St. Luke’s can claim success

A St. Luke’s Rehabilitation Institute effort to track workers’ compensation claims has been so successful in its first year that the Washington Department of Labor and Industries will ask the Legislature to expand the program from three Eastern Washington counties to 15.

The Center for Occupational Health & Education and a similar program based in Renton have also attracted the attention of other states, the federal government, even foreign governments trying to improve occupational health medicine.

A just-released University of Washington study of the Spokane center attributes its early success to patient-tracking software developed at St. Luke’s Rehabilitation Institute, support from business, labor and the medical community, and excellent teamwork from the top down.

Tom Wickhizer, who wrote the assessment, says interest in the centers has been high because other attempts to manage work-related medical claims have been limited to hospitals or health maintenance groups. Community-wide programs are rare.

The St. Luke’s-based center has been particularly effective because of its Occupational Medicine Information Tracking System, which gives doctors, employers and employees ready online access to a claim’s status. “That’s the whole concept here, to do a better job of managing,” Wickhizer says.

But two critical tests remain for both COHE programs. They must show they can get workers back on the job sooner and save the state and employers money in the process.

The Legislature authorized the pilot programs in order to improve management of worker claims, improve communication among worker, employer and doctor, and improve doctor awareness of standards for the treatment of fractures, lower-back injuries and the carpal-tunnel syndrome associated with repetitive movements. L&I handled 144,000 workers’ comp claims last year at a cost of about $500 million. Premiums for the state program have jumped sharply the last two years.

Carolyn Logue, state director for the National Federation of Independent Business, notes complaints about workers’ comp rank second only to health care costs in membership surveys. Time-lost injuries, she adds, are one of the fastest growing causes of cost increases. Although the buzz in the state business community about the COHEs has been positive, she says, owners will want evidence the programs can restrain costs if officials want more money for expansion.

That said, however, Logue says there are hundreds of small-business owners who would embrace a system that made it easier for them to contend with the occasional claims filed by their employees. Now, she says, “They have no idea how to use the system.”

Dr. Daniel Hansen, co-medical director for COHE, says claims that have been resolved cut time losses significantly. But the real assessments start Jan. 1 for the Renton program and Jan. 1, 2006 for Spokane’s. That’s when L&I will undertake six-month evaluations to determine their effectiveness.

St. Luke’s began compiling the claims that will be used in that evaluation on July 1. The clock runs for one year, then a six-month period will be set aside for as many of those claims as possible to be resolved.

Hansen says he is encouraged by strong recruitment among individual employers — 130 have signed on so far, as well as interest from group-rated organizations like Associated General Contractors and the Washington Farm Bureau. Although software rewrites delayed enrollment of employers that are self-insured, Empire Health Services is expected to be on board shortly, with several other major employers to follow.

And doctors, hospitals and other medical service providers are joining daily, rapidly filling out the geographic outlines of Spokane, Stevens and Grant counties. An additional $220,000 in state funds for 2005-2006 would allow the Spokane center to enroll another 100 medical providers, almost a 50 percent increase from present levels. Hansen says the number grows almost daily, and Inland Northwest Health Services, St. Luke’s parent, has committed its own money to installing new servers that can keep up with burgeoning demand for access.

In June, the system handled more than 136,000 hits.

With growing interest in the COHEs from outside Washington, Hansen says St. Luke’s and INHS are developing a business model to support an effort to sell information processing and other services related to workers’ comp claim management.

By all accounts, they certainly have an attractive product. Hospital and Health Networks amplified the recognition INHS is receiving by saluting — for the third straight year — five Spokane hospitals and Kootenai Medical Center for technical superiority. Information Resources Management, an INHS affiliate, manages their wireless network.