Early Telehealth Intervention and RTW Case Management Drive Better Outcomes
By Anita Linn, MA, CPDM
VP Analytics & Business Intelligence
Research has shown for decades that early intervention and a supportive employee experience are critical contributors to positive outcomes in workers’ compensation (WC) cases.
The employer featured in this case study is a publicly traded U.S. healthcare company employing more than 26,000 people during the longitudinal study period of 2012-2018. The workforce is comprised predominantly of clinicians and professional staff distributed across the country.
This case study describes an innovative early intervention model that was applied in a WC plan. It includes a pre-claim 24/7 telehealth model that leverages immediate telephonic access to occupational health nurses and physicians. Employees who call have the option to receive guided first aid/self-care and stay at work, as clinically appropriate. They can also request referral to a clinic, where a treatment and return-to-work (RTW) plan is developed.
The model is designed for effective transfer between each level of care, whether pre-claim or later. It includes referrals to onsite ergonomic resources and a dedicated nurse case manager (NCM) who facilitates optimal stay-at-work and RTW outcomes after a WC claim is filed.
The guided first aid/self-care option is particularly relevant to this population: In 2017, healthcare and social assistance employees in private industry had the highest number of injuries/illnesses, accounting for approximately one in five cases reported by all private employers that year. Employees who are trained healthcare professionals, or other staff who have the additional support of on-site caregivers, may be more comfortable using guided first aid/self-care, compared to the general population.
The model was designed to address several challenges identified by the company’s human resources (HR), risk management, and safety professionals:
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