Creative Technologies at the University of Southern California, in Playa Vista, Calif.

For example, mirroring is already proven to help patients with phantom limb pain by using a real mirror. VR is simply a new tool to improve on the proven technique.

One Call is looking at ways to measure different outcomes when using VR, such as quality of life improvements, cost and clinical outcomes. The company is also developing ways to track and develop its own VR data.

“We need to show that the technology works in a way that makes financial sense,” Craft said.

The Cost of the Technology and the Treatment

According to a “2016 Goldman Sachs Global Investment Research Report,” the virtual reality and augmented reality market could reach $80 billion in revenue by 2025. Its use in health care alone could generate $5.1 billion in sales.

“Looking beyond video games, we see real estate, retail and healthcare among the first markets that VR/AR disrupts,” Goldman Sachs said in the report.

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“I think you’ll see it impacting claims this year,” Craft said. “Over the next one to two years I can’t even image where we’ll be with it.”

Goldberg expects workers’ comp payers will probably decide each case individually.

“I don’t think they are going to hold back on new technology scripts,” Craft said.  Some insurers are going to be very willing to approve scripts on VR rather than opioids, he said.

The challenge pertains more to the cost of VR’s technology than its medical value. Carriers will need to understand how to vet VR products, and recurring costs.

The technology may become obsolete more quickly than expected and there are other data costs that may make it difficult for adjusters and case managers to gauge the projected cost of the equipment for each claim.

The good news is that the cost of the VR technology is falling.

“It’s exciting because every day there’s new technology,” Craft said. “It’s no longer in the future; it’s here.” &

Juliann Walsh is a staff writer at Risk & Insurance. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

2017 RIMS

Resilience in Face of Cyber

New cyber model platforms will help insurers better manage aggregation risk within their books of business.
By: | April 26, 2017 • 3 min read

As insurers become increasingly concerned about the aggregation of cyber risk exposures in their portfolios, new tools are being developed to help them better assess and manage those exposures.

One of those tools, a comprehensive cyber risk modeling application for the insurance and reinsurance markets, was announced on April 24 by AIR Worldwide.

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Last year at RIMS, AIR announced the release of the industry’s first open source deterministic cyber risk scenario, subsequently releasing a series of scenarios throughout the year, and offering the service to insurers on a consulting basis.

Its latest release, ARC– Analytics of Risk from Cyber — continues that work by offering the modeling platform for license to insurance clients for internal use rather than on a consulting basis. ARC is separate from AIR’s Touchstone platform, allowing for more flexibility in the rapidly changing cyber environment.

ARC allows insurers to get a better picture of their exposures across an entire book of business, with the help of a comprehensive industry exposure database that combines data from multiple public and commercial sources.

Scott Stransky, assistant vice president and principal scientist, AIR Worldwide

The recent attacks on Dyn and Amazon Web Services (AWS) provide perfect examples of how the ARC platform can be used to enhance the industry’s resilience, said Scott Stransky, assistant vice president and principal scientist for AIR Worldwide.

Stransky noted that insurers don’t necessarily have visibility into which of their insureds use Dyn, Amazon Web Services, Rackspace, or other common internet services providers.

In the Dyn and AWS events, there was little insured loss because the downtime fell largely just under policy waiting periods.

But,” said Stransky, “it got our clients thinking, well it happened for a few hours – could it happen for longer? And what does that do to us if it does? … This is really where our model can be very helpful.”

The purpose of having this model is to make the world more resilient … that’s really the goal.” Scott Stransky, assistant vice president and principal scientist, AIR Worldwide

AIR has run the Dyn incident through its model, with the parameters of a single day of downtime impacting the Fortune 1000. Then it did the same with the AWS event.

When we run Fortune 1000 for Dyn for one day, we get a half a billion dollars of loss,” said Stransky. “Taking it one step further – we’ve run the same exercise for AWS for one day, through the Fortune 1000 only, and the losses are about $3 billion.”

So once you expand it out to millions of businesses, the losses would be much higher,” he added.

The ARC platform allows insurers to assess cyber exposures including “silent cyber,” across the spectrum of business, be it D&O, E&O, general liability or property. There are 18 scenarios that can be modeled, with the capability to adjust variables broadly for a better handle on events of varying severity and scope.

Looking ahead, AIR is taking a closer look at what Stransky calls “silent silent cyber,” the complex indirect and difficult to assess or insure potential impacts of any given cyber event.

Stransky cites the 2014 hack of the National Weather Service website as an example. For several days after the hack, no satellite weather imagery was available to be fed into weather models.

Imagine there was a hurricane happening during the time there was no weather service imagery,” he said. “[So] the models wouldn’t have been as accurate; people wouldn’t have had as much advance warning; they wouldn’t have evacuated as quickly or boarded up their homes.”

It’s possible that the losses would be significantly higher in such a scenario, but there would be no way to quantify how much of it could be attributed to the cyber attack and how much was strictly the result of the hurricane itself.

It’s very, very indirect,” said Stransky, citing the recent hack of the Dallas tornado sirens as another example. Not only did the situation jam up the 911 system, potentially exacerbating any number of crisis events, but such a false alarm could lead to increased losses in the future.

The next time if there’s a real tornado, people make think, ‘Oh, its just some hack,’ ” he said. “So if there’s a real tornado, who knows what’s going to happen.”

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Modeling for “silent silent cyber” remains elusive. But platforms like ARC are a step in the right direction for ensuring the continued health and strength of the insurance industry in the face of the ever-changing specter of cyber exposure.

Because we have this model, insurers are now able to manage the risks better, to be more resilient against cyber attacks, to really understand their portfolios,” said Stransky. “So when it does happen, they’ll be able to respond, they’ll be able to pay out the claims properly, they’ll be prepared.

The purpose of having this model is to make the world more resilient … that’s really the goal.”

Additional stories from RIMS 2017:

Blockchain Pros and Cons

If barriers to implementation are brought down, blockchain offers potential for financial institutions.

Embrace the Internet of Things

Risk managers can use IoT for data analytics and other risk mitigation needs, but connected devices also offer a multitude of exposures.

Feeling Unprepared to Deal With Risks

Damage to brand and reputation ranked as the top risk concern of risk managers throughout the world.

Reviewing Medical Marijuana Claims

Liberty Mutual appears to be the first carrier to create a workflow process for evaluating medical marijuana expense reimbursement requests.

Cyber Threat Will Get More Difficult

Companies should focus on response, resiliency and recovery when it comes to cyber risks.

RIMS Conference Held in Birthplace of Insurance in US

Carriers continue their vital role of helping insureds mitigate risks and promote safety.

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]