Lessons Learned After 10,000 Telehealth Visits
BY: DAVID LUPINSKY, CORVEL'S VICE PRESIDENT OF MEDICAL REVIEW SERVICES
January 30, 2019
“For the things we have to learn before we can do them, we learn by doing them.” ― Aristotle.
As the first company to offer telehealth in the workers’ compensation space, there was no roadmap to follow. Since adding telehealth services in 2015, CorVel has completed 10,000 virtual visits. With this significant milestone, we thought we’d review a few of the lessons we’ve learned:
Redefine Intake for Greater Efficiency
We have seen that in order to make telehealth equally efficacious to the brick and mortar visit, we need to offer the same features patients have come to expect, value, and appreciate. Immediate access to medical services such as physical therapy, diagnostics imaging, pharmacotherapy, and durable medical equipment are essential to a successful telehealth offering.
Redefining intake increases efficiency to ensure quality care is provided to injured employees in a timely manner. Our telehealth physicians have prescribed medications, ordered vaccines, requested durable medical equipment, and scheduled short term physical therapy and diagnostic imaging when clinically appropriate.
Brick and mortar evaluations take 4+ hours on average, factoring travel and wait times, while virtual visits last an average 30 minutes from start to finish. And though it is customary for injured employees to wait 1-2 days for the claim to be completely set up before receiving treatment, telehealth provides appropriate clinical care within minutes of the injury. Moreover, all claims data obtained through virtual visits is loaded into CareMC, our claims management technology, making the information immediately and easily accessible for all constituents.
Interdisciplinary Care Improves Patient Satisfaction
Interdisciplinary care is defined by its multi-specialty shared relationships and common goals. While it’s appropriate to have multiple team members and providers working on a claim, we have learned the importance of working towards a shared goal of providing timely, appropriate care for injured workers.
To ensure consistent protocols and concordance with each case we see, we have a dedicated medical director who oversees our telehealth physicians and maintains communication with our nursing director. Communication between the claims intake department (FNOL), Advocacy 24/7 nurse, and treating telehealth physician significantly reduces duplication of services and thus patient wait times, patient frustration, and coding errors.
As a result of an integrated and shared database, all data captured by our Advocacy 24/7 and telehealth services can be accessed by both our FNOL intake team and our adjusters in real time. This is crucial to minimizing talk time, ensuring consistency, and maximizing the patient experience.
With telehealth becoming more popular in “mainstream healthcare”, it is now an expectation for injured employees. Since patients expect a telehealth platform to provide these services, it’s essential they be delivered in a coordinated fashion with updated clinical notes available to the providers on follow up visits to maintain an equal or superior standard of care to brick and mortar outcomes.
Achieve True Integration with Artificial Intelligence
Healthcare is evolving and at the core of its change is data and artificial intelligence (AI). At CorVel, we have utilized AI with the Edge, our completely modernized claims management portal. The Edge takes claims data from a variety of sources, including bill review and pharmacy, to identify potential risk for certain claims and push out telehealth visits to mitigate the risk.
The real cost of a “minor” injury can significantly change when viewed in the context of medications, psychosocial factors, testing, and opioids. Automatic identification of these proprietary factors can elevate this case to higher acuity and a telehealth visit can be pushed out to the patient for a collaborative and holistic approach to care that can be implemented while working in tandem with other treating physician already involved in the patient’s care.
Being able to integrate this data into our claims management platform has allowed us to prevent many minor injuries from becoming expensive claims.
As the first organization to offer telehealth coverage in the workers’ compensation market, we have had our share of late night meetings. Through the experience, however, we are proud of the integrated product our patients have come to value and we look forward to the lessons learned in the next 10,000 visits.
Read our recent white paper, Breaking Down Barriers, to learn more about our approach to telehealth in performance-based networks.
