Column: Workers' Comp

Telemedicine’s Urgent Questions

By: | April 7, 2017

Roberto Ceniceros is a retired senior editor of Risk & Insurance® and the former chair of the National Workers' Compensation and Disability Conference® & Expo. 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. &

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