5 Myths About Telemedicine
Telemedicine has generated a lot of buzz within the workers’ compensation industry for several years, but many employers remain slow to implement it for their injured employees. Some of the resistance arises from internal hurdles, like a decentralized structure that impedes decision-making or a cultural fear of change.
But much of the hesitation is a consequence of confusion.
“There is a lot of misinformation circulating about where telemedicine is permitted and what it can and can’t do. Combined with the hyperbole regarding new products in the marketplace, there is a lot of noise for employers and payers to sort through. The information overload can lead to paralysis,” said John deLorimier, executive vice president and chief sales, marketing, and product officer at Concentra.
Those with expertise in telemedicine, however, understand the value it brings to employers, payers, and employees when delivered correctly, and they know how to separate falsehoods from facts.
Below are five of the most common myths and misconceptions about telemedicine in workers’ compensation, demystified.
Myth #1: Telemedicine is only useful for employees in rural areas.
It’s true that telemedicine can eliminate time-consuming and costly transportation challenges for employees located in rural areas, connecting them with care faster and helping to produce better outcomes — but the same benefits also apply to employees located in urban settings.
Despite closer proximity to medical facilities, urban employees must still contend with obstacles like heavy traffic, limited parking, and challenging work schedules that make it difficult to access quality care. All these factors can delay care and increase stress and frustration for injured employees.
“The vast majority of injured or ill employees who access our telemedicine offering are from urban and suburban locations,” deLorimier said. “It’s a tremendous convenience and time saver for people, regardless of access to brick-and-mortar facilities.”
Myth #2: The same quality of care provided in-person cannot be delivered via telemedicine.
Clinicians can detect common symptoms and review an injured employee’s medical history to diagnose many conditions without touching or seeing the employee in person, reducing the need for traditional physical exams. According to the American Medical Association and Wellness Council of America, nearly 75 percent of all primary care, urgent care, and emergency department visits are either unnecessary or could be handled safely and effectively via telemedicine.
“We’re confident with the quality of care that can be delivered through telemedicine for appropriate work injuries. A patient-guided physical exam delivered by an experienced occupational medicine clinician and treatment supported by proven guidelines is essential for any well-planned telemedicine program,” said Dr. Teresa Bartlett, senior medical officer, Sedgwick.
And despite not being in the physical presence of a clinician, employees using telemedicine often get more one-on-one attention. In an office, the clinician may be looking down at a chart or shuffling through papers while an employee is speaking but engaging via video provides an extra impetus to look up and pay attention.
“Having the camera reinforces the idea that you are being examined as much as you are doing the examining. It encourages clinicians to really engage and devote their undivided attention to the injured employee,” deLorimier said.
Myth #3: Telemedicine is for first aid only.
Many of the most common injuries in workers’ compensation — i.e. sprains and strains — can be addressed solely via telemedicine without an in-person follow-up, eliminating the need to switch clinicians and contend with the communication challenges that may arise from the transition.
“There is a false notion that telemedicine in workers’ compensation has to be one-and-done or will need to be referred to in-person care. However, four out of five of our telemedicine cases are completed without the injured employee ever visiting a medical center,” said Ann Schnure, vice president of telemedicine operations, Concentra.
Even when hands-on care is necessary, the data collected via a telemedicine visit should be easily integrated with the injured employee’s electronic medical record, minimizing friction in handoffs between providers.
“Increasingly, employees express no concern about seeing multiple clinicians,” deLorimier added. “Employers assume their people will want to stick with one clinician throughout treatment, but we’re finding that this is not a priority. They’re okay with having different clinicians if it results in greater convenience for them,” deLorimier said. “The bottom line is that people are more likely to attend follow-up visits when it’s easier to do.”
Myth #4: Telemedicine requires a large investment without a guaranteed return.
This is a dual misconception. The first misunderstanding is that the primary purpose of telemedicine is to generate savings. The second is that implementing telemedicine requires a technology overhaul.
“Telemedicine is really a productivity play. The primary goal of workers’ compensation is getting injured employees back on the job as quickly as possible,” Schnure said. “By making care more convenient for injured employees, telemedicine ultimately means employees spend less time away from work, which positively impacts productivity.”
The second side to this myth is that implementing telemedicine requires purchasing new technology or aligning internal networks with a new system. Neither is true.
“There are two primary decisions for the employer: what equipment will be used (employee on smartphone or company-provided equipment), and which private space on-site will employees use to conduct their visits,” deLorimier said.
Though companies can provide computers for their injured employees to use, it’s not necessary. In fact, allowing employees to use their personal devices can increase their comfort level with the process.
Myth #5: Telemedicine is approved and available in all 50 states for occupational injuries.
While some form of telemedicine is allowed in all 50 states, the regulations, fee schedules, and treatment guidelines that determine reimbursement vary widely.
“If a state follows Medicare guidelines, for example, it may only approve telemedicine treatment for employees in rural areas. Other states are less restrictive, and still others will stay silent on the issue altogether,” Schnure said. Even if a state’s regulators don’t comment on telemedicine, its workers’ compensation board may still publicly oppose it.
“This creates confusion, which makes it challenging for all the parties involved in workers’ compensation to align. Employers, payers, providers, networks, nurse triage, and employees all have to be on the same page for telemedicine to work, and that can’t happen if all parties are unsure about how to adopt telemedicine in a compliant way,” Schnure said.
Clearly, it’s important to choose telemedicine providers who actively engage with state workers’ compensation officials, understand the nuances of the regulatory landscape, and have carefully vetted the states where they operate.
Expertise and experience matter.
Unfortunately, many telemedicine companies do not fit that bill.
The truth is that providing an effective telemedicine service means taking the time to understand the nuances of state regulations and reimbursement models, developing a team of trusted occupational clinicians, and having a reliable, user-friendly, and HIPAA-compliant technology platform.
Concentra works directly with state legislators to help them understand telemedicine and write clear and consistent regulations. To date, Concentra has launched its telemedicine service in 29 states and has been delivering telemedicine for work injuries for more than two years.
“For many companies, telemedicine is just an arrow in their quiver. They have it just to say they have it, but they don’t really invest in it,” deLorimier said. “They may not be using workers’ compensation clinicians, or they have inadequate tech platforms. Unfortunately, it’s a lot of smoke and mirrors. But we are working to provide clarity.”