EBM Insights podcast series is a deep dive into current issues surrounding insurance and risk management in today’s ever-changing world.
In this podcast with Biosymm, we are joined by Ruth Lennon, a Physiotherapist and Biosymm’s Business Development Manager, and Tom Kelly an Occupational Therapist and their Workplace Injury Video Triage Manager.
A transcript of the interview with Biosymm is below. The complete EBM Insights podcast series is available here.
Introduction:
In this episode we meet with Ruth Lennon and Tom Kelly from BioSymm – an occupational health business who specialise in the management of workplace injuries. In particular how they use medical-grade video technology as part of their triage program.
Disclaimer:
In this podcast, we have provided general advice only and not personal advice. In giving this advice, we have not considered your personal circumstances.
00:00:00 Disclaimer – Speaker 1
00:00:00 Speaker 1 – Disclaimer
In this podcast, we have provided general advice only and not personal advice. In giving this advice we have not considered your personal circumstances.
00:00:13 Speaker 2
Welcome to EBM Insights. Today we are chatting to Biosymm, an occupational health business who specialise in effective management of workplace injuries when they occur and in helping prevent them happening in the first place. We’ll focus specifically on the benefits of immediate triage of workplace injuries and how this can link in with early intervention treatment for both physiotherapy and medical where needed.
Joining me today from Biosymm is Ruth Lennon, a Physiotherapist and Biosymm’s Business Development Manager, and Tom Kelly an Occupational Therapist and their Workplace Injury Video Triage Manager.
Welcome to you both. All right? So, to get us started can you give an overview of early intervention triage and the benefits.
00:01:00 Speaker 3
Yeah, so firstly, just to understand those benefits, we need to acknowledge that return to work is an emergency.
So being off work due to an injury has significant impacts on health outcomes and the person that’s injured. So, the longer that worker is off work due to injury, the less likely they are to return to work.
The rapid triage within the first hour of injury by registered Allied health professional leads to more than half of those cases being able to self-manage, so they don’t need any treatment.
And it also means that where treatment is required, it’s identified as early as possible, so early intervention also means reduced or eliminated lost time and suitable duties being able to be recommended. So, it’s really important in that way.
00:01:47 Speaker 4
And I just wanted to add to return to work being an emergency. Essentially when someone gets injured, there are times where you know you see an ambulance taking someone off to hospital but, as we’ll discuss a bit later, there ultimately should be an ambulance returning someone straight back to work. Because the detrimental health effects on someone being off work really make it an emergency.
00:02:15 Speaker 2
Definitely thank you and do you have a case study example you could share about the benefits?
00:02:22 Speaker 3
Absolutely. So, if we just imagine Joe is at work. Joe bends down to pick up a box and he notices a pain in his lower back as soon as he’s done that movement.
So, Joe’s dad had a similar incident years ago, and he’s never been right since. So, Joe knows this. He knows the pressure that it put on his dad and his family so he’s really worried about this back injury. He reports the injury and he calls his company triage service straight away as soon as it happens. He gets to speak to a registered nurse and that reassures Joe that his symptoms are expected.
So, you know, yes, you’ve got pain, but that’s what’s expected. This injury has occurred is you know, quite common and providing him with that first aid advice and really reassure him. And so, Joe follows that advice, and he feels so much better, so he’s uncomfortable in the night and is worse in the morning.
But he knows to expect this from his triage call.
So, after getting up and moving, Joe’s symptoms improve. So, when he’s followed up after 24 hours, Joe is able to say to the nurse,‘do you know what actually things have really improved. I feel like I’m going to be fine, I don’t need any treatment.’
And that is just a common scenario that we would see with triage.
00:03:44 Speaker 2
Well, thanks Ruth for sharing that one. That really explains the benefits of early intervention and that by speaking with a triage service early on, the ‘Joes’ know exactly what to expect with their symptoms.
00:03:59 Speaker 4
So, someone is getting the right advice very quickly, so they’re being told what to expect. They’ve been given the tools to manage the injury from a first aid perspective really quickly and they’ve given the tools to do suitable duties at work and that leads to people just getting better quicker because they’re remaining at work.
And we know that people recover faster at work, so long as the work is suitable and come with that advice and reassurance and plan. They, people are unnecessarily over medicalized.
00:04:35 Speaker 2
So, we mentioned that the longer a person is off work due to injury, the less likely they are to return to work, do you have any statistics you can share on this?
00:04:47 Speaker 4
The Australian Faculty of Occupational Medicine detailed in 2011 a consensus statement on the health benefits of work, and essentially absence that perpetuates itself, so we know that 20 days of work, the chance of ever going back to work is 70%. And 45 days off work the chance of ever getting back to work. It’s 50% and 70 days off work – the chance of ever going back to work is 35%. So essentially, anyone that hits 20 days in a row off work, there’s a 30% chance of that individual will never work again.
00:05:26 Speaker 2
Right, well so why is it less likely they’ll return to work the longer they are off work?
00:05:34 Speaker 4
So essentially barriers start to appear as soon as an injured worker is off work, so they can take many different forms to physical, psychological, or even say their perception of how they’ve been treated.
00:05:48 Speaker 3
Yeah, absolutely. So, a practical example of this is if an employee sustains an injury at work and their employer doesn’t have an early intervention triage service where they’re able to report that injury early and receive that first aid advice and return to work advice. Then the employer is more likely to not report the injury so they go home for the day.
One day off creeps into two and then the employee decides that they need to see their GP because things aren’t getting better. So, they would prescribe you know potentially prescribed West and decide that yeah, the worker needs more time off work.
During the week off the employee experiences more pain and they’re not moving. They haven’t, you know, received necessarily the best advice and they start doing, you know, minimal things around the house and trying to avoid that pain. They also start avoiding doing, you know, their daily activities and cleaning and cooking and things that they need to absolutely do usually in the day. The employee thinks about their injury and their pain all the time. They’ve got nothing else on their mind, nothing to distract them. So that’s all they’re thinking about and you know one barrier leads to another and then they start to feel like ‘OK well, my employer hasn’t been contacted me. They don’t even care’. And you know, like Tom said, all of a sudden you have 20 plus days off work and you start to imagine yourself not getting back there, yeah.
00:07:16 Speaker 4
And so, if you think about, say, a work cover certificate, most states allow a doctor to issue up to two weeks as an initial certificate ‘unfit’ which is in my opinion, a very long period of time for someone who’s just had an injury to be given two weeks unfit. But let’s say they give that first certificate and then they’re off work for that period of two weeks and they’re in this scenario where their pain is perpetuating and they’re thinking about it. And then they go back to the doctor and get another two weeks. We’re at 20 days and 20 days means 30% of people will never work again.
So, this is where the early intervention programme gets in where we’re encouraging people to report their injuries within the first hour. They’re encouraged to remain at work. Uh, given the right advice and tools to stay there, and are given a key plan of action instead of unnecessarily going to see a Doctor who doesn’t understand those benefits of remaining at work.
00:08:09 Speaker 2
Thank you, thank you. And so, you work with businesses that have multi-site work forces such as mining.
How do you deliver an early intervention programme for injured workers in these circumstances?
00:08:24 Speaker 3
That’s a really good question, and we basically have a triage service and an early intervention physio service that uses our proprietary video technology. So that means that we can connect with the worker as soon as the injury occurs even if they’re in the most regional or remote locations across Australia, New Zealand as long as they’ve got a Wi-Fi connection then we can see them via video. So, you know on our videos are, you know doctors, nurses that are doing the triage on the early intervention. They’re trained in being able to deliver these services, and we were doing this even before COVID, you know it’s become a lot more of a common modality since COVID. But prior to that was where we had really embedded this service and it’s been successful, you know, even prior to that. And yeah, and really that just means that we can get not only to someone really quickly, it means they don’t have to travel to an appointment, they don’t have to sit in a surgery or clinic for a long period of time to wait for that when they get to be seen straight away and also, they’re not leaving the workplace.
So again, that kind of reinforces that benefit to stay at work.
You still going to get treated. You’re still going to get attention while staying there. And it means that we can support those businesses that have a huge geographical footprint. Or even you know, really remote locations. And we all know the challenges that come with them trying to receive health care services within those remote locations and this really just tackles that so it also just gives that single point of contact, and so it’s not like a business as it is having to try and find and refer to multiple different services.
Yeah, they’re just getting that through the one point of contact, and so businesses that do have that large geographical footprint are able to get a centralised point to report their injuries and then have a distributed network to be able to receive it back. The information is really useful for those injury management teams and Health and Safety Managers that do have to manage a large geographical area that might not have, say, Injury Management Advisors in every single location.
They find a lot easier to be able to have that 24/7 service that gives them the information back as the injuries occur.
00:10:43 Speaker 2
Thank you. So, with any triage programme is it important to provide the injured employee with the skills and knowledge to self-manage their injury?
00:10:53 Speaker 4
Yep, Sandy 100% . A triage program’s first goal should be to empower the employee and their managers to have the skills and confidence to be able to self-manage their injuries. I say Manager as well, as ultimately managers are the ones that will make and break a return to work programme. Being able to give an injured worker and their manager the skills and knowledge as well as confidence is a big part of it. A lot of managers without the reassurance that you know it is actually better for them to remain at work so long as the work is suitable empowers a manager to have and keep an injured worker at work as opposed to just sending them home and off on their way.
Our model is to have injuries reported to us within the first hour, so self-management is a big part of that because the injury has just happened. So, first aid advice and making sure that they are given that correct first aid advice so that they can manage it over the next 24 hour periods is key. There are going to be some injuries that require medical treatment or physiotherapy treatment and we’re not trying to underplay that at all. They might be a delayed report or the significance of the injury might need that but being able to ultimately get those injuries reported quickly and giving those people the skills and confidence to self-manage injuries with a follow up call after say 24 hours.
Once they’ve applied the strategies that we’ve recommended is really important so that we’re not up so that we’re not programmed, say the injury management early intervention programme is not unnecessarily sending, say, every single person with an injury off to see a doctor and getting those unnecessary scans and advice that you know it might be detrimental to their recovery.
00:12:39 Speaker 2
With advances in technology across the last few years, in part stemming from the pandemic, how is your technology helping with your early triage programmes.
00:12:49 Speaker 3
That’s yeah, so, like we mentioned before, I think the technology piece is something that we’re very familiar with in our early intervention Physio product. And so, our triage product is an extension of that. It’s the only one in the market that uses video technology for that initial triage. Everyone else will use just a telephone call, but we feel that by having that face to face more human contact that you’re going to be picking up different things.
You know, picking up subtle cues, not just that verbal report. People’s verbal reports as we know can vary drastically from you know ‘I’ll be right, but my arms hanging off’ and yeah, to the opposite, where they’re ‘I need to see a doctor’, but actually it’s a paper cut so you know having that extra medium really does increase the accuracy of the advice and the appropriate next steps.
00:13:48 Speaker 4
Yeah, it’s not so much relying on the articulation of saying the injured person who might have English as a second language and can’t really properly articulate the significance or how the injury really appears. So, to be able to see it through the video element and also photo technology is really helpful for actually giving the accurate advice to what the person really needs. We are using medical grade secure technology, which is, I think is really important in a lot of recent hacking that’s been going on.
00:14:31 Speaker 2
Yes, I’ve read that muscular skeletal injuries make up almost two thirds of all reported workplace injuries in Australia. What is your process to help manage this type of injury?
00:14:43 Speaker 3
Yeah, so musculoskeletal injuries can occur from many different mechanisms, so we’re talking sustained postures, repetitive movements, forceful movement, so heavy lifting or pushing, pulling, and there’s also vibration. And then there’s slips, trips and falls, and so the list goes on. Our triage products not only will address your musculoskeletal injuries, but there is also the medical element as well, so your lacerations and stings, bites, you know anything to concussion or pretty much any injury in the workplace. We are able to cover both sides of things. But when we’re talking about musculoskeletal injuries, we’re going to have access to physiotherapists on that triage call. So, you’re literally talking to the specialist in a musculoskeletal injury and when that’s the right person to answer that call and then you’ve got, you know, nursing staff that can cover that as well as the medical side of things as well. So, you’re going to be getting the best practise advice.
You’re going to get an education, and when you get on to our early intervention and Physio programme, you’re going to be getting that. You know education and exercise programmes. And best practise advice to manage that injury. So, we’re also going to be giving timely feedback to the workplace regarding what the best duties are for that person. So that really feeds into how to best manage your musculoskeletal injuries. Often you know what you should be doing for most of your day. There’s your treatment side of things, but there’s also what you should and shouldn’t be doing when it comes to the rest of the day. You know the tasks that I just have to perform because that’s where we get a lot of fear avoidant behaviour. When people don’t know that answer, they don’t know. What they should and shouldn’t be doing so they avoid everything and therefore that’s going to perpetuate the problem rather than getting that best practise advice.
00:16:40 Speaker 4
Biosymm being founded originally as an on-site physiotherapy business. What the triage product does and enables is Biosymm also has this early intervention Physio programme which is a tele-physio programme that’s been running since 2016 and has a large number of clients that are in a dispersed network. The triage product is able to triage someone so we’ve got someone got an injury. They’re being triaged. Then we identify they might benefit from some, say speaking with the physio, actually having a full appointment with the physio.
Given we’ve got two of those three services, they’re able to interact with each other, and we’re able to get someone really quickly from a triage into seeing a physio to get that advice and a more comprehensive assessment in suitable duties plan.
00:17:23 Speaker 2
Do you have any concluding thoughts to share before we wrap up the podcast?
00:17:29 Speaker 3
Yeah, so look I think in conclusion, best practise management of workplace injuries is really putting in place an early intervention type programme so that we would recommend is triage being immediately at the time of injury so that covers you know that first essential important hour when an injury occurs.
Because really, that’s where you’re going to get the best outcomes. And that’s going to assist in reducing those medical treatment costs and reducing your lost time and really ensuring that the injured worker gets back to work or stays at work, you know as soon as possible.
So, this is going to just lead to that better outcome and doesn’t necessarily need to go down the road of having a lot more stakeholders in the management of that person, it can really be sorted a lot more efficiently than that.
00:18:20 Speaker 4
Yeah, and so empowering managers and getting them involved in a triage call or having them be present for some sort of triage early intervention product is the key to a successful early intervention programme. They’re the ones that are going to make or break or return to work. Upskilling and educating a manager on how to support their employees after the injuries occurred is a key factor for success.
I think with the employers that have that dispersed network or really rural and remote locations, having that single point of contact is really key.
00:18:57 Speaker 3
You know you’re really making the most out of your own injury management team or person that looks after injury management within your business. If you’re having this approach where you’ve got a one stop shop, you know one single point of contact and they are the people that are organising your entire workforce so yeah, I think it’s really key from that point.
00:19:18 Speaker 4
Yeah, and also embracing technology, so being able to use programmes that have video photo recognition and also looking at the model of a triage programme.
Ensuring that if you were interested in a triage programme, one that has a follow-up model within it and is not essentially just a booking service is really important so that you’ve got someone who’s giving the advice, but then actually checking in on the people and then determining is it an appropriate pathway for them, or do they then need to go to somewhere like treatment?
00:19:47 Speaker 2
Great thank you. That is fantastic information. So, thank you again to Ruth and Tom from Biosymm for joining me today. If our listeners would like more information, please visit their website which is biosymm.com.
Also, if you would like to access our time podcast series, please head to Spotify plus we have links to each episode on ebm.com.au.
Thank you, Ruth and Tom.
