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DANA POINT, California — Telemedicine has been touted as a trend to watch in workers compensation yet the use of technology to link medical providers and injured patients has been slow to take hold in the comp sector because of regulatory and other obstacles, experts say.
But telemedicine as a way to treat minor on-the-job injuries holds promise, said Rick Sumner, director risk of management for Bolingbrook, Illinois-based cosmetics chain Ulta Beauty, which employs 40,000 and sells beauty products via four large warehouses, where telemedicine is offered to warehouse workers onsite.
“I believe this is the future,” he told attendees of the California Workers Compensation and Risk Conference on Wednesday.
“Like other innovations and emerging technology, telemedicine offers many promises and benefits, clinically, financially, and from a service standpoint but it has its limitations,” said Curtis Smith, executive vice president at McHenry, Illinois-based Medcor Inc. “Adoption has been slow and it has its challenges. There are many platforms and vendors coming into the market.”
Among the challenges are regulatory — with states “being all over the place” on accepting telemedicine as a viable and fair treatment option for injured workers, according to Mr. Smith.
The possibility that injured workers could be “railroaded” into visiting with doctors remotely over the internet is a concern for regulators, according to panelists.
“Regulators have big concerns with patients forced to use telemedicine,” said Lisa Anne Bickford, Sacramento, California-based director of government relations for Coventry Workers Comp. “One of the things that is really important is that (patients) can opt out. If they want the hands on (treatment), they do have that right. They are not being railroaded into that model. The clinic is always an option. If you want to go to bricks and mortar you can.”
A telemedicine doctor can also refer an injured worker to a clinic, she added.
Privacy concerns and the availability of adequate technology appear to be the overarching complaints from injured workers, according to Itasca, Illinois-based Matt Engels, vice president at Medcor Inc.
However, for comp and for injuries that require more than traditional first aid, telemedicine can make visits easier for both patients and employers, panelists said.
“Patient compliance is a lot easier in telemedicine,” said Ms. Bickford. “We all know failed appointments is a big problem in workers comp. We’ve gotten a lot of positive feedback from patients.”
Mr. Engels added that it took a least a decade for group health to widely adopt telemedicine. A show of hands in the audience revealed that at least one-third of attendees — more than 100 — had experienced a telemedicine visit with a primary care or urgent care physician.
Attendees viewed on a large screen in a conference room a sample telemedicine visit with a woman named Tracey, posing as a retail manager “on her feet all day” who hurt her ankle. Within four hours, experiencing increasing pain, she contacted a doctor via a telemedicine provider.
On the other line was panelist Dr. Nadia Tereshchenko, the Steamboat Springs, Colorado-based associate medical director for Medcor Inc., which provides online triage and other telemedicine services for injured workers. Dr. Tereshchenko asked Tracey a series of questions about the incident and asked her to lower the camera lens to show her ankle. The doctor said she noticed the bruising and, after several instructions to wiggle her toes and to touch parts of her bones, to walk to and from the camera, the doctor diagnosed her with a minor injury that could be treated with rest and ice and ibuprofen for pain. Dr. Tereshchenko also noted that based on the movement no imaging was necessary. The video conference ended.
“Moving forward this will not be an unusual thing,” said Dr. Tereshchenko.
Doctor availability in telemedicine is another challenge the industry is overcoming, with more and more doctors getting licensed in many states since they need to be licensed in the state where the patient is located, she said.
And telemedicine will become more widely adopted when patients and employers better understand its simplicity, she said.
“When you are injured you want to see a doctor right away, you don’t want to get in your car and drive,” she said. “The providers are comfortable with this model.”
The use of telemedicine continues to grow as the medical community, the public and insurers see the potential benefits of virtual medical visits to speed treatment, control costs and simplify follow-up care, but legislation and regulation facilitating its use to treat injured workers has been slow to emerge.