Should Your Workers’ Comp Program Include Telemedicine?

Offering the promise of increasing convenience while decreasing costs, telemedicine is becoming standard in employee benefit packages. Some employers may also be wondering whether they should include telemedicine in their workers’ compensation programs.


An Example of Telemedicine’s Impact

To see how telemedicine could improve workers' compensation programs, it’s helpful to look at how it’s worked in healthcare.

The Department of Veterans Affairs has embraced telemedicine. More than 307,000 veterans used clinical video telehealth in 2016 and more than 150,000 veterans used home telehealth. Additionally, more than 304,000 veterans used asynchronous “store and forward” telehealth services.

Veterans who used home telehealth services saw a 59 percent decrease in bed days and a 31 percent decrease in hospital admissions. Satisfaction rates were also promising. Veterans who participated in home telehealth services had a satisfaction score of 88 percent, while veterans who participated in the store and forward telehealth program had a satisfaction score of 94 percent.

Veterans who used home telehealth services saw a 59 percent decrease in bed days and a 31 percent decrease in hospital admissions. Satisfaction rates were also promising. Veterans who participated in home telehealth services had a satisfaction score of 88 percent, while veterans who participated in the store and forward telehealth program had a satisfaction score of 94 percent.

According to the Office of the National Coordinator for Health Information Technology, telemedicine is especially valuable in rural settings because it can improve access to care and reduce travel requirements. However, telemedicine can be useful in other settings as well.

Workers’ compensation programs strive to keep injured workers engaged and to help them recover and return to work as quickly as possible. It appears that telemedicine may be able to assist in achieving these goals. For injured workers in rural areas, the benefits may be even greater.


The Risks of Telemedicine in Work Comp Programs

Despite the appealing benefits that telemedicine offers, there are risks to consider.

While many things can be done online or over the phone, providers are somewhat limited by the lack of face-to-face interaction. As a result, there may be risks associated with misdiagnoses.

Cyber risks are another serious concern. Healthcare data is a popular target for hackers interested in stealing protected health insurance to commit medical identity theft, and ransomware often targets the healthcare industry as well. Workers may not be eager to participate in telemedicine if they are worried about the security of their healthcare information.

Telemedicine is a relatively new idea that has only recently begun to experience significant popularity. As a result, there may be some kinks to work out in terms of rules for telemedicine programs, especially within heavily regulated workers’ compensation programs.

Telemedicine is a relatively new idea that has only recently begun to experience significant popularity. As a result, there may be some kinks to work out in terms of rules for telemedicine programs, especially within heavily regulated workers’ compensation programs.


Telemedicine and State Regulations

States establish their own laws governing workers’ compensation. Before implementing telemedicine as part of a workers’ compensation program, it’s important to understand the relevant state rules regarding telemedicine.

For example, as of September 2018, Texas allows billing and reimbursement for certain telemedicine services for workers’ compensation. However, there are restrictions. According to the Texas Department of Insurance Division of Workers’ Compensation, not all medical services are eligible for telemedicine. Physical therapy cannot be delivered via telemedicine, for example. Additionally, employers cannot require injured workers to use telemedicine; participation must be voluntary, and the employee is still entitled to the initial choice of doctor.

This means that even though Texas employers may want injured workers to use telemedicine in order to reduce costs, they cannot force injured workers to do so. It has to be up to the worker. Other states may have or pass similar regulations, or they may have rules that are more or less restrictive.

Although there are those who will always prefer traditional doctor’s visits, as telemedicine’s popularity continues to grow more organizations and employees may be interested in using this model of care for their workers’ compensation claims. At the same time, because telemedicine is still an emerging field, relevant regulations and policies can be expected to continue to evolve.