Applying Lean Six-Sigma: Here’s What Systems Engineering Can Do for Workers’ Comp

Omar Taha, senior director of continuous improvement at One Call, shared how his research on continuous improvement can help improve care for injured workers.
By: | December 16, 2019

It’s no secret that the workers’ compensation system can get bogged down by wait times, bureaucratic inefficiencies and other issues. 

Injured workers can end up waiting weeks for an appointment due to physician shortages or delays in getting their treatments or claims approved. When claims drag on, workers return to work later, and payers often end up spending more, causing consternation for all parties involved.

When it comes to managing these processes, the workers’ compensation industry could learn a few things from the manufacturing industry, which has long used systems engineering to cut down on wait times and identify technologies that can make things more efficient. 

“When you think about systems and, when you think about return-to-health, you notice that return-to-health is a collection of processes. Each of these processes is managed by a team of people and enabled by technology.” said Omar Taha, senior director of continuous improvement at One Call.

“If you have these three elements, you can apply systems engineering to improve the system you are looking at.”

Taha is conducting PhD research through The George Washington University on how systems engineering and the Lean Six Sigma methodology can be used to improve wait times for physical therapy appointments in the workers’ compensation system.  His research is sponsored by One Call.   

Approaching Workers’ Comp from a Systems Engineering Perspective

Taha’s research seeks to apply Lean Six-Sigma as a continuous improvement method in order to improve the speed at which injured workers receive care and to reduce costs for payers.

Lean Six-Sigma is a continuous improvement methodology that combines Lean, a system developed by Toyota to eliminate waste in the manufacturing process, and Six-Sigma, a methodology that began at Motorola as a way to eliminate variation in processes and produce consistent results. Taha is a certified Lean Six-Sigma Master Black Belt. 

Omar Taha, senior director of continuous improvement, One Call

“When you think about systems engineering, the first thing we think about, or the first word that comes to mind is ‘system.’ And a system is a collection of three elements — people, processes and technology,” Taha said. 

“Systems engineering as an interdisciplinary field focuses on designing and managing complex systems by ensuring that all three elements, people, processes and technology, are working in synergy to deliver the intended goals.”

His research looks at each step in the process of how a workers’ compensation patient ends up receiving and completing physical therapy, including the length of time between a referral for PT and an appointment, the length of time between appointments and how long it takes for a patient to recover.   

“When we examine a system, we analyze it end to end, with the intention of identifying opportunities and challenging the status quo,” Taha explained. 

As he was examining the different processes in the workers’ compensation system, Taha worked with payers and providers to schedule meetings where he could closely follow and map each step. 

“Through these scheduled meetings I got the chance to conduct a Gemba Walk, where I walked the floor with the intention of gathering system related information through observing and interacting with associates closely.  This enabled me to map out processes and sub-processes, and technology with the intention of examining the current value stream and identifying non-value added activities,” he said.  

While this process is typically used in manufacturing, Taha believes it can benefit the health care and workers’ compensation industries as well. 

“The healthcare and workers’ compensation industry has its own characteristics and emergent behaviors, but it’s also, like any other industry, a collection of the three elements, people, processes, and technology, hence we can apply systems engineering,” Taha said. 

“Some activities are very hectic, time consuming, or it’s very challenging for a human being to take care of them. And this is where you can re-engineer the process and leverage technology to enable humans to better perform these activities.”

Better for Patients, Better for Payers

By mapping out all of the processes involved in getting treatment for a workers’ compensation patient, Taha’s research will help streamline the referral workflow which will enable injured workers to get the care they need sooner. 

“One of the non-value added activities identified through the Gemba Walk is the waiting time between physical therapy sessions. This type of non-value added activity between visits could be eliminated through the application of different continuous improvement methodologies such as Lean Six-Sigma,” Taha said. “What’s stopping the patient from receiving the care he or she needs immediately?”

“The thought is that we can improve patient outcomes by reducing patient waiting time between sessions,” he added.

Getting patients faster care can also help them get back to work faster, allowing them to move past their injuries and return to work sooner. Reducing the length of claims by getting employees back to work has obvious benefits for payers, meaning both the injured worker and their employer benefit from this system. 

“Reducing the waiting time will also be cost effective for both the payer and the provider,” Taha said. “It is going to reduce the referral cost for our payers and the administrative cost for our providers.”

Once he is completed with his research, Taha will receive feedback from other engineers and people working in the industry. 

After that, he plans to publish his findings in a research journal and they will be available for others to read. He plans to present some of his research at the 6th International Conference on Information Management and Industrial Engineering in Cape Town, South Africa in January and plans to have it published by 2021. 

“We are very passionate about workers’ compensation and having patients return to work faster. This is something we strive to achieve day in and day out. Systems engineering is my passion. There is nothing more rewarding than applying it for a good cause,” he said.

“And I realized there is an opportunity here to make these two things work together, it just requires the right balance of science and art.” &

Courtney DuChene is an associate editor at Risk & Insurance. She can be reached at [email protected]

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