The MedRisk Blog
For workers who unexpectedly become injured and cannot resume their professional functions, getting to and from appointments has historically been a challenge. Until now.
Advanced telemedicine capabilities are beginning to transform the workers’ compensation industry, providing injured workers with a much-needed alternative to on-site medical care. Workers’ compensation professionals generally define telehealth as a virtual interaction involving multiple parties in the claims process. Some consider telephone communications between injured workers and nurse case managers to be an example of early telehealth at work. However, in recent years, the definition has come to encompass more clinical services, such as virtual face-to-face interactions and the remote measurement of vital signs.
Following an injured worker’s initial diagnosis and the creation of the doctor’s first report, follow-up visits are generally conducted every 45 days. In some cases, these visits are largely hands-off, and a time for the worker and their provider to discuss how treatment is progressing. This is one example of the 70 percent of clinical encounters that can be successfully performed through telemedicine without an on-site clinic visit, according to the American Medical Association.
In the field of physical therapy, the utility and effectiveness of telemedicine has been analyzed in recent studies, and according to 2016 research, clinical outcomes associated with telehealth sessions may be equal to that of traditional in-person care services.
The Bini & Mahajan study set out to compare the clinical outcomes of total knee replacement patients who underwent traditional in-person outpatient physical therapy to those who participated in physical therapy delivered through an asynchronous video-based tool. The 23 narrated videos created for the study demonstrated the same exercises taught in clinics, were each under 3 minutes in duration and featured on-screen text-based instructions.
On average, study patients engaged with the video-based model reported exercising for a mean of 47 minutes a day. They also logged in 49 times during the study period, posted 9 videos and 5 photographs, and sent 10 messages to their physical therapy providers. And, while patients utilizing the traditional care model logged 11 more minutes of exercise a day, they also reported a mean travel time to appointments of 75 minutes.
Patient satisfaction levels were high among both patient groups, with participants reporting that it was “easy or very easy” to communicate with their physical therapist. On top of this, the study authors write that “clinical outcomes following asynchronous telerehabilitation administered over the web and through a hand-held device were not inferior to those achieved with traditional care,” suggesting that telehealth sessions of this nature are clinically equivalent to the in-person care model.
There are several situations when an injured worker’s access to care would be greatly enhanced by telemedicine capabilities. For instance, if a manufacturing employee injured himself or herself while working an overnight shift, the only other option may be to visit an emergency department for evaluation. Or, if a truck driver sustains an injury while on the road, the closest clinic may be at a remote location. Under these circumstances, telemedicine may prove to be an advantageous resource for immediate assessment.
In addition to initial injury evaluations, follow-up appointments such as post-operative visits and second surgical opinions, may be handled through telemedicine technologies. Remote patient monitoring technologies can also allow healthcare providers to monitor complex, high-risk conditions and remain attuned to a patient’s progress and recovery to help prevent re-injury, complication, or delays in treatment.
Considering these positive effects, telehealth-powered care models have the potential to save both time and money for patients and employers alike. It’s true that not every injured worker may be an ideal candidate for telemedicine – and in some circumstances, there is simply no replacement for hands-on care – but any resource than can alleviate obstacles for even a subset of injured workers while upholding exceptional clinical standards is certainly worthy of consideration.
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