Managing Care During COVID-19

A Patient-Centered Approach

As COVID-19 continues to spread, companies, especially those with workers on the frontlines, are looking for new ways to manage care for employees who have been exposed or are presenting symptoms. According to CorVel, a national provider of risk management solutions, virus-related occupational reports are growing between 25 to 40% week-over-week, as new claims pop up across the country. The key to addressing this increase in claims is a patient-centered approach that leverages technology to provide open communication and prompt, appropriate care for workers, while minimizing risk for all parties involved.

At the heart of this patient-centered approach are the nurse case managers—they are the true advocates for improving the health and well-being of the worker. Nurse case managers act in an advance practice role to ensure the safety, recovery, and continued progress toward return to work. They are the vital human element behind the expanded virtual tools and resources that are being utilized to enhance communication and support ill or injured employees during the COVID-19 outbreak.

Information and Communication

With so many unanswered questions about the virus, employees are looking for dependable information about their health, jobs, and communities. Implementing a special COVID-19 hotline where nurses can answer questions and help employees determine next steps for care is one way that companies can provide prompt, accurate information. CorVel’s COVID -19 Nurse Hotline utilizes credible sources, such as the World Health Organization (WHO) and the Center for Disease Control (CDC) websites to provide updates on public health practices and facility policies, and has seen calls increase from five calls per day to well over 100 per day.

Potential COVID-19 exposure or onset of symptoms can be frightening, so enabling high-touch communication at the first indication of exposure or onset of illness is critical. When exposure is suspected or symptoms have developed, virtual Advocacy 24/7 is being used to connect injured workers with a registered nurse for immediate medical evaluation and care direction. At CorVel, nurses are the first point-of-contact and an ongoing presence throughout the life of the claim. Nurses bring vast clinical experience to identify respiratory, infection, neurological and behavioral complications associated with COVID-19. They offer a compassionate, positive initial interaction that is a stark contrast to the impersonal, administrative questions that typically characterize the first report of injury. The Advocacy 24/7 nurses at CorVel have seen a 30% increase in calls related to COVID-19. Providing open communication and accurate medical direction eases fears and enables prompt treatment.

Virtual Care

In this period of social distancing, virtual care facilitated by nurses ensures the recovery process is uninterrupted. After being screened by an Advocacy 24/7nurse, telehealth connects employees with a provider through a virtual visit via a computer or smart device. Video calls are utilized to complete clinical assessments, as allowed by federal/state law. Virtual physician visits offer more immediate care for exposed workers or those who are required to shelter in place. This technology allows nurses to connect with their sick or injured workers and provide the reassurance of frequent face-to-face connection.

Patients who need additional testing can be directed to a provider who manages the process to minimize the potential for infection and the possible spread of the disease. Follow-up protocols are being put in place for infected patients, making sure they get support and education throughout the incubation period. At CorVel, nurses support COVID-19 recovery, regardless of severity, through the continuum of care.

Workers with more complex care or ongoing treatment needs can also benefit from virtual services, including rehabilitation by telehealth, virtual medical visits, home delivery of prescriptions and durable medical equipment, and coordination of any diagnostic testing to minimize exposure to the virus and accelerate return to work, when possible. For injured workers awaiting surgery, CorVel nurses facilitate pre-surgical conditioning using a user- friendly app that provides education on nutrition, flexibility exercises, pain/anxiety management and environment safety. Nurse case managers remain in close contact with treating physicians to ensure the worker’s recovery continues on a positive trajectory.

Increasingly, issues such as Post-Intensive Care Syndrome (PICS), Post-Traumatic Stress Disorder (PTSD), anxiety and depression must be addressed to fully recover from COVID-19. Completing video or telephonic wellness checks allow nurses to continually assess the psycho-social well-being of the injured worker and their family. Providing on-going support to these workers, their families, and our communities is crucial to restoring balance and function.

Looking Ahead

In the coming days, virtual case management is going to become even more critical to assist injured/sick people with navigation through the health care process and to promote recovery and good health. At CorVel telehealth services have increased over 100% and are averaging over 50 visits per day. The company is actively recruiting, credentialing and onboarding new medical providers to meet the demand and keep wait times low. It is important to continue to explore new ways to address the current situation with virtual solutions like leveraging telehealth to provide prescriptions for COVID-19 testing and to assess the ability to return to work after recovering from the illness.

With COVID-19, the use of telehealth is becoming the new normal in workers’ compensation claims. However, what makes it work are the people behind the technology. Nurse case managers infuse warmth and compassion to a virtual platform. They provide intervention through Advocacy 24/7, virtual care, and case management services, and are working tirelessly to ensure the safety, recovery and continued progress toward return to work for sick or injured workers. By placing nurses at the heart of innovative technology, a patient-centered approach to caring for employees in a virtual setting can be accomplished during this pandemic, and beyond.

Article for: ARAWC

Author: Karen J. Thomas, RN, MSN, CCM, Director of Case Management Innovation at CorVel Corporation