It's a WCI 2018 Wrap: Thursday's 5 Things Takes a Comprehensive Look at What You Missed (8/23)


Sarasota, FL ( - 

1) WCI 2018: Block Chains, EDI, ETL… Oh My! 

At the tail end of Wednesday’s “Impact of Digital Innovation on Risk Management” segment, Skip Brechtel, EVP and CIO at CCMSI; James Benham , CEO at JBKnowledge; Chris Griffith, VP and CIO at Safety National, and Stan Smith, predictive analytics at Milliman took the stage to talk tech. Benham emphasized the importance of EDI, and the ability to exchange data. “I can’t tell you enough how super important commonly agreed upon standards are to communicate data.” While each state has a different means of disseminating their EDI information, we are all trying to access and utilize the same types of data. That is when the term “Block Chain” came into play in the conversation. “Think of it as a train that goes back and forth from CA to NY over and over again… the cars are locked, but you can see everything inside of the train.” Encryption, if you will. Another format in the same family is ETL, or “Extract, Transform, Load.” ETL is a bit clunkier, a bit newer, but someone with an Office 365 subscription can utilize this sort of system to create their own data haul. “…Block chain benefits are phenomenal… think about everything involved as a carrier in a premium audit… think about all that data in the chain, all the different types of numbers. If you are able to add, say, workers’ payroll data into the secure data base, now one of the biggest challenges of a work comp carrier can be eliminated,” Griffith said. Then, there isn’t a need to audit for those numbers.

2) Concentra’s Telemedicine Approach: What it Entails

On the medical track, Concentra reps took some time to explain how their telemedicine approach works in a few steps: 

1) Employee logs in to connect with a care coordinator

2) Care coordinator completes check-in and transfers employee to a therapist

3) Therapist completes evaluation and treatment, then initiates a home exercise program… Employee is then scheduled for a tele-rehab or in-person follow-up appt.

4) After visit, employee receives paperwork via secure email

According to Concentra stats presented in the session, almost 70 percent of adults are willing to see a doctor using video and more than 50 percent of adults say telemedicine has improved their medical experience. An astute attendee asked the question a lot of us are thinking, “What if the patient doesn’t have access to a smart phone?” Care coordinators walk triage patients through the system, and give the injured worker a link easily accessed via an internet connection.

3) Looking at Pain Sources: A Session with Dr. Ira Fox, Anesthesia Pain Consultants Founder

Dr. Fox got down to business quickly during the last medical track section of the afternoon. He spoke of a clinical case where a woman was involved in a horrible car accident, and pain meds, surgery, and PT failed. Where do we need to focus on this? Dr. Fox said the first thing to look at isn’t more treatment, or more surgery, necessarily, but a very critical look into why epidural injections aren’t working (or are only having a temporary effect)… How is the medication spreading? That might be the cause of why the relief is so temporary. Another case involved CRPS (Complex Regional Pain Syndrome) with one foot at a normal size, and the other at almost 1.5 times its size. You have to make sure that there is a real pain block, which involves measuring temperature before and after the injection… and that isn’t a common step in this sort of treatment. Blood flow increases when the temperature is up. Once that can be regulated, maybe that foot, that couldn’t even be looked at the wrong way before it throbbed, might now be tolerant of a little exposure. Also, what about spinal stenosis and obesity? Dr. Fox said everyone deserves to be helped, and this is where stem cell treatment will come into play as an important treatment… “You have to make them feel like they are a part of the team. (Pain relief) can be done in all patients,” he said, including the obese and the elderly.

4) ‘Talking Pot’ in Medical Marijuana and Work Comp Claims

Cori Repp, MD and Florida Director of Medical Operations told via email that the Wednesday “Medical Marijuana: How To Keep Your Claims From Going to Pot” session seemed to be quite popular. “…We needed more chairs for this lecture,” she said. “Seems like things that are cutting edge (with) controversial and multidisciplinary appeal(s) do the best.” Also to note: Dr. Fox was asked about medical marijuana in the pain management session. “I’d say I have to give it a thumbs up. Only because we seem to have managed to get some pain patients off narcotics with the use of medical marijuana. SOME patients. But the problem is once this patient is feeling better, it is difficult to decrease their narcotics regimen too,” because the combination is helping the patient manage pain. “But at least, in some cases, the dosages of the narcotics don’t get higher over time (as in other cases without the medical marijuana).”

5) Tuesday’s ‘Talking Pot,’ But with a Physician Panel 

Rewind to the second day of WCI 2018: R. Stephen Coonrod, attorney at McConnaughhay, Coonrod, Pope, Weaver & Stern; Adam Oliver, neurosurgeon at the Tallahassee Neurological Clinic; and Susan Griffee, MD at the Gulf Coast Pain Institute participated in a discussion that required extra registration. But, was able to catch up with the crew to learn what went on behind these closed doors. Dave Newell, director of education and workforce development for FAIA, said, “…Regarding opioids , their (the speakers’) philosophy is setting a defined timeline for medications and setting expectations with the patient on the front end. They both are very conservative with meds and neither one prescribes medical marijuana, (and there can be) too many unknowns,” he said. “The audience was engaged in learning how both use physical therapy options before meds for pain management and surgery are considered… (Also) being strong enough to tell patients treatment is complete and (there is) nothing more they can do for them. No open-ended prescriptions and communication (are) key in treating work comp patients.”

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