Sarasota, FL (WorkersCompensation.com) - A technological revolution is advancing in workers’ compensation on two fronts — the treatment (and prevention) of workplace injuries, and the close monitoring of claims for signs of fraud.
However, the increasing reliance on technology on both of those fronts will continue to require a human touch to ensure their effectiveness, according to two experts.
The use of wearable health monitors — think FitBits and the like — is well established as a means of helping employees both avoid and recover from workplace injuries, although it’s not clear how many employers may actually be monitoring those devices. To read more WorkersCompensation.com coverage of wearable technology, click here.
But there are other pieces of technology, from sophisticated pieces of medical equipment that are expanding the definition of wearable technology, to digital applications to help injured workers get to doctors’ appointments. These different types of tech are becoming available in the industry, and can have a clear role in workplace injury treatment and prevention.
As an example of the former, attendees at the Workers’ Compensation Institute’s (WCI’s) annual educational conference in August got a chance to see a demonstration of an “exoskeleton,” a mechanical bio-electronic device used in connection with spinal cord injuries.
“It’s pretty costly,” Michelle Despres, a vice president at One Call Care Management, said of the exoskeleton. “It’s not used in people’s homes; it’s used in rehabilitation.”
On the other end of the spectrum, smartphone apps like Uber, a ride-hailing service, have proven to be a boon to injured workers who need a quick and reliable way to get to doctors’ appointments and meet other responsibilities.
Between exoskeletons and ride-hailing apps, there are numbers of other technological aids to addressing workplace safety and workplace injuries.
In an interview this week with WorkersCompensation.com, Despres mentioned everything from computer programs that capture keystrokes and typing speed in connection with addressing potential carpal tunnel injuries, to “telerehab” opportunities that allow people to interface virtually with a physical therapist. That approach to rehabilitation can be particularly valuable to workers such as over-the-road truck drivers, who may not be able to keep more traditional appointments for physical therapy sessions, Despres explained.
There are some key advantages and conveniences associated with digital technology, Despres said. As an example, she contrasted a traditional approach to physical therapy to an approach integrating digital technology into the process.
Traditionally, Despres said, a physical therapist would assess an injured worker's’ therapeutic needs, select some appropriate exercises, provide the worker with printed illustrations of those exercises, and send the worker home to do the exercises on his or her own, reporting back at their next appointment.
Today, though, those kinds of things will be made available digitally to injured workers, providing them with video of the actual exercises completed, and even incorporating incentives like awarding virtual badges for the successful completion of exercises.
Looking to the future, Despres says she expects “telehealth” — the use of electronic information and telecommunications technologies for long-distance clinical health care, patient and professional health-related education via videoconferencing, the internet, and terrestrial and the wireless communications — to become more a part of the workers’ compensation system.
With regard to whether an expanding reliance on technology might problematically reduce the human touch in addressing workplace injury treatment, Despres suggested that a central question is whether that reliance leaves an injured worker feeling as if they’re getting lost in the system. One key to addressing those concerns, Despres said, is offering technology-based services “as a convenience to the worker.”
“If it [technology] is guiding processes, that’s good,” Despres said, but “it can never be punitive.”
One ancillary way that technology is being used in workers’ compensation is “predictive analytics” — the assessment of data to address identified trends in workplace injuries.
As an example, Despres went through a hypothetical scenario. If, for example, workplace data begins to show a trend in forklift operators sustaining specific types of injuries, that data can help employers take steps to prevent those injuries in the future. The data can also inform treatment decisions, Despres said.
When such actionable data are available, Despres explained, “everyone pulls out all the stops” to ensure that proper steps toward prevention and treatment are taken.
Predictive analysis also has another expanding role in the workers’ compensation arena, in terms of detecting instances of potential misuse of workers’ compensation and other insurance, both on the part of injured workers and healthcare service providers.
Carl Hammersburg, manager of government and healthcare risk and fraud at SAS, an analytics software firm, said the development of computer software to detect problematic behavior in workers’ compensation and other healthcare arenas is relatively new, but is advancing quickly.
“The maturity level is increasing dramatically,” he said.
Much of the data being subjected to predictive analytics has routinely been available. It’s just that now, software is helping insurers and other interested parties to take a deeper look at it, Hammersburg said.
And, he added, some of that available data isn’t particularly sophisticated. For example, identifying a potential instance of insurance fraud can sometimes be assisted by a suspected perpetrators’ posts on social media, whose posts might show them engaged in some activity not consistent with a claimed injury.
Such data are among the “low-hanging fruit” of looking into potential fraud, and may not be particularly helpful, in the long run, in addressing problems.
“Typically, it’s just an interesting piece of information,” Hammersburg said.
Other data points, such as a proliferation of “Monday morning, no witness” incident reports in workplace injury claims, might signal an increase in the numbers of people seeking to get treatment of a weekend, non-work-related, injury through workers’ compensation, he explained.
However, even though predictive analytics software is maturing rapidly, an ongoing challenge is “trying to find the right level of trust in the data,” Hammersburg said.
The question with regard to healthcare data, he said, is: “When is it meaningful?”
Even with sophisticated predictive analytics, he added, “sometimes, you’re going to get a ‘false positive’” — an indication that something is amiss when, in fact, a claim is entirely legitimate.
And that’s why Hammersburg believes that, just as with specifically treatment-related technological advances in workplace injuries, human beings will always have a role in detecting problematic behavior in the claims arena.
“You need good software,” Hammersburg said, “and you need good people looking at it.”
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