Digital Connectivity Helps Improve the Patient Experience and Outcomes. How Can More Workers’ Comp Stakeholders Adopt It?

Our world is more digitally connected than ever — so why doesn’t it feel that way in healthcare?

Paper-based systems are particularly frustrating in workers’ comp, where multiple stakeholders — employers, adjusters, and providers — must stay aligned throughout the care process. Cumbersome analog processes delay treatment approvals, leading to frustration for all involved.

“Sometimes, when we don’t move fast enough, the injured worker’s experience suffers. They hear one thing from the medical provider and something else from the payer, because the information hasn’t synced up yet,” said Elisha Krempetz, vice president of strategy and innovation at Concentra.

“If you’re constantly managing information, trying to track it down and get it, often through phone calls, that really impacts the patient experience. Our partners need information from Concentra, and we need information from our partners to support the patient’s care journey and the claim process.”

Workers’ compensation stakeholders are starting to embrace digital connectivity, however. New tools are helping medical providers and adjusters communicate better throughout the claims process, creating a better experience for injured workers.

Adjuster Workloads Drive Digital Innovation

Elisha Krempetz, Vice President of Strategy and Innovation, Concentra

Much of the push for workers’ comp to digitize came during the pandemic or shortly after. Belabored claims adjusters wanted digital tools that would help them better manage their workloads — a major concern for industry leaders amid the Great Resignation.

Around this time, Concentra started talking with payers and other stakeholders about how workers’ comp could be more digitally connected. They spoke with major stakeholders about their needs and reimagined how the industry could use data and digital communications to improve the claims experience for injured workers.

“We made a deliberate effort to spend time with our partners and customers, and that feedback shaped our approach,” Krempetz said.

“We heard the same things over and over,” Krempetz said. “Our partners shared that their greatest challenges were the number of adjusters leaving the industry or changing jobs. The leaders were looking for opportunities to take things off adjusters’ desks and reduce the heavy workload of manual tasks.”

The Challenges of Digital Connectivity in Workers’ Comp

Despite the push for digitization, workers’ comp faces hurdles like non-standardized data and varied digital readiness across companies, which complicates tech adoption.

“One of the biggest challenges is the lack of an agreed-upon data framework in occupational medicine,” Krempetz said. “The key is starting with clean, structured data and leveraging existing standards in consumer healthcare to create a unified model for workers’ compensation.”

State regulations can also complicate the process of digitization. Every state has different workers’ comp requirements, some more complicated than others which can greatly impact implementing technology solutions designed to reduce manual workflows.

“Our technology roadmap addresses the state-specific data, forms and processes that must be taken into account when developing solutions,” Krempetz said.

John deLorimier, Executive Vice President and Chief Information and Technology Officer, Concentra

Concentra has a long-term vision and plan to digitize the workflows with a variety of industry partners to support key stakeholders, such as adjusters and nurse case managers. This will allow medical providers to focus on patients, and adjusters or nurses can quickly access information and approve treatments.

Their journey of digitizing data will make it easier for AI and large language model tools in the industry to analyze data and detect issues that could derail a claim, offering greater support to adjusters and other stakeholders.

“We know our payer partners have their own innovation strategies that value structured data, and we are excited to support that,” Krempetz said.

Some of the latest strategies are designed to reduce the number of times an adjuster has to call a medical provider, because the information they need is all accessible digitally.

As an added benefit, these strategies allow medical center staff to focus on patient care, rather than answering phone calls.

“Concentra aims to create a welcoming, skillful and respectful environment for injured workers, which can be challenging when phones are constantly ringing,” Krempetz said.

“We can move a patient throughout the center and have them spend more time with clinicians and less time waiting,” added John deLorimier, executive vice president and chief information and technology officer at Concentra. “We really started with digitizing our workflow. Like everyone else, from a data standpoint, we want to eliminate paper.”

Driving Better Outcomes and Improving the Patient Experience

Digitizing communications and claims data can help improve the workers’ compensation experience for patients. Concentra is committed to being a leader in the industry when it comes to embracing technology and prioritizing patient experiences.

“We are leading the industry, especially from a medical perspective, on digitizing information,” Krempetz said. “Our advantage is – it’s our systems, our data and our information.”

When patients feel supported by their medical providers, they are more engaged in their recovery. That can reduce claims durations and help people get back to work sooner. Digital communications and data exchange can help streamline these processes, resulting in a better patient experience.

“All of this done right — done well — creates a level of trust,” Krempetz said.

“When the injured worker trusts their medical provider, adjuster and nurse that they’re working with, they are much more engaged in their care. That’s what drives a good outcome.”

Concentra is prepared to work with stakeholders to use technology in a way that best meets their needs. Payers and other organizations might be in different places in their technological journeys.

“Everybody has their own technology road map,” deLorimier said.

“We have a largely standard integration pattern, however there is not a one-size-fits-all solution. There is a level of customization every time we engage with an external party,” Krempetz added. “The positive outcome of the customization is we continue to uncover insights that drive further enhancements and make our solutions better for everyone involved.”

To learn more about Concentra, visit: https://www.concentra.com/

This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with Concentra. The editorial staff of Risk & Insurance had no role in its preparation.