Integrating Occupational Health and Employee Health

Jackie Burt

How can you sell your community a product if your health institute does not trust you to care for your own employees? It is important organizations look at themselves and provide their experiences of success to potential clients.

Our EHS are separate from OHS, how can I get senior management to approve integrating them with OHS? Referenced ACOEM’s article ”Workplace health protection and promotion.” It provides guidance for the total health of the employee market. We need to be aware we can’t sell something if we do not support it. Occupational health is the best practice standard. Productivity can be used to attribute value-added services to the health system. Monthly, the OHS and the EHS should be provided to the administration.
Do we still need an employee health nurse if we integrate? It is essential to have a designated individual providing oversight for the regulatory compliance needs acting as the liaison of occupational health.
How do we keep risk management if we integrate? We always need risk management. Every employer has the need for interactions with the public and is part of the team for all employee interactions.
What specific models are there? The development of the ‘team’ was discussed as a driving force that includes many roles to provide diverse services in a comprehensive format. Models vary depending on the size of the institution and the number of employees serviced.
Who monitors the RTW – OHS or EHS? The team monitors the RTW plan.• What role does HR have in the integration? It depends on the model you have and how and what HR will contribute. The TPAs work closely with the team to monitor appropriate care and the best practice outcomes. The goal is to provide a total health management focus.

White Collar Occupational Health Services

Mike Schmidt

What services are the most lucrative for this segment of the market? Concierge services for executive physicals are the most common format for providing executive, white-collar occupational health services. The focus is for a total health management overview for

the monitoring of the health and well-being of the white-collar worker in the executive role. Evaluating the individual using standards of health for all body systems and a comprehensive summary of all findings is provided in a high-end medical environment. Scheduling the services so the executive has no wait time is key. Fasting labs are initiated on admission and then a gourmet breakfast is served. Some programs provide opportunities for the spouse to participate as well.

Can you form consortiums for these workers? It depends on your market. The key to consortium development is the formation of cohesive groups that can benefit from problems, issues, and concerns. In the parts of the country where you have multiple companies in a small geographic area, consortiums can provide an excellent opportunity for developing educational forums, stress reduction programs, healthy eating programs, and coping strategies. The sales focus on the executive physical is a one-on-one interaction with the executive. The benefit is to the individual and their ability to stay healthy, provide a productive focus to work, and maintain a healthy work-family balance.

What focus is best for injury prevention for these workers? Determining the type of functional needs for the executive’s role is essential. Many of the white-collar executives are office-based performers, but some do go into the field to review work production and product

development. There needs to be a clear understanding of the physical requirements for site visits and the necessary endurance levels the executive might be exposed to perform in reviewing the work environment. Endurance testing is not required for every executive.

What model works best for pre-placement screening for office workers? Past medical, social, and occupational histories of previous job placements can provide red flags regarding the health of the candidate. Today, it is also necessary to review what hobbies are involved; we have seen some avid players of video games suffer from soft tissue hand, wrist, and elbow strains and sprains.

What forms of risk appraisals are best? Reviewing the DPH risk factors for the zip codes where the executive lives provides a community-focused review of common health issues. A review of family history provides the connection between the community evaluation and the individual risk factors. Clear history review is essential as well as reviews of past medical health experiences.• What approach works best for these clients to use our services? A direct one-on-one approach works best. Testimonials from other executives that have participated in the program to provide the best evaluation of the value of the program for both personal as well as for the executives of the company.

Primary Care and Occupational Medicine

Jackie Burt

Employers are recognizing that due to a shortage of primary care physicians, their employees have difficulty accessing care. This results in waiting for care and costly use of emergency rooms in the community. Episodic care can be added to your service lines with the NP providing the care.
How do we integrate primary care with OHS? Careful use of the primary care physicians can be used for the visit type. HIPAA follows primary care so that the only access is the physician and the employee. You need a separate focus so HIPAA guidelines are followed.
How do we approach our private physicians to get in this model? Challenging roles. There are providers that welcome the role opportunities for expanded care and others who ONLY want to do primary care. You need to be sensitive to what providers want. Many want separate clinics and other markets can provide separate times and days for that onsite primary clinic separate and apart from the occ med clinic. The model is a clinic in a clinic.
What pricing structure works best? Different models vary the fee structure: some employers contract for services, directly billed to the employer who is self-insured, co-pay model with insurance companies, all costs billed to the insurance policy. ACOEM is exploring a true workers’ compensation model for reimbursement.
What software do we use to maintain confidentiality? Use occupational health software for occ med services and the electronic medical record for primary care services.
Do we have to contract for a hospital privilege? The advent of the “hospitalist” role fulfills coverage in the hospital unless you do not have that role available. Then, your occ med docs might need to have hospital privileges.
Do we need to bill private insurance? It depends on the contract with the employer and how you have defined the services.• Do we need different software for documentation? Yes, the confidential differences are vital to make sure we do not have a HIPAA violation. Occ med is preventative medicine and flows into primary care. We need to be on the cutting edge of providing service to our markets. Look at the total health model, and in some markets, we may need primary care in the occ med program. Think outside the box. Break down silos to provide comprehensive care.