Recognizing that significant delays in recovery drive tremendous increases in spend for workers' compensation claims, the company MedRisk has responded with an innovative program that tackles psychosocial factors behind many of the issues associated with the trend. The program, called MedRisk Restore, is addressing the issue of injured workers who are “disengaged” from life activities, and often suffering debilitating and chronic pain.
And it appears to be getting very impressive results.
In the interest of full disclosure, MedRisk is a customer of WorkersCompensation.com. I don't believe that has any bearing, however, on the excellent results they are seeing (as much as I would like to take credit).
According to MedRisk COO Michelle Buckman, the Restore program was launched within the past year, and specifically looks at injured workers' who have not returned to work, “not because of physical limitations”, but rather “because of other barriers”. The Restore program attempts to identify those psychosocial barriers, and combines two specific evidence based programs to confront them head on. The physical medicine based treatment protocol offered by MedRisk is combined with a Progressive Goal Attainment Program (PGAP).
PGAP, developed by Psychologist Michael Sullivan, has made strong inroads in recent years, and is held out by many as a valuable tool in the ever more complex world of Return to Function/Return to Work. According to PGAP News:
On average, participants who completed the PGAP showed a 27% reduction in IEQ [Injustice Experiences Questionnaire] scores. Although comparisons with previous research must be made cautiously, the results suggest that the inclusion of techniques such as guided disclosure, validation and emotional problem solving can enhance positive rehabilitation outcomes in individuals with disabling musculoskeletal injuries.
Combining PGAP with traditional medical care makes tremendous sense, and probably accounts for the excellent results the MedRisk Restore program is seeing. According to the company, the program boasts a 77% enrollment success rate, a 33% reduction in ongoing use of pain medications and a 60% rate of return to work. This holistic approach effectively treats the entire patient, and not just their physical condition.
According to Buckman, Restore can help identify those barriers that are preventing an injured worker from recovery, and “target those psychosocial issues and then work with those injured workers reintegrating those activities in their life that will help them overcome those barriers”. She also explains, “We then work in conjunction with their MedRisk PT to take those concepts and apply them to their PT program so that all elements work in sync for an improved outcome”. She is emphatic when she states that “the goal [is] to return them to work and return them to their life”.
Patients can be referred to the Restore program via a series of red flag indicators. Those red flags could be cited by the therapists within the network, or the client company themselves noting progress is not following the normal path expected of an injury of a comparable type. Buckman says at that point patients are put through a screening process to assess and confirm if the Restore program would be applicable. Much of that depends on the injured worker themselves, and their willingness to “buy in” to the process.
The true strength of the program can be found in other comments Buckman makes regarding the focus of Restore. She speaks of the importance of a “continuum of care”, and not “looking at treatment from the silo of our traditional PT vertical”. She is talking about elements too often ignored by our industry; the mental side of the equation that regularly derails an otherwise treatable worker. It is the pain or perceived pain, and the “anxiety, fear or hopelessness” that an injured worker may feel that must be recognized and addressed so that the physical healing can be achieved. Saying that the results have “just been remarkable”, Buckman clearly gives the impression that they recognize they are on to something that can get results where traditional medical care alone has been falling short.
Interestingly, Buckman notes the results appear to be sustainable, as those instances where an injured worker experienced a second injury and returned for treatment, they were able to use the information learned in the initial PGAP/Restore session, and expedite their traditional care as a result.
We need to be clear here. The combining of PGAP with traditional physical therapy regimens is not a “one size fits all solution”. The success of a program such as this recognizes that different issues drive different people, and identifying barriers for one person may be completely different than another patient with otherwise similar conditions. It is, as Buckman noted in our interview, about “caring about the individual patient and remembering the human element”.
For some in our industry, that's just crazy talk. But it is crazy like a fox, because it works and works well.
The core of my message here, and the reason I selected Restore for my third article in the “Walking the Walk” Series, is that MedRisk has recognized the importance of both mind and outlook of an injured worker as related to total outcome of a workplace injury. They seem to be acknowledging the importance of an area too often ignored by the industry in general. In this day and age of increasing disability rates and greater societal pressures regarding entitlement, recognition of psychosocial influences is no longer an option for the workers' compensation industry. It is an absolute “must do”, and continued avoidance of that reality will cost us dearly in the future.
The fact that they are integrating it into their service, rather than treat it as an external add on unrelated to core therapy, is for me just icing on the cake.
We have much to learn regarding the power of the mind when it comes to health and happiness. Yet, we are learning that the mind is an integral part of the healing process, and innovative parties like MedRisk are leveraging that knowledge for success. Programs such as Restore will do much more than return injured workers' to a productive role in society; they will also restore faith in the system intended to help them in the first place.
Robert Wilson is President & CEO of WorkersCompensation.com, and "From Bob's Cluttered Desk" comes his (often incoherent) thoughts, ramblings, observations and rants - often on workers' comp or employment issues, but occasionally not.
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