Jun 6, 2017 | Insights
Employers need to be prepared to guard against the risk factors of heat-related illness when an extraordinarily hot day strikes – summer or not.
Under Occupational Safety and Health Administration (OSHA) law, employees must provide workplaces free of known safety hazards, which includes protecting their workforce against extreme heat. However, mercury rising isn’t the only—or the best—indication that your workers are at risk for health-related illness.
The heat index is a single value that factors in both temperature and humidity and is a better reflection of how hot it feels on a given day. The higher the heat index, the less able our bodies are to evaporate sweat and cool the skin. Before heat index levels have the chance the rise, take these four steps to ensure you and your employees are prepared to beat the heat.
1. Formulate a heat illness prevention plan.
The actions required by your company will vary depending on the level of risk on a given day. One way to frame out your heat illness prevention plan is to base it on the National Oceanic and Atmospheric Administration’s system, which uses the heat index to delineate four risk levels:
| Risk Level | Heat Index | Protective Measures |
| Lower (Caution) | Less than 91°F | Implement precautions and heighten awareness |
| Moderate | 91°F to 103°F | 97164 Re-evaluation |
| High | 103°F to 115°F | Additional precautions to protect workers |
| Very High to Extreme | Greater than 115°F | Triggers even more aggressive protective measures |
Source: Adapted from OSHA.gov
2. Prep your workforce.
For low-level days, OSHA recommends providing water and provisions located at convenient rest areas, and advising workers to wear sunscreen. As the heat index increases, you may want to consider reevaluating your work/break schedule to allow for more frequent periods of shaded rest. At extreme temperatures, psychological monitoring may be called for and certain work activities may need to be rescheduled. Click here for OSHA’s complete list of recommendations by risk level.
It might seem like overkill to remind workers to drink water on a hot day, but the daily grind can be a serious distraction and it’s easy to forget to hydrate. Drive home this point in new worker training, and establish a system for reminding workers on exceptionally hot days. In addition, make sure your employees know how to recognize signs of heat-related illness, when to report them, and where to go if they need immediate medical assistance.
3. Monitor conditions day-by-day.
Just because you have your plan on paper and your employees trained, doesn’t mean it’s time to sit back and run on autopilot. Employers should track worksite weather daily to assess heat-related risk and take appropriate action. Begin each day with a mandatory check of the current and predicted heat index from the National Weather Service or consider downloading OSHA’s Heat Smartphone App to check the conditions of your worksite as well as risk level and corresponding recommendations.
4. Stick with the plan – but adapt when needed.
The plan established in step 1 will serve as a guide for general implementation, but be aware of additional risk factors that require extra vigilance. Any worker exerting exceptional energy, working in direct sunlight or using bulky protective equipment or non-breathable clothing may be at higher risk of heat-related illness. Be particularly watchful of workers who may not have established a tolerance to hot conditions, such as new employees, temporary workers or those returning after a break of week or more. Allow these employees to gradually increase their workload and take more frequent breaks to acclimatize to hot conditions.
We can’t always accurately predict when a hot day might strike. Use the steps above to formulate a plan that allows you to take action to protect your employees’ health – and your operation – at a moment’s notice.
May 9, 2017 | Insights
Learn more about the primary approaches driving today’s telerehabilitation services and how they can serve the workers’ compensation market.
In recent years, we have seen a growing body of research supporting the positive impact telemedicine can bring to patient care. As a result, telehealth has picked up steam among group health payers, with a growing number of patients interested in trying a remote care option in lieu of an in-person visit. However, telemedicine is only just now generating interest in the workers’ compensation arena. The obvious benefits for injury triage, case management and physician follow-up is clear – but the value of telemedicine for a traditionally hands-on service like physical therapy has not yet been recognized fully. Below we explore three models of telemedicine technology, how they’re being used in PT and the benefits of each.
Live Video (Synchronous)
Often referred to as “real-time,” synchronous telehealth tools facilitate live, two-way interactions between patients, caregivers and providers using audiovisual technologies. This type of telemedical care is often employed as an alternative to an on-site clinical visit for the purposes of consultation and diagnosis. In addition to reducing transportation costs and bolstering access to care in remote areas or during off hours, these convenient virtual visits have been shown to improve patient satisfaction and potentially improve care outcomes. This type of technology may be used by physical therapists to perform an at-work environmental assessment, conduct a goal setting session or dispense patient education. It may also be possible to administer functional training, movement facilitation, a guided assessment or a therapeutic exercise through the use of live video.
Store-and-Forward (Asynchronous)
As the name indicates, store-and-forward telemedicine involves the secure transmission of pre-recorded materials. A wave of tech start-ups and apps has been developed to generate educational tools for patients. Orca Health, an educational app company, provides tools that PTs can use to explain common injuries of the shoulder, knee and spine in layman’s terms through the use of interactive anatomical 3-D models, videos and images. Orca’s videos demonstrating stretches and strengthening techniques are also a valuable resource for patients to safely and accurately execute therapeutic exercises away from the clinic.
But store-and-forward applications don’t just benefit patients; they also strengthen communication between providers by facilitating the transmission of documented patient history including videos, digital images, lab results and health records. Asynchronous platforms designed for this purpose provide the means to exchange protected health information in a secure manner. This technology is often employed when a physical therapist needs to evaluate a case or render a service outside of a live interaction. Clinical store-and-forward applications have become quite common, enabling faster diagnoses and better treatment strategies, especially in settings where specialists may not be readily available. Inexpensive and easy to use, asynchronous telemedicine services can also lower wait times by optimizing the use of health care providers’ time.
Remote Patient Monitoring (RPM)
RPM technologies allow an individual’s personal health and medical data to be collected and transmitted to a provider. Often used to aid chronic disease management – such as diabetes, heart conditions or high blood pressure – these platforms allow providers to track a patient’s vital signs while they are at home or in a care facility. In many cases, the RPM data is transmitted automatically, generating a report for the provider or a team of health monitoring professionals who flag unusual findings for clinical review. By providing practitioners the means to monitor for early warning signs and quickly intervene, RPM, or telemonitoring, can help patients adhere to their treatment plan and potentially reduce life-threatening complications.
The latest RPM technology for telerehabilitation includes The Vera System, a new innovation from Reflexion Health, which guides patients through exercises and, using cutting-edge motion-tracking technology, tracks their movements to ensure they are doing them correctly. The physical therapist receives the performance data, and the patient receives real-time feedback and tips as they perform the exercises. Duke University plans to research the effectiveness of the system in its in-progress 2017 study.
A Look to the Future
Although different in their approaches, all three models of telemedicine can deliver significant value for physical rehabilitation. It is only a matter of time before telerehabilitation becomes integrated into treatment strategies for patient-centered organizations. In a world where people use apps to track everything from fitness and eating habits to nightly sleeping patterns, it is easy to imagine a healthcare system where the link between technology and physical medicine is strengthened: where, through the latest technologies, patients can reach their healthcare provider quickly and easily, and where injured workers are guaranteed the therapeutic support they need when and where they need it most.
Mar 14, 2017 | Insights
When savings have plateaued, a new approach to cost containment that applies outcome-driven analysis and clinical expertise may be in order.
While traditional bill review catches the vast majority of issues and has resulted in myriad cost reductions, payers are still missing out on an estimated $3.5 million in savings for every $100 million in medical charges.
Luckily, a new system for medical cost containment has been unveiled and it has the potential to provide aggressive savings above what is currently being achieved.
NexGen Advantage℠ is the industry’s first single solution that uses analytics, technology, and clinical expertise to ensure accurate and fair medical payment of each and every bill. Employed post-bill review, this new solution is designed to maximize medical cost containment specifically for the workers’ comp industry. Here’s how:
Calculates complexities
Common bill review catches a lot of errors, but most systems are not set up to do a deep dive. Bill codes are assessed using software and triggers that are programmed to primarily look for coding conflicts that indicate errors. For example, if it’s a workers’ comp bill, why is there a code for a thyroid scan on here?
Complex cases, however, are not always this clear or straightforward and can slip through the cracks. The NexGen system relies on nuanced algorithms, leveraging over 200 million code combinations from the group health industry to maximize savings by recognizing complex bill patterns that may require clinical intervention.
Includes Peer-to-Peer Clinical Conversations
Approximately 70% of flagged billing issues require some kind knowledgeable human assessment. Whether it’s complex coding errors like “return to surgery” at a physician’s office, or suspicious billing patterns like a patient with 17 facet joint injections being billed in a single year, only peer-to-peer evaluation by a physician or expert coder can determine if these bills are clinically appropriate.
NexGen Advantage employs peer-to-peer conversations with providers about benchmarks, coding and payments, and offers online access to data that helps all parties engage in non-confrontational discussions to arrive at the right decision.
Strategic discount arrangements
In-network discounts don’t always result in the greatest savings available and often come with complicated stacking structures and hidden access fees; out of network solutions add vendor management burdens and even more access fees. NexGen Advantage assesses the potential savings possible across all channels at once–appropriateness of charges, network rates, benchmarked costs and whether negotiation is possible and desirable–to apply the most advantageous discount arrangement possible.
Ready to break through the savings ceiling and realize more streamlined, more efficient results and payment integrity? Learn more about MedRisk’s NexGen.
Dec 12, 2016 | Insights
Slips and falls, as well as illnesses and injuries caused by cold stress, pose considerable risk to employee health. Take these precautions to safeguard the well-being of your workers and maximize operability this winter.
Depending on your location and climate, winter can take a toll on the health and safety of your workforce. In frosty Michigan, for instance, slips and falls represent one-third of all workers’ compensation claims during winter months. Additionally, studies have shown outdoor work in colder temperatures to increase the incidents of low back and neck pain.
Although the Occupational Safety and Health Administration (OSHA) does not have standards that cover work in cold environments specifically, it is the responsibility of employers to provide a safe working environment for all employees, free of recognized hazards that are likely to cause serious physical harm. Here are some tips for carrying out this responsibility – and supporting your employees’ well-being – when winter arrives.
Minimize and alleviate cold working conditions
The best way to prevent cold-related illness and injury is to reduce the amount of time workers spend outside. You can do this by arranging for routine outdoor tasks, such as maintenance and repair jobs, to be handled in warmer months. During winter, minimize exposure to the cold by scheduling outdoor work for the warmest part of the day and limiting the amount of time spent outdoors on extremely cold days. If a long, demanding job can’t be moved to a warmer day, consider adding relief workers to the rotation for shorter shifts. Supply blast heaters where needed, and shield work areas from drafts or wind to reduce wind chill. Be sure to encourage workers to take breaks indoors and to consume warm beverages throughout the day.
Plan for hazards
Ice and snow buildup poses serious risk of slips and falls if not tended to properly. Have a maintenance plan in place to apply ice melt or salt to your parking lots, walkways, loading/shipping docks and steps. Lay down mats near entrances to prevent tracked ice, snow and mud and to prevent slippery conditions. If your workforce includes employees who routinely work outside, consider adding a mud room or entry room for workers to remove and store boots and outerwear to minimize tracking into other work areas.
Foolproof your communications
When winter conditions come on suddenly, employee communications can be critical, even life-saving. Have a system in place for monitoring weather conditions and staying attuned to public announcements related to severe weather. If operations must be suspended, be sure your communication methods allow you to reach all workers, including those in remote areas.
Assess your equipment
Routine tools and equipment may need to be rethought when being used in colder temperatures. It’s important to bear in mind that wearing bulkier clothing may restrict workers’ movement. Identify potential hazards so you can train your staff on appropriate safety measures. Have safeguards in place on machinery to prevent clothing from catching on handles, switches or levers.
Provide employee training
Environmental cold can affect exposed workers and put them at risk of cold stress, which occurs when the body can no longer maintain a normal temperature. And cold stress can lead to cold-related illness or injury, permanent tissue damage, or death. Workers with hypertension, hypothyroidism, and diabetes are particularly vulnerable, and employees who have been away from work or are new to working in cold temperatures may require more frequent breaks and time to build up a tolerance to colder temperatures. Direct employees to dress appropriately, by layering loose fitting clothing. Train your workers to recognize the signs of cold stress and how to help those who are affected. Finally, remind workers of the importance of stretching and physical activity in cold temperatures, which can prevent muscle tension and mitigate the risk of musculoskeletal injury.
Whether your organization’s primary work environment is indoors or outdoors, in cubicles or on a factory floor, winter requires planning and vigilance. Protecting your workforce and minimizing illness and injury by taking the steps outlined above will help keep operations smoothly – and safely – all winter long.
