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Digital EditionBetter for Case Managers, Better for Injured Workers: How Telehealth Tools Are Enhancing Claim Flows
Connecting with an injured worker after an incident is paramount. Every good case manager knows this.
That’s because most workers facing an illness or injury at work are entering into the workers’ compensation system for the first time, meaning they not only have to contend with the medical side of their injury but also with an entirely new industry.
To ease that transition, nurse case managers are utilizing digital innovations to help their patients. And in turn, these digital innovations are making it easier for the case managers to do their jobs effectively and efficiently.
“[Technology] enables us to connect not only with the patients, but it also lets us connect with physicians, physical therapists, adjusters or any other specialist involved with the claim,” explained Rachel Mattioli, case management supervisor, CorVel Corporation.
That connection to all relevant parties creates a seamless process for worker and case manager alike. And that’s just the start when it comes to incorporating digital innovations into the case management process.
Talking Telemed
Though it’s been around for several years, with a large utilization uptick around the start of the COVID-19 pandemic, telemedicine is one type of digital innovation that continues to grow within the workers’ comp space.
And for good reason.
Rachel Mattioli, case management supervisor, CorVel Corporation
“Telemedicine has that in-person connection without really being there, especially if a worker is unable to drive or if they have to stay at home,” Mattioli explained.
One truly beneficial aspect of telemedicine is giving nurse case managers the ability to work with injured workers out of state. Mattioli, for example, is based in Pennsylvania, but she handles claims in Ohio and West Virginia as well.
And, at one point, she even managed a claim in Utah via telemedicine’s help.
“The worker lived in Utah,” she explained, “but he works in Pennsylvania for two weeks, travels home to Utah to work for two weeks, and then would have two weeks off.”
During one of his stints in the Keystone State, the worker suffered a severe injury to his dominant hand and needed surgery. This all took place in Mattioli’s state, where the injured worker had the chance to heal from that first surgery and return home.
A few months later, he started experiencing complications.
“He lost range of motion. He needed a second surgery,” said Mattioli.
In the interim, this worker had continued to work his normal rotation — Pennsylvania, Utah and back again. The second surgery needed to be coordinated in Penn., during one of his two-week stints.
“Via telemed services while he was in Utah, we were able to communicate with the worker. We got everything for pre-op scheduled, including post-op appointments, to make sure that he was [in Penn.] for that time, all in advance,” Mattioli said.
All seemed well for this worker, until recovery proved difficult after the second surgery. Due to some “intense complications,” as Mattioli described them, the worker needed a third surgery all while in his home state of Utah.
“He was unable to come back to Pennsylvania safely, and this needed to be addressed immediately.”
States away, Mattioli and her team took charge. They coordinated with the medical team in Utah, using telemedicine as the bridge between the worker’s past medical history and surgeries and the present situation.
All of his records were in one place. All of his workers’ comp claim notes. All of his comorbidities, case files, job description. Everything.
“I was able to get those to the new provider, so that he was safely able to operate on this injured worker,” said Mattioli. “Without telemedicine, I’m not sure how we would have been able to care for the worker the way he needed at the time.”
It’s All About the App
Telemedicine isn’t the only digital innovation that’s turning case management into a workers’ comp powerhouse; digital apps have changed the way injured workers interact with the industry, further empowering these case managers to effectively do their jobs.
As Mattioli’s colleague Ryan Akers, nurse case manager, CorVel, relayed, “Apps engage the injured worker, because sometimes they’re more apt to be active in an app or reporting things to the case manager that way.”
So much happens on our phones these days — emails, video chats, banking, more.
By bringing the comp space to injured workers via their phone, utilizing digital applications specific to their care, has come a long way in helping them through their claims.
“As far as education,” Akers said, “sharing education tools with them through an app has been a game changer.”
Like Mattioli, Akers handles claims outside her home state of West Virginia, all the way to Pennsylvania, Colorado, Ohio and Kentucky. And like Mattioli, Akers has workers who move from state to state for their jobs, which means there’s a transition of care needed when injuries occur.
“Transition is seamless with the technology that we have,” she said. “All because that information is within one system. So, I’m never lacking at receiving medicals or an update on a claim … workers have access to their claim and know what they need.”
The CorVel My Care app is a prime example of this communication and education in action in workers’ comp. The team has created this app to connect with injured workers digitally, providing information, answering FAQs about the comp system and easing them through the process.
“If someone is having pain or associated pain, they can go into the My Care app, enter that information in, and it pops up in our system,” Akers said.
“We can see that and kind of have an advantage at addressing their needs and taking care of them.”
Digital Tools for Case Management Recruitment
No industry is shy from the current talent shortage, and medical professions often see a bigger deficit than others.
Ryan Akers, nurse case manager, CorVel Corporation
But with digital innovations, from telemedicine to digital apps, to even some applications using artificial intelligence and machine learning, workers’ comp case management has an opportunity to attract fresh faces and really make a difference in the workers’ compensation space.
In this profession “sometimes you may not feel like you are actually a nurse, because you aren’t working in the hospital or in a clinical setting,” Akers explained.
Ask any nurse why they do what they do, and nine times out of ten, you are going to hear that they chose that profession to help people.
“Workers’ comp case management is a place where nurses can help. The job is much more enjoyable when you hear, ‘You are doing a good job, and nurses are meaningful in this format,’ ” said Akers. &
