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

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.

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That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.

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Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

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