Welcome to the MedMetrics Blog

The MedMetrics blog provides comments and insights regarding the world of Workers’ Compensation, principally, issues that are medically-related. The blog offers viewpoints regarding issues affecting the industry written by persons who have long experience in the industry. Our intent is to offer additional fabric, perspective, and hopefully, inspiration to our readers.

Search The MedMetrics Blog

Sunday, May 15, 2011

Aristotle was a “know-it-all”…

In his recently published memoir, Paul Allen, co-founder of Microsoft, reflected, “Aristotle, the Greet scientist and philosopher, was literally a know-it-all. He mastered the knowledge of his day on every topic that mattered, from history and political science to medicine and physics. Even more impressively, he could explain what he knew to his students. But in today’s world, where scientific knowledge may be doubling by the year, it is impossible for any one person to absorb more than a small fraction of it.”1

Incoming information overload
Stated more broadly, just reviewing the general knowledge available today is overwhelming, if not impossible. How many newspapers can you read, news casts can you view, newsletters, Internet pod-casts or streaming webcasts, and email can you absorb daily?

Taking a step further, for those of us working in Workers’ Comp industry, the problem can be even more daunting. Claim information comes in continuously from every angle. Claims adjusters, medical case managers, UR professionals, managers, and supervisors, those who are supposed to manage all this information are inundated.

Of course, it’s not possible to adequately manage the information, at least without help. Collecting, organizing, analyzing, and acting on the flood of incoming claim information is unachievable for anyone, even Aristotle. Yet most continue to manage by going it alone, assuming they can “catch” the important stuff and keep their heads above water. Managed Care (medical cost containment) results demonstrate how wrong that idea is.

The results of information overconfidence are evident in unbridled medical costs. Medical cost control is elusive because no mere human can touch all the information, let alone understand and act on it logically in reasonable time. Sadly, the Workers’ Comp industry has not widely embraced the computerized tools that can address the end question. In fact, the industry has lagged well behind other industries in implementing the tools that will leverage success. but they could--quickly, easily, and affordably.

Computer-aided medical cost management
Computers do two things extremely well that address the issue of effective medical information management appropriately and proactively. Computers organize and analyze information—exactly what is needed to manage the deluge of claim information. Organized, easily understood, concurrent, actionable information will inspire cost control success. This is not news, of course, but computerized information resources are not typically applied in the Workers’ Comp industry.

Linking analytics to operations
To illustrate, consider how well-designed analytics can answer these questions in real time within the operational process:
Who are the best orthopedic physicians in a specific geo-zip region?
Which doctors have the poorest Workers’ Comp outcomes for specific injury types?
Which doctors exploit expensive, high risk treatments?
Which claimants have co-morbidities that portend high risk, high cost and poor outcomes?
Notify me when a claim involves very severe injuries.

Each of these scenarios relies on analytics pushed to operations. Moreover, each represents an opportunity to manage claim information efficiently and cost-effectively—while in progress. Why not let computer-aided medical management expand the knowledge, abilities, and effectiveness of front line workers?

Applying technology to the problem of claim information overload will not turn everyone into an Aristotle, but it will powerfully impact claim costs, outcomes and organizational profitability.

MedMetrics is a Workers’ Comp medical cost analytics provider.

1 Allen, Paul. Idea Man: A Memoir by the Cofounder of Microsoft. Penguin Publishing. 2011.