WCRI Recap: Single Biggest Factor To Turn-Around Opioid Crisis

WCRI Recap – 3 Part Series

It’s been two weeks since the WCRI Conference recently held in Boston. I’m Michael Stack with Amaxx. Today I want to give you some highlights and recap from that recent conference from the notes that I took and the perspective that I had on it.

The next session that I took some detailed notes on was how are states battling the opioid epidemic. I took a lot of different notes in this session, but Dwight Lovan who was formerly with the Kentucky Department of Workers Comp Claims made one statement that I think is the only statement that really needs to resonate with our industry and with state lawmakers.

Single Biggest Factor To Turn-Around Kentucky Opioid Crisis

We all know, or a lot of people know, that Kentucky was the epicenter of opioid overdose deaths and opioid drug problem, so they took this head on. He talked about really how they addressed it in Kentucky and the progress that they’ve made, which has been significant. He made one comment, and he said, and he kind of almost said it in passing, but I wrote it down and I highlighted it and I starred it and I bolded it, because he said, “The biggest impact and the one thing that they did that made the biggest difference was they required their physicians to check the PDMP data.” They made a mandate that required their physicians to check the PDMP data. If you’re not familiar with the prescription drug monitoring program it’s a database that basically doctors can check. It takes maybe 5-15 seconds to see what other drugs that injured worker is taking so they don’t overprescribe, so prevents doctor shopping. A lot of those biggest challenges that cause overdose deaths, so they made a mandate that required the physicians to check this PDMP data before they prescribe the drugs.

That made the biggest impact at the epicenter of opioid overdoes deaths and the significant progress that they have made. I checked this research. I researched it a little bit online. I’m not sure how accurate this data is, but it said 16 states have since implemented this mandate and it should be implemented in every single state, in all 50 states. If this made the biggest impact at the biggest problem area in our country, it’s an easy fix and it only takes five to 15 seconds to save a life, so hugely important point on this how states are combating opioids. If you have not implemented this in your state talk to our lawmakers. Let’s make this mandatory across the board.

Non-Pharmalogical Treatment of Pain

The last session was non-pharmacological treatment of pain as alternatives to opioids. This was a fantastic session. The information covered was very impactful and very moving for the results that it can give for each individual injured worker.

Dr. Dawn Ehde and I apologize because I’m probably pronouncing that wrong, from the state of Washington. She gave a tremendous presentation. Here’s the highlights of what she covered. She covered the idea that this medical model, or the currently medical model as far as the treatment of pain. It just doesn’t work. It doesn’t work because the biopsychosocial factors in all the different elements that go into how an individual perceives their own pain. This reinforces that idea of the do you think you’ll be back to work in four weeks. It reinforces that same idea, the perception of that individual person is such a huge factor on how well they’re going to do, and a huge predictive indicator of how well that claim’s going to go.

She talked about some of the current different options of what’s currently being used out there today. She talked about cognitive behavior therapy and she talked about mindfulness, so two different popular options which you may or may not be familiar with. What she went into a more detail, which I thought was extremely interesting and compelling was this idea of collaborative care. That’s what I want to cover here today.

Collaborative Care Model

It’s very much in sync with the best practice that I recommend, which is the weekly claims round table. It’s about looking at an individual claim, bringing in perspective some different experts to collaborate and come up with the best solution for that individual person because the solution for Tom’s going to be different than the solution for Sally is going to be different than the solution for Joe. Each individual person needs their own path and their own direction. You get the perspective from different experts to work together, collaborate for that outcome. That was really what she reinforced here.

She drew out this picture of the injured worker really being at the center of this model. You’ve got the providers up here. You have a care manager down here, and over here you have what she called consultants, and these consultants and everyone ties into here to service the injured worker. These consultants are psychiatrists, they’re different experts that can bring in and share some expertise with this care manager and with this provider to all work together to collaborate on the different elements that maybe needed to suit that person’s needs, to meet them where they are, to move them towards this positive outcome.

I’m oversimplifying this conversation, I’m oversimplifying this presentation, but you get the idea of what we’re trying to accomplish here and what she’s talking about and how they’re addressing this in the state of Washington to hopefully provide a model for the rest of the country to follow for these outcomes. The idea is to collaborate, connect with this injured worker regularly, have conversations with him, set those expectations. We talked about that in the worker outcome studies of how trust is such a huge factor so you build this huge level of trust with this care coordinator and they’re talking to them, that injured worker, about their expectations that do you think you’ll be back to work question is a huge factor in how they’re dealing with their pain, and how they’re going to recover.

They implemented, they haven’t done a ton of studies on this idea yet, but they implemented in a case of multiple sclerosis patients. There was 188 patients and it achieved what the medical community deems is the triple aim, which is better outcomes, lower cost, and higher satisfaction. That was the only study and they’re starting to roll this out in work comp, so very exciting for the solutions that can be brought to the table. Very impactful, very practical information as always from the WCRI Conference. I hope that you can take this information and put it into practice today.

Pick One Idea & Implement!

My recommendation is to start with one thing, start with one thing. What is it from that conference that you want to implement today and build that momentum, which is how significant change happens. Again, I’m Michael Stack with Amaxx, remember your success in Workers Comp is to defined your integrity, so be great!