icare trials scheme to improve claims process

icare Chief Medical Officer, Dr. Chris Colquhoun, today announced the launch of a pilot program to trial how an independent panel of medical specialists could radically improve the time to approval, and provision of treatment in workers compensation claims for injured workers.

Dr. Colquhoun said from today, icare’s Medical Support Panel will be trialled to address the current delays in approving evidence-based best practice treatment requests within the NSW workers compensation scheme, and fast-track injured workers getting the right treatment as soon as possible.

“Currently injured workers can face delays of up to six weeks before a treatment plan is approved. The delay is not only frustrating to injured workers, employers and treating doctors, but also potentially adversarial. More importantly it can lead to a deterioration of the injury, causing further complications and delaying return to work,” Dr. Colquhoun said.

“Weeks of delay is simply not acceptable. We’ve looked around the world at what other health and injury organisations do, and found that a panel of medical experts providing guidance can speed up the process considerably – our pilot goal is to speed it up to no more than 5 days,” he said.

“The recommendations provided by the Medical Support Panel will be evidenced-based, tapping into the most up-to-date global medical practices and recommended treatment pathways for different types of injuries."

“For the injured worker, it will mean they not only receive treatment more quickly, but they can have the added confidence that their treatment meets global standards.”
Dr. Chris Colquhoun icare Chief Medical Officer

“For Independent Medical Examiners, the quality of referrals will be improved via a “clinician to clinician” process, ensuring the specific issues within a particular case are directly identified and addressed.

“Another key goal of the pilot is to gather evidence on early treatment intervention, and assess the lasting beneficial impact this can have on quality of life and return to work outcomes."

“The panel will provide our scheme agents with medical case support and resolution strategies for more complex cases. Over time, we aim to extend this support to other stakeholders within the scheme, particularly treating doctors,” he said.

The trial will operate within the following parameters:

  • Receive between 12 and 20 referrals a day, 5 days a week
  • Use experienced medical experts, ranging from occupational health physicians and psychiatrists, to other sub-specialists providing advice to case managers.
  • Over time, we aim to extend this support directly to Nominated Treating Doctors (GPs).

The trial will run for 12 weeks, by which time icare will make an assessment on its value to injured workers. Clinicians involved in the Medical Support Panel pilot are occupational physicians with years of experience in the NSW Workers Compensation scheme, who are well versed in up to date evidence-based best practice treatment pathways, as well as understanding the Health Benefits of Good Work.[1]

[1] The Australasian Faculty of Occupational & Environmental Medicine’s (AFOEM) Australian and New Zealand Consensus Statement on the Health Benefits of Work presents compelling international and Australasian evidence that work is generally good for health and wellbeing, and that long term work absence, work disability and unemployment generally have a negative impact on health and wellbeing. (AFOEM is a Faculty of the Royal Australasian College of Physicians (RACP)).
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