Is there a potential for a pharmaceutical dependency?.Examples of medical diagnosis indicators include: For example, if an employer is notified when an employee is first prescribed opioids, they could monitor the drug-dispensing process for signs of it becoming problematic. Some systems can provide an alert when an actionable item occurs.
Medical data can be used to predict potential issues based on the type of injury, current diagnosis and treatment, treatment history and prescriptions. It is optimal to identify which comorbidities are present in a claim up front and then determine the best way to manage the claim differently when they are identified. Information around patient comorbidities, such as obesity, diabetes, hypertension and/or overuse or misuse of opioids for pain management, can also be very useful in claims management. Intervention strategies specifically designed to address the identified psychosocial factors are an essential component for changing outcomes for the better. Does the employee have outstanding financial or legal issues?.Is the employee dissatisfied with their job?.Is the employee experiencing family stress?.Does the employee have an addictive personality?.Examples of psychosocial indicators include: “Psychosocial” refers to a patient’s psychological and social issues that can negatively impact or delay recovery from the work-related injury. But the beauty of this tool is that it can identify red flags early enough for the right resources to be implemented, thus avoiding negative trends and minimizing claim exposures.” Psychosocial Indicators & ComorbiditiesĪnalytics that identify psychosocial indicators coupled with intervention strategies have been recognized to be very effective. “Building predictive analytics programs can be expensive, and the customization can be very time consuming. “There are lots of reasons why this technology is underutilized in claims,” said Steve Peacock, Assistant Vice President – Claims at Safety National. But achieving these results means focusing on the right types of data, as it applies holistically to the injured worker.
Through machine learning, these analytics can provide cost savings, faster claims closure and less litigation. Predictive analytics can be the key to keeping minor injury claims from becoming costly creeping catastrophic claims.