Winter 2020/2021

Rebuilding the Recovery Model: Balancing the Patient and the Big Picture

By Daryl Corr, CEO at Healthesystems

There’s no denying that 2020 will go down in history as one of the most defining years of the century, but what will we be able to say about the change it inspires?

The COVID-19 pandemic, and other major events of 2020, have touched each and every one of us in a multitude of ways. Our families have been affected, as have our places of work, simple day-to-day tasks like shopping and eating, our emotional and mental health – almost everything imaginable.

Going forward, 2021 will be a year to rebuild. But it’s also an opportunity to go a step further. Now is not just the time to rebuild; it is also a time for progress. Now is the time for change and innovation.

But progressing in the right direction requires a guiding purpose. It requires us to ask the right questions, and within the workers’ comp industry, one of the biggest questions we must ask ourselves is: 

Where is the injured worker in all of this?

No matter how advanced the solutions we build may be, they will fail if they don’t address the number one goal in workers’ comp – to restore an injured worker’s health.

Injured workers are often overwhelmed by the workers’ comp system. They may feel their concerns are not being heard, they may face difficulties with their care, and they may require guidance on their road to recovery. These difficulties are what can lead to ineffective care, higher medical and claim costs, and unnecessary pain and suffering.

At Healthesystems, we’ve been advocating on behalf of injured workers for a long time – and the impacts of the pandemic have only accelerated our efforts in developing and delivering innovation that will best serve our customers and their injured worker patients.

The articles featured in this edition of RxInformer touch upon many different topics, but at their core they all tie back to patient-centric concerns.

In 2020 we have made a concerted effort to include the patient experience in our research efforts, some results of which you will see in The Patient Experience in Perspective: Applying Empathy to the Work Comp Claims Process, where we explore how frustrating the workers’ comp system can be for injured workers. Because a better claim experience leads to better patient outcomes, it is imperative that we examine how we can improve the patient journey at all steps of a claim, whether that involves changing industry policies, processes, or perceptions.

Meanwhile, the COVID-19 pandemic has greatly impacted patients in a variety of ways.

In Side Effects: COVID-19-Related Healthcare and Pharmacy Trends Impacting Workers’ Comp, we see how injured workers face hindered access to care. However, tools like telehealth are helping, and easier access to prescription medications can help to maintain continuity of care – but as we employ new solutions, we may also have to find new ways to maintain clinical oversight to ensure these solutions are working effectively.

From another angle, Returning to Work in the COVID-19 Era focuses on infection prevention in the workplace, unique population considerations, and reentering the workplace after COVID-19 infection. For instance, patients with comorbidities face higher risks with COVID-19, as do patients taking opioids, as well as entire occupations that face greater viral exposure. By understanding various patient-specific risks, stakeholders can create more effective mitigation strategies.

Additionally, the COVID-19 pandemic has impacted opioid considerations. Moving Forward: How Should Opioid Guidance Continue to Evolve? takes note of the American Medical Association’s recent recommendations for changing opioid policy to be more patient specific. However, it is undeniable that the pandemic has caused complications that impact opioid use. For instance, social distancing, anxiety, and uncertainty can increase the likelihood of mental health disorders, along with the need for psychiatric drugs – both of which require increased caution with opioid use. Understanding such complex factors is the only way to carve a better path forward not only for injured workers, but for the professionals who manage their claims.

Driving a More Personalized Claim Experience in a Digital World focuses on the need to better detect early warning signs for potentially complex claims by utilizing smart technologies like artificial intelligence and natural language processing. By automating the analysis of certain claims data, we can augment – but not replace – human decision making and better drive clinical guidance to improve claims outcomes.

I hope you find value in these articles, and I hope you will join me in taking the time every day and in every project, task, and initiative, to consider how our work benefits injured workers – or how it should.

Complications will come and go, different trends will emerge, and we often find ourselves focused on large, conceptual problems, but we must root our thinking in the injured worker’s point of view. By tailoring care management around their needs, by ensuring that the constant factor in our work is to remain dedicated to giving them the help they need, in a way that truly touches them, we will find the best path forward to face any challenge that may come, no matter how big or small.

Daryl Corr Image

About the Author

Daryl Corr is Chief Executive Officer at Healthesystems. Mr. Corr has long been a technology innovator developing new ways in which to improve the delivery and quality of medical services. His focus on innovation has helped improve performance across the industry by automating various manual functions and improving transaction efficiency. His efforts to make disparate processes and systems work together helped transform the organizations he managed. Under Mr. Corr’s leadership, Healthesystems has grown into one of the largest workers’ compensation pharmacy and ancillary medical benefits management providers in the market.

RxInformer

Since 2010, the semi-annual RxInformer clinical journal has been a trusted source of timely information and guidance for workers’ comp payers on how best to manage the care of injured worker claimants and plan for the challenges that lay ahead. The publication is an important part of Healthesystems’ proactive approach to advocating for quality care of injured workers while managing the costs associated with treatment.