Patient Engagement in Workers’ Compensation
By Carlos Luna
The call to increase patient engagement to inform the development of standards and policies is gaining traction. The development of these standards ultimately helps improve health outcomes in workers’ compensation, and other health care influenced industries. Efforts to consistently collect and incorporate patient perspectives into the scientific process is becoming a priority for many. This is welcome news to all patients and patient advocates!
Understanding the importance of
patient involvement in the composition of evidence-based Guideline Development Groups
(GDG), The National Academies of Sciences, Engineering, Medicine (formerly the
Institute of Medicine (IOM), included the requirement of patient input as one
of its eight Standards for Developing Trustworthy
Clinical Practice Guidelines in 2011. The standard directs guideline developers to incorporate
patient involvement, at least, when formulating clinical questions and reviewing
Clinical Practice Guideline (CPG) drafts. Former patients, patient advocates,
or patient / consumer organization representatives qualify to participate in
the GDGs under this requirement.
Patient
Engagement beyond Content Development
The administration can consider the systematically gathered patient preference information, in conjunction with its assessment of scientific evidence that demonstrates a device’s probable benefit outweighing its likely risks, to form its complete grouping of clinical and non-clinical testing.
The call to increase patient engagement to inform the development of standards and policies is gaining traction. The development of these standards ultimately helps improve health outcomes in workers’ compensation, and other health care influenced industries. Efforts to consistently collect and incorporate patient perspectives into the scientific process is becoming a priority for many. This is welcome news to all patients and patient advocates!
How important is patient input to
ensuring the best possible health outcomes for ill or injured workers?
Accordingly, the requirement of
patient involvement is included in AHRQ’s National Guideline Clearinghouse’s (NGC)
assessment of submitted guidelines’ adherence to the academy’s standards of
trustworthiness. Patient and public perspectives, along with multidisciplinary
group participation and methodologist involvement, is measured by the NGC when
grading the content developer’s GDG composition.
The newly energized push for patient
engagement is prompting content developers aiming to align with National
Academy standards to improve methods for soliciting, receiving, and incorporating
patient and public input into the content development process. The American
College of Occupational and Environment Medicine (ACOEM) accepts patient, and
other stakeholder, input through an online portal to assist the development of its
evidence-based medicine practice guidelines.
Notable
recent activity from the Food and Drug Administration (FDA) includes assembly
of a Patient Engagement Advisory Committee (PEAC). A statement issued by the FDA explains the
committee exists to support its efforts to broaden engagement with patients and
deepen patient involvement in the administration’s regulatory activities.
More
specifically, the initiative will seek patient perspectives for use across medical
device design, clinical trial process, and post market evaluation. Additional guidance
on patient preferences, such as tolerance of risk and patient point of view on
benefits, will be used by the FDA to assess device benefit-risk profiles. The administration can consider the systematically gathered patient preference information, in conjunction with its assessment of scientific evidence that demonstrates a device’s probable benefit outweighing its likely risks, to form its complete grouping of clinical and non-clinical testing.
Workers’
Compensation Continues its Efforts for Patient Engagement
Very few
venues exist in workers’ compensation that facilitate direct engagement between
industry vendors and patients. Perhaps the most visible platform today is
WorkCompCentral’s Comp Laude® Awards & Gala. Event participants advertise that
Comp Laude’s most memorable moments typically occur when patients are involved
in panel discussions. Event organizers have voiced their excitement about the
overall positive impact patients have on the industry get-together.
Stemming
from the mission and vision of the event’s late founder David DePaolo, Comp
Laude® created a scholarship intended to create a path for direct engagement
between the industry and its patients. The scholarship provides travel funds
and covers lodging expenses along with conference registration for the patient
and a guest. Several vendors, among them ReedGroup, are honored to have the opportunity
to be sponsors of the scholarship fund.
Many have
criticized the workers’ compensation industry for its numerous shortcomings,
myself included. While it is important to acknowledge the industry has more
work to do in the pursuit to increase patient engagement to improve health
outcomes, it is equally important to acknowledge the progress gained by
organizations whose corporate point of view regularly advocates for patients
and their wellbeing. For this the industry should be complimented.
The FDA unfortunately does not provide grants to patient advocates to speak, and travelling from California to DC is very expensive. This is one reason why there were only a handful of patient advocates who attended the PEAC meeting, and most attendees were from industry. I was scheduled to speak but had to unfortunately cancel due to the expense. This meeting was called a patient engagement meeting, but most of the speakers and attendees were from industry. I am happy to read Workcompcentral is providing some grants to for IW's to attend their award ceremony. I would like to see them and CAAA go further and allow patient advocates to attend their educational seminars or even just view their online seminars without charge, if they are actively volunteering in any way to help other injured workers . It is very difficult to help other injured workers without having a basic understanding of the maze we have in the CA WC system. I have receive grants to attend and engage in seminars that deal with general issues relative to my patient advocacy, but I have not had the same experience within the work comp world. I was provided tickets to attend the complaud award ceremony twice. I appreciated it very much and miss David Depoalo, who was on my opinion also a patient advocate for injured workers. He always treated me with kindness and respect. (California injured worker patient advocate)
ReplyDeleteThe reason I haven’t spoken out is because I only have a rudimentary understanding of worker’s comp. I think you’d have to look at worker’s comp as a whole before you can make any drastic changes.
ReplyDeleteIt is very difficult for injured workers to learn about the industry when seminars and online classes are expensive and many are living off of a limited income. There are classes offered once a month at the WCAB, however the information is very basic. I read the information on the states website that is free. It is also difficult to appeal UR denials when ODG and ACOEM charge yearly memberships just to have access to treatment guidelines. MTUS and chronic pain guidelines are on the states webpage, but they are very limiting and really do not cover patients who have multiple, complex injuries. This is another reason why this UR and IMR paper review is so unfair to injured workers. Very difficult to fight treatment denials when you are barred financially to the info needed to appeal. The situation is only compounded by the insurance industry's blatant misuse of guidelines, and who would know if they do not have access to these guidelines? In my opinion the FDA and also the California insurance industry only want to hear stories of success and not issues patients bring forward of the severe problems they are having. Just FYI on some of the patient advocates who speak at the FDA, some of them are paid by industry to forward industries agenda. They speak to loosen regulations on industry, which ultimately harms patients. I do give Workcompcentral credit as they will report on problems injured workers are having. David DePoalo wrote several blogs on some of these problems, one called Vultures On Both Ends is one example of this.(California Injured Worker Patient Advocate).
DeleteYour comment does explain my experience. I really wish I could get involved, but I don’t know where to start.
DeleteGreat ,Thanks for sharing
ReplyDeleteSubrogation Outsourcing