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The Future of Musculoskeletal Health Management

How forward thinking organizations are linking employee well-being and productivity through

musculoskeletal professional disciplines and technology

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ABSTRACT

The current structure of healthcare systems in the United States has induced a fractionalization of the prevention, care, and management of health conditions. Medical providers are isolated to clinical environs from which managing worksite interventions and organizational influence is difficult. The health payment systems further isolate worksite productivity and disability prevention efforts. Workers’ compensation medical and indemnity deals with conditions arising from maladies suffered during “daylight” 9-5 hours and private health care systems and disability management systems manage care from health conditions suffered from 5-9. The current approach minimizes the potential net positive impact that health care and related disciplinescan provide. The prevention and care of musculoskeletal conditions is no exception. This essay explores thepotential net gain that can be achieved by integrating the disciplines of physical rehabilitation, musculoskeletal wellness, disability management, return to work, occupational injury prevention, and job classification underthe sciences of physical, cognitive, and organizational worksite interventions. The application of thesesciences collectively and from a provider base trained and supported across these domains can have positiveimpacts on employee satisfaction and retention, workers’ compensation injury rates and costs, organizationalproductivity, healthcare utilization, disability management, and corporate economic metrics. The integrationof the physical, cognitive, and organizational domains can be delivered through appropriately trained andcredentialed specialists, each of whom must have the didactic background to support the application ofservices, institutional knowledge gained from multiple successful worksite implementations, and technologyapplications that connect and leverage data sources from medical, disability, injury prevention, occupationalhealth, and occupational safety to optimize the linked and common benefits to working adults across thesedomains.

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WELLNESS OF THE WORKINGPOPULATION: THE STATUS QUO

In a 2005 report, a committee formed by the American College of Occupational & Environmental Medicine1

sounded the alarm bells on what they described as a fundamentally flawed system of ensuring the wellness of the working population. The report placed “devastating psychological, medical, social, and economic effects” associated with “poorly managed health-related employment situations” into stark contrast with the authors’ cardinal imperative to “do no harm”. Why is it, the committee asked, that employees with the exact same medical condition experience vastly different outcomes in their capacity to return to or stay at work? Furthermore, why is it that seemingly everyday problems like wrist or back strains can lead to long term disruptions in an employee’s capacity to perform meaningful work

It should be no surprise that the responsibility of keeping employees healthy, and successfully returning them to productive work after illness or injury, is challenging to employers. Employers sit at the frontlines of having to deal with the aftermath of mismanaged, delayed, and escalated medical cases. They bear not only the direct and hidden costs, but also experience significant distress while trying to do the right thing, in an environment where control over the process has been diminished and largely yielded to the experts in the medical community. Never mind that the experts in the medical community often have very little information on the work setting, and that they regularly lack tools at their disposal to guide employees back to healthy and productive employment.

This is true particularly with respect to those occupational disorders that are due to strains, sprains, tears, and non-specific pain and soreness (musculoskeletal disorders, or “MSDs”), which together account for 53% of all work-related absences, per the Bureau of Labor Statistics.2 For an outsider looking in, it may appear very strange that key decisions that have profound impact on the trajectory of an injured employee’s recovery are often made in a complete vacuum, with no insight into the actual triggers of disability in the workplace – the physical demands, the levels of exertion and repetition, the static postures, psychosocial risk factors,organizational barriers, and stress. Meanwhile, the subject matter experts, the managers, supervisors, andjob incumbents, who are intimately familiar with those triggers and how to modify them, rarely have a seatat the table in the health and wellness conversation. These factors multiply and forge a pathway for run-of-the-mill injuries that would otherwise recover uneventfully, to evolve into expensive indemnity cases, disruptproductivity, and provide yet more fuel to the problem of employee turnover – all from a largely preventableclaim.

1 Christian, Jennifer, MD, MPH, et. al. “Preventing Needless Work Disability by Helping People Stay Employed. A Report from the Stay-at-Work and Return- to-Work Committee of the American College of Occupational & Environmental Medicine.” 2005.2 “Nonfatal Occupational Injuries and Illnesses Requiring Day Away from Work.” Bureau of Labor Statistics. www.bls.gov/news.release/pdf/osh2.pdf. 2015

WHY IS IT THAT EMPLOYEES WITH THE EXACT SAME MEDICAL CONDITION EXPERIENCE VASTLY DIFFERENT OUTCOMES IN THEIR CAPACITY TO RETURN TO WORK?

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This narrative exemplifies the now widely understood underlying reality of the status quo: A multitude of well-meaning people, all experts in their own domains, working in their respective silos of influence, with negligible communication and often conflicting agendas, attempting to provide a therapeutic environment in which workers can return to work, stay at work, and strive for optimal health – often in vain. Wellness committees launch Wellness campaigns; Safety Committees hold Safety Meetings; meanwhile, managers attempt to interpret doctors’ Return-to-Work notes for employees who still get hurt despite all the best efforts of employer-based stakeholders such as Safety Professionals. This all occurs in the face of unrelenting organizational pressure to maintain their department’s productivity.

Adopt a disability prevention model by shifting the focus away from evaluating and certifying disabilitytoward preventing it;

Improve and standardize the methods and tools that provide data for employee health, especially in themusculoskeletal realm;

Use these methods and tools to improve information exchange between employers, medical providers, and payers;

Embrace the central role that positive interpersonal communication plays in affecting successful Return to Work (RTW) and Stay at Work (SAW) efforts and in ensuring worker health; and

Recognize the prevention, treatment, and management of worker health as a progressiveinterdisciplinary professional specialty uniquely positioned to disrupt the status quo.

Instill a sense of urgency to address musculoskeletal discomfort early to prevent chronicity;

A NEW PARADIGM OF WORKER HEALTH

An alternative structure for the management of worker health exists. This structure arises from a foundation that places the objective of providing a positive, productive, and safe work setting at the center while drawing from a multi-disciplinary cadre of capabilities. The authors present a validated paradigm for designing a system where both workers and employees can thrive around structural components that inform one another seamlessly, and, based on some of the same objectives outlined by the 2005 report:

EFFECTIVE TOTAL WORKER HEALTH?

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Worker’s CompensationIndemnityFirst-AidNurse Triage

PrivateHealthcareDisability Programs

9 to 5 5 TO 9

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This paper documents a path to achieve these objectives by cataloguing essential program elements that need to be put in place to establish this new paradigm of managing musculoskeletal employee health. It underlines both the imperative and the opportunity in building these program elements on top of a smart and solid foun-dation of integrated technology to break up information silos and make the correct and necessary information accessible to anyone functioning anywhere in the continuum between preventing injuries, providing medical care, and optimizing worker productivity. It also formulates the background, experience, and skillset required of the type of professional who implements and manages these programs, as well as the infrastructure that sup-ports them.

The ultimate goal for many stakeholders involved in medical case management, medical care, and employment of injured employees is early and successful RTW with minimal or no temporary total disability/days away from work. It is common knowledge that the costs associated with injuries requiring time away from work are much greater than for those where the employee can stay at work in some capacity. Greater direct and indirect costs accumulate when an employee is out of work due to injury, and the employee’s perception of disability is likely to increase along with the duration of days away from work. In one large study of 1,119 participants suffering from chronic MSDs, early functional rehabilitation was associated with savings of up to 64% in medical costs and up to 80% savings in disability benefits and productivity losses. Functional rehabilitation applied early in the course of injury resulted in estimated cost savings of approximately $170,000 per claim.3 This cost accumulation and disability severity can quickly spiral, leaving an employer with the problems of replacing the employee, training new staff, burdening supervisors and managers with additional problems in productivity, and managing the medical claim of an employee who may never return to work at their company, whose care accumulates more complex medical interventions while function and RTW prospects do not improve. The employee is often disgruntled by the claims process and associates that dissatisfaction with his or her employer. He or she becomes deconditioned, less able to work, and less motivated to return to work over time. This can also lead to depression, which is a factor associated with work-related injury and diminished RTW potential.4

It is now well-documented that the effective RTW and SAW management is vital to preventing such needless disability. Employer-based health care providers using collaborative, evidence-based care models and information-sharing strategies to manage work-related disability have been shown to be critical for the improved ability to perform work, and for earlier and lasting RTW outcomes for individuals with musculoskeletal disorders - especially for those with MSDs. Proposed interventions include program elements such as ergonomic education using a participatory approach with the employee, effective employee management, and involving an ergonomist or clinician trained in ergonomics. Time and again, studies point out that multidisciplinary care for injured employees that includes physical and psychological factors, occupational medicine, and vocational rehabilitation early in the course of injury and disabilityresults in greater rates of RTW and are more cost effective approaches than traditional care models.5,6

3 Theodore B, Mayer T, Gatchel R. Cost-Effectiveness of Early Versus Delayed Functional Restoration for Chronic Disabling Occupational Musculoskeletal Disorders. Journal of Occup Rehab. 2015; 25(2): 303-315 https://link.springer.com/article/10.1007%2Fs10926-014-9539-0. 4 Asfaw, A, Souza, K. Incidence and Cost of Depression After Occupational Injury. Journal of Occupational & Environmental Medicine. 2012; 54 (9): 1086-1091. doi: 10.1097/JOM.0b013e3182636e2.5 Steenstra IA, Anema JR, van Tulder MW, et al. Economic Evaluation of a MultiStage Return to Work Program for Workers on Sick Leave Due to Low Back Pain. J Occup Rehabil. 2006;16(4):557-578. doi:10.1007/s10926006-9053-0.6 Gatchel RJ, Mayer TG, Theodore BR. The Pain Disability Questionnaire: Relationship to One Year Functional and Psychosocial Rehabilitation Outcomes. J Occup Rehabil. 2006;16(1):72-91. doi:10.1007/s10926-005-9005-0.

MANAGING WORKER DISABILITY: THE SCIENCE

EXCESS COSTS FROM OUT OF WORK CLAIMS

88%

1.2M

$87B

MORE TOTAL COST THANRTW

DAYS AWAYFROM WORK

ANNUAL WCCOST TOEMPLOYERS

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RE-DEFINING THE ROLE OF THE MEDICAL PROVIDER

They recommend that strategies should include a workplace-based functional assessment, functional rehabilitation, prescribed progressive exercise, psychosocial screening, and coordination of care with other members of the team.7,8

These are the known facts. However, hardened models of “collaborative” and “interdisciplinary” approaches that are reproducible across different work settings are not yet well-articulated. The system could benefit from a disruptive impulse. The programmatic integration of the medical provider into the workplace can provide just such an impulse: it lowers the threshold for the active participation of the employer in RTW planning, it provides a platform for more immediate and meaningful functional clinical goals, and it effectively removes the fundamental dichotomy between employer vs. medical objectives that are so detrimental to the prospects of an injured worker’s recovery. Once the infrastructure of such an arrangement is established, the clinician will no longer need to rely on guesswork, outdated job analyses, or on the employees’ subjective narrative to formulate functional goals – instead thresholds for successful RTW become obvious from a disciplined understanding of the demands, workflows, and intricacies of the injured employee’s work setting. Obstacles to the safe performance of job functions are quickly clarified and often eliminated with a brief conversation with the manager. The task of bringing the worker back to work becomes a genuinely collaborative exercise built into the process, rather than a bullet point on a workflow document paying lip service to the necessity of “improving communication.” At the same time, the psychosocial advantages of maintaining connection of the injured worker to his or her workplace, of knowing that he or she is wanted and needed, cannot be overstated in minimizing chronicity and reducing the risk of unneeded disability.

The ultimate success to this shift in the paradigm in the care and management of musculoskeletal disorders in the workplace depends not just on properly setting up the program infrastructure. It is equally important to be able to draw from a new category of providers capable of operating beyond the confines of the clinic. An effective service provider operating under this new paradigm – often a rehabilitation or physiological sciences professional – transcends the requirements of superior clinical practice

and brings an equal skill level to the realms of organizational design, fluency in the nuances of workers’ compensation and disability claims, ergonomics, motivational interviewing, and team management. Because the capabilities required from this new class of provider are unique, programs that operate from this point of view must be based on well-established structures of content matter expertise, managerial support, systematic mentoring, and intuitive data management systems.

7 Lindström I, Ohlund C, Eek C, et al. The effect of graded activity on patients with subacute low back pain: a randomized prospective clinical study with an operant conditioning behavioral approach. Phys Ther. 1992;72(4):279-290.8 Jensen C, Jensen OK, Christiansen DH, Nielsen CV. One Year Follow Up in Employees Sick Listed Because of Low Back Pain: Randomized Clinical Trial Comparing Multidisciplinary and Brief Intervention. Spine. 2011;36(15):1180-1189. 694 doi:10.1097/BRS.0b013e3181eba711.

SUCCESS DEPENDS ON PROVIDERS CAPABLE OF OPERATING BEYOND THE CONFINES OF THE CLINIC

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INJURY PREVENTION:THE MISSING LINK

However, the benefits of taking the clinician out of the clinic and into the workplace go far beyond its implications to medical care and disability management – truly progressive employer-based models of care recognize the inherent value of a clinical eye on the demands of the workplace, and broaden the scope of the care provider into injury prevention. The provider therefore becomes a highly effective focal point functioning at the intersection between treatment, RTW planning, and injury prevention.

Effectively managing disability and expertise in Return to work and Stay at work (“RTW” and “SAW” respectively) are vital to improving worker health, productivity, and cost control. However, moving upstream to prevention of disability and injury is paramount: Dollars spent in prevention will reap more long term benefits than efforts and dollars spent in the realm of management of injury and disability that has already occurred. More spending currently occurs on the least beneficial reactive activities, while investment on proactive strategies that advance worker health is negligible.9 These data demonstrate that the prevalent health investment practices are in opposition to evidence-based best practices – that organizational economic benefits are best achieved via appropriate investment in integrated injury and disease prevention.

A more effective approach to reducing disability, chronic disease, and costs of medical services starts with prevention programs - and a service provider capable of positively affecting both the clinical and occupational factors playing a role in workplace health. The scope of influence of the service provider must be placed squarely at the center of a new structure of workplace health management that emphasizes valuable interventions while dis-incentivizing those associated with poor outcomes. No employee, or employer for that matter, benefits from a scheme that rewards medical providers for increasing the number of visits or dragging out the resolution of a case in the name of irrelevant clinical goals. Similarly, no physical therapist reaps rewards in the traditional workers’ compensation case workflow for actively engaging with the employer on Return to Work planning. If, however, that same physical therapist was to be given the opportunity and imperative to engage in disability management and injury prevention for the sake of outcomes beyond a narrow clinical scope; if the structure of the system provided rewards for this activity, cases would resolve at a fraction of the costs normally associated with standard musculoskeletal disorders, with less disruption to either the workplace or the employee’s working life. After all, injury prevention and disability management occur along a continuum which includes proactive strategies such as exercise programming and ergonomic advising, as well as reactive strategies such as incident reporting, early medical care, stay at work and return to work strategies. Workers may move in and out of various points on the continum over time- making a strong case for a right time, right place, right person approach to managing workplace wellness.

Boston Foundation and the New England Healthcare Institute, sourced from:http://bipartisanpolicy.org/library/what-makes-us-healthy-vs-what-we-spend-on-being-healthy/

MEDICALTREATMENT

RTWPLANNING

INJURYPREVENTION

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EFFECTIVELY TARGETING MUSCULOSKELETAL HEALTH

Targeting prevention activities in the most effective manner begins with musculoskeletal health. Musculoskeletal disorders (MSDs) account for over 60% of all worker related injuries in the private sector, and include sprains and strains, carpal tunnel syndrome, back pain, tendinitis, and fractures.10 Sprains and strains are among the costliest injuries and in the top five with respect to days away from work.11 Musculoskeletal wellness thus is an appropriate focal point for prevention efforts made by employers. Evidence indicates that this holds true across industries - from manufacturing to distribution to office workers to transportation to healthcare.

Successful prevention strategies depend on prioritizing and configuring interventions in such a way as to optimize their effectiveness. Employers are often at a loss to determine whether a problem calls for training, management controls, or new equipment. Employee training in particular often suffers from significant variations in quality and efficacy, with considerable efforts invested in activities that don’t actually affect employee behavior or their exposure to workplace risks.

Safety initiatives are launched regularly in response to workplace incidents in the understandable desire to address risk, but often lack the multidisciplinary input that would inform understanding of ALL the leading indicators that drive injury risk – physical, cognitive, and organizational. This gap in process often leads to cynicism that meets these efforts: that they represent a mere compliance check, that they place the responsibility of workplace safety solely on the employee, or that ALL injury risk can be designed out of the system or process. Research on the most effective components of injury prevention programs are clear: We know that ergonomic equipment and employee education are neither effective alone, but that the combination of the two in coordination with organizational and cultural support has a positive effect on reducing injuries. We know that practices such as effective and supportive supervisory response to reports of injury have a positive effect on injury and disability reduction, and that these practices can be learned.12 And we know that exercise has a positive effect on injury and illness reduction, including behavioral health disorders and other non-communicable diseases and disorders such as diabetes, stroke, and heart disease.13,14,15,16

10 Distribution of Injuries and Illnesses by nature, private industry, 2006. https://www.bls.gov/iif/oshwc/osh/os/osh06_28.pdf. Accessed 3/2/2017.11 Travelers Injury Impact Report. http://investor.travelers.com/Cache/1500085614.PDF?O=PDF&T=&Y=&D=&FID=1500085614&iid=4055530. Accessed 3/2/2017.12 https://www.iwh.on.ca/sbe/are-workplace-prevention-programs-effective13 Exercise Reduces the incidence of high blood pressure and heart disease by approximately 40%. http://www.ncbi.nlm.nih.gov/pubmed/1629371714 http://www.ncbi.nlm.nih.gov/pubmed/7934752?dopt=Abstract Exercise in the prevention of coronary heart disease: today’s best buy in public health. Med Sci Sports Exerc. 1994 Jul;26(7):807-14.15 Reduce the incidence of diabetes by approximately 50%. http://www.ncbi.nlm.nih.gov/pubmed/10068380 The association between cardiorespiratory fitness and impaired fasting glucose and type 2 diabetes mellitus in men.16 Dunn A, et al. Exercise Treatment for Depression; efficacy and dose response. American Journal of Preventive Medicine. 2005. http://www.ncbi.nlm.nih.gov/pubmed/15626549

A STRONG CASE FOR A RIGHT TIME, RIGHT PLACE, RIGHT PERSON APPROACH

ACCESS TO AN APPROPRIATE PROFESSIONAL IS A KEY FACTOR ASSOCIATED WITH SUCCESSFUL PARTICIPATORY ERGONOMICS INTERVENTIONS

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To remedy this situation, a trained service provider embedded in the workplace, who is equally fluent in addressing ergonomic risk and in coaching workers using an approach founded in behavior change methodology, can effectively turn the negative connotation associated with workplace safety on its ear, driving positive changes in the organization’s safety “culture.” Access to this type of professional is one key factor associated with successful participatory interventions, and these types of interventions have been shown in the literature to have a positive impact on reducing injuries and lost work days from work or sickness absence.17

This type of professional must be equipped with the training, experience, and institutional support to interpret workplace injury statistics, identify and quantify leading indicators for injury risk, configure the most effective mix of workplace interventions in collaboration with workers and management, and who can deliver solutions contributing to a culture of workplace safety. That professional also becomes a trusted employee confidant uniquely positioned to foster an environment of Early Intervention - a critical success factor in addressing physical, behavioral, and organizational issues before an injury has occurred. Case study data indicate that this approach has repeatedly proven effective in multiple settings over time. Relevant statistics show over 92% of individuals receiving this level of Early Intervention experience resolution of symptoms - which might otherwise have developed into costly workers’ compensation or personal disability claims. These methods do not apply solely to work-related disability management. Work is clearly a major life function that consumes the largest share of most working-age adults’ non-sleep hours.18 As a result, health-related absences consume up to 9% of an employer’s payroll, at a cost of up to $400 billion per year in the US.19 Non-occupational illnesses and injuries are a significant proportion of those dollars, and MSDs are proportionally similar in occupational and non-occupational claims (averaging 40-60% of incidence and cost). The same strategies that are effective for occupational health are effective for non-occupational health, making an even stronger case for implementing highly integrated disability prevention models in the workplace.

One underappreciated, but fundamental factor contributing to operational inefficiencies and poor outcomes in disability management and ergonomic programming is the way key data crucial to all workplace stakeholders are collected, retained, and made available. Many employers would attest to an all too common mismatch between the effort that goes into the implementation and stewardship of prevention, treatment, and disability management programs, and their outcomes. What these programs notably do not suffer from is a lack of effort - instead they suffer from deep-seated inefficiencies and redundancies, as today, silos of care and interventionexist even within the occupational realm.

Even where a coherent Return-to-Work plan is articulated for an injured worker, it tends to have little impact on either the worker’s medical treatment plan or his department’s safety practices – both missed opportunities in the objective to return the worker more quickly to a safer workplace. Consequently, Human Resources continue to address RTW issues relatively independently from treatment efforts in remote clinics, while Safety Departments rely on awareness campaigns in the hopes that the next claim might be avoided.

THE CASE FOR SMART BUSINESS INTELLIGENCE SYSTEMS

PROGRAMS DO NOT SUFFER FROM A LACK OF EFFORT BUT FROM DEEP-SEATED INEFFICIENCES AND REDUNDANCIES

17 Effectiveness of Participatory Ergonomic Interventions: a Systematic Review. Institute for Work and Health. 2005. https://www.iwh.on.ca/system/files/sbe/summary_pe_effectiveness_2005.pdf. Accessed 3/2/2017.18 Regulations to Implement the Equal Employment Provisions of the Americans with Disabilities Act, as Amended. Publication date 3/25/2011. https://www.federalregister.gov/documents/2011/03/25/2011-6056/regulations-to-implement-the-equal-employment-provisions-of-the-americans-with-disabilities-act-as Accessed 3/1/2017.19 Managing the Costs of Occupational and Non Occupational Absence and Disability. https://www.marsh.com/us/insights/research/managing-costs-of-occupational-and-non-occupational-absence-disability.html. Accessed 3/1/2017.

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The effort of crossing each respective organizational boundary in order to benefit the workplace as a whole is often perceived as excessive and reliant on inefficient means of communication, not to mention the fact that veering outside one’s sphere of organizational clout and responsibility often is frowned upon, rather than rewarded.

It is striking to note that despite this disjointed approach, virtually all parties involved in preventing, treating, and managing workplace injuries rely not only on the same workplace demands information, but also on nearly identical behavioral, physical, and organizational strategies intended to minimize workplace harms and reduce employer risks. As the consolidated and integrated disability prevention and management industry evolves, we must move to a point where Return-to-Work strategies can be considered as part of an organizations’ safety strategy; or where job demands quantified in accommodations situations can be used by medical providers for clinical goal setting; or where cultural and communication variables are tracked and considered when assembling RTW, SAW, employee engagement, or safety strategies. When evaluating the root causes for why these opportunities are consistently missed today, we find that contrary to assumption, they are not necessarily driven by organizational structures inherently protective of their own domains. Instead, it is often inadequate information management and a lack of supportive business intelligence systems that set up these information silos in the first place. Simply put, usually the teams responsible for these respective occupational domains lack systems that allow for the systematic and consistent collection of job demands, occupational risks, safety incidents, and associated employee or team-based interventions. This data, if collected at all today, is commonly found to live in analog safety logs, sign-in sheets filed with Training & Development, employee job descriptions, or an e-faxed RTW plan.

Even in progressive organizations that may have invested in the development of a custom Safety database or may have a Human Resources module developed in conjunction with their corporate ERP system, or a Disability Management platform offered by an insurer – in virtually all instances, the counter-party stakeholders who consume and should collaborate with this information lack access to the application and the resulting data. Further, to an astonishing degree these systems lack the ability to derive insights, visualize collected data, or support even minor degrees of process automation or integration with up-stream or down-stream applications. Such gross inefficiencies, which would never be tolerated in an operations domain are widespread in the integration of human resources, occupational health, and safety management – commonly resulting in frustrated users returning to their paper-based systems of old.

A LACK OF SUPPORTIVEBUSINESS INTELLIGENCE SYSTEMS CREATES INFORMATION SILOS

TECHNOLOGY INVESTMENT CONTINUES TOIGNORE A WIDE-SPREAD MULTI-BILLION DOLLAR OPPORTUNITY COST CONFRONTING EMPLOYERS

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While investment in Artificial Intelligence continues in consumer domains resulting in smart refrigerators and trashcans that can reorder their liners – technology investment continues to ignore a wide-spread multi-billion dollar opportunity cost confronting employers today. Information management systems intending to establish a common denominator for all institutional domains responsible for occupational health, safety, and disability management must be put in today. The barriers to collecting and cataloguing physical, psychological, and organizational job demands and the capabilities to use the resulting insights must be significantly lowered.

When integrated solutions are available, coupled with process automation and real-time algorithm-driven, science-based insights, team-efficiency, team-efficacy, and resulting employee outcomes significantly improve. Thus, information management, optimized to efficiently serve all stakeholders in the continuum of occupational injury prevention, treatment, and management, builds the basis for the programmatic integration of a new class of service provider, to break up silos of influence and to provide an impulse for driving forward genuine, consistent, and results-oriented interventions in the workplace.

The evidence is clear – Integrated injury control systems leveraging professionals trained, qualified, and supported to break out of the vertical domains in which they are commonly associated (clinical, safety, organizational) presents a clear and present opportunity for employers to optimize employee health, reduce healthcare and occupational health costs, and deliver economic returns. The foundations of this type of total health improvement professional arise from a breadth of expertise in the physical, cognitive, and organizational domains coupled with information systems that inform activities and program design. Considering the constraints that employers now face – rising health care costs, continued employee exposure to occupational health risk and associated costs, an aging workforce, stiffening global competition – integrated injury, health, and disability prevention, condition management, and health optimization will become increasingly important to retain and secure a healthy and productive workforce and optimize corporate economic benefits. The premises laid out above provide a primer surrounding this notion upon which forward thinking employers can differentiate and excel in their respective markets.

This essay is a product of Briotix’ Business Transformation Group. Copyright 2017 - All rights reserved.

CONCLUSION

ACKNOWLEDGMENTS

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BRIOTIX...evidence-based care models and information-sharing strategies to manage work-related disability have been shown to be critical for the improved ability to perform work, and