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General – Page 9 – WorkCare

WorkCare

Category: General

  • Meeting Multigenerational Needs of Industrial Athletes

    While preparing for our webinar on Ergonomics and Total Worker Health for Industrial Athletes, we reflected on why we don’t often see these terms seamlessly interwoven.

    Ergonomics is both a science and an art. It involves educating employees about physiology, injury prevention and how to manage physical discomfort. It also covers factors such as adjusting tools, tasks and workstations to fit the individual, in turn reducing the likelihood of musculoskeletal disorders (MSDs) caused by repetitive stress and overuse.

    Total worker health takes many forms in the workplace. The National Institute for Occupational Safety and Health’s Total Worker Health® Program uses this definition: “Policies, programs and practices that integrate protection from work-related safety and health hazards with promotion of injury and illness prevention efforts to advance worker well-being.” It involves designing work and employment conditions to prioritize safety and improve physical and psychological outcomes. This may include sleep hygiene, stress management, hydration and nutrition, and personal physical fitness.

    The term industrial athlete typically refers to workers who can benefit from coaching to help them adapt to physically demanding or repetitive jobs. This may include obtaining athletic trainer-style guidance to prevent injury or recover from strains, sprains and other types of MSDs.

    Reducing Risk

    This raises two important questions:

    • How do supervisors, safety leaders and/or fellow employees perceive MSD risk factors?
    • In addition to ergonomics, what other factors play a role in musculoskeletal health?

    There are five major ergonomic risk factors: force, frequency, posture, vibration and contact stresses. Training on stretching and proper postures, handling material and tools, and working safely in enclosed spaces or extreme temperatures are examples of ways to mitigate these risks.

    This is where ergonomics and total worker health intersect with industrial athletes. It takes skilled practitioners and a multi-disciplinary team to successfully merge these concepts and develop strategic partnerships to make a difference in people’s lives.

    In sports, children and adults are often assigned to age categories to help “level the playing field” and make competition fair. Similarly, ergonomic and total worker health interventions must be adapted to the needs of multigenerational employee populations. Age, gender, physical conditioning, cultural and behavioral norms, communication style and comfort level with the use of technology all must be taken into consideration.

    MSDs do not have to be accepted as part of life and a cost of doing business. Ergonomics, total worker health and multigenerational interventions for industrial athletes create opportunities for positive personal change by employees and allow employers to support their health and well-being over the long term.

    Click here to access the webinar recording.

  • 3 Heat Stress Prevention Steps for Regular People

    By John Longphre, M.D., M.P.H.

    As the temperature rises in the summertime, so do employer concerns about heat stress prevention.

    I was asked to review an overly complex heat-stress plan that a client was trying to implement. It had all sorts of data, urinalysis charts, instructions for co-worker hydration teams, and so on. It did NOT include anything about the heat-battery effect or the need for salt replacement, which are fundamental considerations.

    I recommend taking a simple, three-pronged approach, which I call Heat Stress Prevention for Regular People.

    Dehydration (water loss)

    People tend to focus on hydration at the expense of other important factors. This is what you need to know:

    • Urine volume: In an intensive care setting, the fluid status of a patient is checked to measure hydration. The average adult male should make about 100cc (or mL) of urine per hour, and an average female slightly less.  A beer can contains just over 300cc of fluid. A hydrated man should be able to fill a beer can with urine every three hours.
    • Being thirsty: Thirst is a lagging indicator. If an employee feels thirsty, he or she is already a quart (or so) too low. Employees should continuously top off their tanks with fluid to replenish the supply they are losing throughout the workday.

    Heat-Battery Effect

    Imagine a 10-pound steel cannonball heated to 150°F. Now imagine 10 pounds of thin sheet steel, also heated to 150°F.  They weigh the same. Which one will retain heat the longest? Correct! The fat little cannonball will have a harder time expelling heat. (Technically, the “surface-area-to-volume ratio” is smaller for the cannonball.) The thin sheet steel has a larger surface area from which to radiate heat. Similarly, people who are overweight or obese have a harder time getting rid of excess heat than do thinner people.

    In extremely hot and humid environments, I advise employees to occasionally immerse both their arms (or legs, or even their whole body) in chilled water to cool their blood. When cooled blood circulates, it helps lower body temperature. Think of an air-cooled engine versus a liquid-cooled engine. We instinctively know it takes a lot longer for a box fan blowing air to cool someone off than it does to simply jump into a swimming hole. Employees can be given circulating-liquid-based cooling (arm) sleeves to wear if providing cold buckets of water onsite is not a practical solution.

    Salt Loss

    The amount of salt lost when people sweat is often underestimated. Sweating helps cool the body. Fluids and electrolytes (including sodium, potassium and magnesium) lost from sweating must be replaced to prevent chemical imbalances that can diminish physical and mental performance. The body uses sodium to regulate fluids and support the heart, liver and kidneys. Potassium and magnesium help prevent cramps.

    In addition to drinking water, many people rely on beverages advertised as sports drinks to replace fluids and electrolytes. Most of these beverages are high in sodium and sugar (primarily for taste) and low in potassium, although a few products are high in potassium, low in sodium and generally have little to no sugar. Check the labels on various products for contents and calories. I recommend alternating between high-sodium and high-potassium drinks. In large quantities, high-potassium drinks can be harmful, but alternating them with high-sodium drinks is healthy and safe.

    It’s easy to make a salt-replacement drink that is zero-carb (i.e., no sugar) by adding 1-2 salt tablets or dissolving one-eighth to one-fourth teaspoon of table salt in 300-500 mL of a preferred beverage. Water mixed with fruit juice or frozen fruit slices is a popular option.

    Bouillon broth and salty snacks are also handy to have on hand when doing physically demanding jobs in hot environments. It’s also important to note that while bananas contain potassium, they are high in sugar, so they are not the ideal food for potassium replacement in high-heat situations.

    In review, although we tend to focus on dehydration, please don’t neglect the heat-battery effect and the need for salt replacements.

    Dr. John Longphre is Senior Vice President at WorkCare.

     

  • Unpacking the Employee Marijuana Use Dilemma

    The complex web of laws regulating marijuana use makes it challenging for U.S. employers to balance workplace health and safety policies with employees’ rights.

    If you are entangled, we recommend that you register for WorkCare’s free webinar on Marijuana in the Workplace: Clinical & Regulatory Update. This timely webinar, scheduled for June 23 at 1 p.m. EDT/10 a.m. PDT, will be presented by Jeffrey Jacobs, M.D., M.P.H., vice president of WorkCare’s Medical Exams & Travel division (which includes drug and alcohol screening programs) and a certified Medical Review Officer.

    Surveys show demand has increased during the COVID-19 pandemic, with 30 percent of consumers shopping for cannabis products more often, and 25 percent of respondents saying their use increased in the past 15 months.

    CBD and THC

    Among topics on the agenda, Dr. Jacobs will discuss differences between cannabidiol (CBD) and tetrahydrocannabinol (THC) to help shed light on physical and mental health effects and impairment risks at work.

    CBD and THC are cannabinoids that interact with the neurotransmitters in the brain that influence pain, the immune system, stress reactions, sleep quality and other critical functions. In some cases, employees depend on medical marijuana to be fully functional and present at work.

    CBD is extracted from hemp or cannabis. CBD is a primary ingredient in medications prescribed for seizure disorders, and it is contained in medicinal gels, gummies, oils, supplements and extracts. It is commonly used to help relieve anxiety and different types of pain. Research is being conducted on the use of CBD oil to treat neuro-degenerative diseases such as Alzheimer’s and Parkinson’s.

    THC is the main psychoactive compound in cannabis that produces a high. It is frequently consumed by smoking marijuana, and it is also available in oils, edibles, tinctures, capsules and other products. People who take CBD-dominant medical products will not get the high that is experienced when consuming products containing THC. (Legal hemp contains 0.3 percent or less of THC.) Some products have both CBD and THC.

    For employers, temporary side effects are a cause for concern. An employee who has recently consumed THC may experience slower than average response times, a general feeling of being high, memory lapses, loss of coordination and increased heart rate. Side effects associated with CBD include drowsiness, fatigue and potential interactions with other medications, although CBD products are usually well-tolerated.

    State vs. Federal Regulations

    Dr. Jacobs will also talk about how the patchwork of state and local marijuana use laws contradicts the federal Controlled Substances Act (CSA), and why it’s important for employers to consider the big picture when reviewing and refining workplace policies – especially if they have multistate operations. He says there are a number of ways to protect employee health and safety without violating employees’ rights, including Drug-free Workplace and other zero-tolerance programs, but the variability in applicable laws makes it wise for employers to get legal guidance.

    For example, medical or recreational products approved for use by a state often fall within the CSA’s definition of marijuana and are listed as Schedule I drugs subject to stringent federal regulatory controls. The CSA aims to protect public health while ensuring patients have access to controlled pharmaceuticals prescribed for medical conditions. (Refer to State Marijuana “Legalization” and Federal Drug Law: A Brief Overview for Congress by the Congressional Research Service, a non-partisan entity under the direction of Congress.)

    Job Protections

    Some states provide job protections for registered medical marijuana patients and/or recreational users, including rules to prevent employment discrimination. In jurisdictions where off-duty recreational cannabis use is protected, attorneys say employers may legally prohibit workers from being under the influence on the job, but they have to specifically define “under the influence” and determine how to test for the presence of THC to enforce that policy.

    According to Dr. Jacobs, while hair, saliva, urine and blood testing can detect recent use, there is not a widely accepted test to detect cannabis intoxication in real-time, making it difficult to evaluate potential impairment in the event of a work-related accident or injury. In addition, training is needed for supervisors and managers who are expected to act on reasonable suspicion.

    WorkCare clients and other employers have so many questions around these issues that Dr. Jacobs has offered to extend the webinar from 60 to 90 minutes for those who want to remain on Zoom for an expanded Q&A period after his formal presentation. Don’t miss it!

  • The Future Workplace: Realistic Mobile Device Policies

    This is the third part of a periodic series on The Future Workplace.

    Employers and workers depend on technology to stay connected and thrive in the global marketplace. This dependence highlights the need for realistic, forward-thinking company policies on the use of smartphones and other hand-held devices.

    Ubiquitous Devices

    The Pew Research Center reports that an estimated 97 percent of Americans own some type of cell phone; smartphone use increased from 35 to 85 percent in the past 10 years. About 75 percent of U.S. adults own a desktop or laptop computer and roughly half own a tablet computer.

    Pew surveys also show 15 percent of American adults are smartphone-only internet users and do not have home broadband service. Reliance on smartphones for online access is especially common among younger adults, lower-income Americans and those with a high school education or less – populations that have been shown to have a higher-than-average risk for work-related injuries, partly due to the nature of work they often do.

    Adaptation Required

    With most employees using mobile phones – and many of them seemingly addicted to their features – employers need a written policy that explains why and when use is allowed or prohibited. The policy should establish accountability and help shape safe work practices. Consequences for non-compliance should be clearly stated. Here are some issues to consider in the context of occupational health and safety:

    • Ensuring privacy and security for organizations and people
    • Monitoring time spent on devices to enhance productivity and limit distractions
    • Using apps for time-of-need safety training and/or health coaching
    • Accessing devices while driving or operating equipment
    • Receiving company announcements and other news
    • Staying connected in emergency situations or when working alone
    • Allowing employees to disconnect and get needed “downtime”

    Recommendations

    Indeed.com reminds us that there are four basic reasons for having a mobile device policy: safety, customer service, productivity and security. Many employees use mobile phones for work-related tasks. In some instances, the company may reimburse employees who use personal devices for business reasons.

    Employees should be expected to practice common courtesy, such as silencing phones during meetings and limiting personal use to break times or for urgent matters. The Society for Human Resource Management (SHRM) says personal use of a company-owned or personal cell phone should be limited while working. Other recommendations include:

    • Requiring employees to follow applicable local, state and federal laws and regulations. Employees may be held personally liable for incidents related to the use of devices while driving.
    • Expecting employees with  company-owned cell phones to protect equipment from loss, damage or theft; an employee may be asked to produce a mobile phone for return or inspection at any time.
    • Requesting permission from management to use a camera, video or audio recording capabilities while on company premises.

    The Occupational Health and Safety Administration (OSHA) offers these suggestions for companies that employ drivers:

    • Prohibit texting while driving and label vehicles as text-free zones
    • Do not have work procedures or duties that require texting while driving
    • Require drivers to stop in a safe place while on the phone
    • Remove incentives or systems that encourage cell phone use while driving

    In high-hazard environments with safety-sensitive positions, a uniform policy focused on decreasing distractions that lead to accidents is appropriate. However, a less restrictive policy may be suitable for office staff or a sales team that travels. A reasonable, enforceable policy ultimately depends on the needs of the company, its employees, and the types of jobs they do now and will be expected to do in the future.

    Here are some additional helpful resources:

  • Cowards Need Not Apply

    Cowards Need Not Apply

    Courage appears to be a critical managerial trait that is not recognized as often as it should be, especially when employee health and safety is at stake.

    The American Psychological Association defines courage as the ability to meet a difficult challenge despite the physical, psychological or moral risks involved in doing so.

    In a recent Gallup survey, managers reported that they work an average of four hours more per week than non-managers and have a lot on their plate. While they may feel resentful about their work load, they also want to be well-liked by their colleagues. Consequently, employees who report to “low-courage” managers wait for hard decisions to be made so they can successfully complete tasks and senior executives assume everything is running smoothly.

    According to Gallup, one of the most noticeable attributes of a low-courage manager is a tendency to tailor assignments, objectives and overall communication to an audience based on what they believe others want to hear – not what is best for an individual or the organization as a whole.

    With COVID-19 dramatically changing the work landscape, experts say the time has never been more urgent to identify low-courage managers, offer them supervisorial training or find a role that is a better fit for them. Otherwise, employees may be exposed to potentially risky or non-productive situations that have not been adequately addressed.

    What Can You Do?

    Bill Treasurer, author of Courage Goes to Work, suggests promoting a workplace culture that encourages managers to go outside their comfort zone. He also recommends speaking up and doing less people-pleasing, a skill that takes consistent practice.

    He breaks aspects of courage into three parts:

    1. Try Courage: Courage is often needed when attempting something for the first time or after a significant failure.
    2. Trust Courage: Having faith in courage is helpful when delegating, following someone’s lead or being trustworthy.
    3. Tell Courage: Courage involves overcoming fears when giving directions, being more assertive or admitting a mistake.

    To begin the process of checking where one falls on the courage scale, the Harvard Business Review suggests asking these questions:

    • What does success look like in this high-risk situation?
    • Is it obtainable?
    • If my primary goal is organizational, does it defend or advance my company’s or team’s principles and values?
    • If my primary goal is personal, does it derive solely from my career ambitions or also from a desire for my organization’s or even society’s greater good?
    • If I can’t meet my primary goal, what is my secondary goal?

    Courage is not the absence of fear but the ability to move forward in spite of it. Identifying an end goal can help a manager assess messages that need to be conveyed and to whom. In turn, this helps build confidence and generate positive outcomes.

    To truly advance the goals and values of an organization, managers should be supported when practicing courage by scheduling difficult conversations, accepting challenging assignments, and being honest with themselves and others about their limitations.

  • Avoid Injury After a Break from Physical Activity

    Avoid Injury After a Break from Physical Activity

    As segments of the country reopen during the COVID-19 pandemic, many employees are returning to physically demanding jobs, gyms and group sports activities after taking a break from their usual work and fitness routines.

    There are ways for them to ease back into physical activity and reduce injury risk.

    Normally active men and women who have been sheltering in place are likely to notice signs of physical deconditioning, such as declines in their cardiovascular fitness, muscle strength and tone.  Physical inactivity also lowers mood and energy levels because rigorous exercise induces positive chemical reactions at the cellular level.

    When not exercising, the average adult loses 1-3 percent of muscle strength per day, with noticeable strength loss occurring within three weeks. A break from aerobic exercise is apparent with an increase in resting heart rate – four to 12 beats per minute higher a month. Meanwhile, after a month of cardio inactivity, maximal oxygen (VO2) gains achieved in the past two months are lost. (Vo2 is used to measure the amount of oxygen a person uses during intense exercise and assess energy production levels at the cellular level.)

    Slower metabolism and burning fewer calories may also lead to unhealthy weight gain. Did you know that for every extra pound gained, four pounds of pressure are exerted on the knees?

    Injury Prevention

    Bryan Reich, a certified athletic trainer and director of WorkCare’s Industrial Athlete Program, recommends the following to reduce employees’ injury risk after a hiatus:

    1. Allow time for reconditioning. Don’t expect endurance levels to be the same as they were at the beginning of the pandemic when workplace and workout routines were disrupted. Allow employees to start slowly and build back up.
    2. Remind employees to warm up and gently stretch before doing any physical activity, and cool down and stretch afterward.
    3. Evaluate levels of exertion required for certain activities and job functions. As feasible, adjust expectations until conditioning is restored.
    4. If job rotation is an option, use it to switch off between strenuous and less strenuous tasks. This principle also applies to fitness activities such as weight training and contact sports.
    5. Eat a nutritious diet, stay well-hydrated (drink half your body weight in ounces of water per day) and get quality sleep to boost your immune system and stay healthy.
    6. Advise employees to get professional advice if they want to start a new exercise program, reduce their caloric intake and lose some weight, or feel anxious or depressed.

    Remember, while there may be a temporary decline in performance compared to previous fitness levels, there is risk of injury caused by expecting someone to do too much too soon.

  • Workplace Safety Index Provides Injury Management Insights

    Workplace Safety Index Provides Injury Management Insights

    Liberty Mutual Insurance publishes an annual Workplace Safety Index on the top causes of disabling work-related injuries and their costs to employers, which exceed $1 billion per week.

    Year after year, the index is an indicator of injuries that could have been prevented or managed early to reduce cost burdens and the likelihood of disability and poor quality of life.

    The newly released 2020 index is based on 2017 data from three sources: Liberty Mutual, the U.S. Bureau of Labor Statistics and the National Academy of Social Insurance. The index ranks events by total workers’ compensation costs, including medical and lost-wage payments. Related reports examine data in eight industries: construction, health care and social services, hospitality and leisure, manufacturing, professional services, retail, transportation and warehousing, and wholesale.

    The index highlights the top 10 causes of the most serious injuries – those that cause employees to miss more than five days of work. Disabling workplace injuries cost U.S. businesses more than $59 billion per year. The top 10 causes of injuries are associated with $52.93 billion in costs. Combined, the top five causes cost about $41 billion per year.

    While the index focuses on employer costs, dollars spent also represent ways in which injuries impact workers’ physical, mental and socio-economic well-being.

    Leading Causes

    The leading causes of injuries offer useful insights for workplace accident and injury prevention measures. It’s notable that they are the same as 2019 and only slightly different from 2018. Here are the top five on the 2020 index:

    1. Overexertion involving outside sources (handling objects): This includes lifting, pushing, pulling, holding or carrying objects. Overexertion accounted for about 23.5 percent of all workplace injuries at an estimated annual cost of $13.98 billion.
    2. Falls on the same level: A serious injury can occur even by tripping on a cord or box or slipping on an uneven or slick surface. These falls account for 18.2 percent of disabling injuries and cost $10.84 billion a year.
    3. Being struck by an object or equipment: These incidents account for 10.3 percent of all injuries at a cost of $6.12 billion.
    4. Falls to a lower level: Falls on stairs and from heights account for 9.6 percent of total injuries and cost U.S. businesses an estimated $5.71 billion a year.
    5. Other exertions or bodily reactions: This includes activities like bending, reaching, crawling, kneeling, sitting, walking and running. Other exertions comprise 7.9 percent of the total injury burden at a cost of $4.69 billion per year.

    Roadway incidents (vehicle crashes), slips and trips without falling, repetitive motion involving microtasks, colliding with objects or equipment, and being caught or compressed in an object or equipment complete the top-10 list.

    Recommended Interventions

    At WorkCare, we help employers investigate causes of injuries so they can take steps to prevent them. For example, our Bio-Ergonomic Surveillance Program uses wearable sensor technology to detect “hot spots” for injury risk while employees do their jobs. Findings from these assessments can be used to modify specific tasks to reduce injury risk for individuals or across an entire enterprise.

    Our Industrial Athlete Program features certified athletic trainers trained as injury prevention specialists who are available onsite and virtually to coach employees on pre-work stretching, conditioning and exercises based on their condition.

    In addition, our Incident Intervention Program provides 24/7 telehealth triage to connect a worker at the onset of a non-emergency, work-related injury with occupational physicians and nurses who provide care guidance. Many injuries can be safely handled at the first-aid level. Immediate reporting and prompt intervention are been repeatedly shown to improve both health and business outcomes. We also help employers manage required medical surveillance exams and provide onsite clinical personnel to manage the health of employees year-round.

    Combined, these efforts help move the needle in the right direction.

  • What’s Up With Super Bowl Monday Blahs?

    What’s Up With Super Bowl Monday Blahs?

    A petition started by a New York teenager on Change.org asking the National Football League to move the 2021 Super Bowl from Sunday to Saturday, potentially with an earlier start time, now has more than 70,000 signatures.

    Arguments in favor of this proposal include economic benefits, giving kids a chance to see more of the game before bedtime and fewer work absences due to the “hangover effect.”

    High work absence rates on Super Bowl Monday (“Smunday”) are a cultural phenomenon. Here are some examples:

    • The 2020 Super Bowl Fever Survey commissioned by The Workforce Institute at Kronos Incorporated and conducted by The Harris Poll estimates that 17.5 million employed U.S. adults may miss work on Feb. 3, a record number since the institute began tracking absences in 2005.
    • About 11.1 million employees are expected to take approved time-off, allowing their employers to make scheduling adjustments. Investigators say that leaves about 4.7 million who will call in sick, 1.5 million who just won’t show up, and nearly 8 million who are going to wait and see how they feel.
    • Nearly a quarter of business professionals (23 percent) surveyed think Monday after the Super Bowl should be a national holiday, according to a Captivate Office Pulse study of 360 U.S. white-collar employees. In addition, 14 percent of respondents said they expect to be hung over or “extra tired;” among younger workers it was 26 percent. Captivate estimates companies lost $484 million in productivity on Super Bowl Monday last year.
    • Fox Sports, which is broadcasting the game, is offering viewers the chance to win a $10,000 bonus by taking off Monday and then tweeting #SuperMonday.

    Based on the Workforce Institute’s findings, executive coaching firm Challenger, Gray & Christmas, Inc., estimates this year’s Super Bowl could cost employers over $5.1 billion in lost productivity during Super Bowl week through post-game Monday. This includes costs associated with lost days, game-related sideline conversations while on the clock, and arriving late or leaving work early.

    Are Reported Injuries Lower?

    Naturally, our curiosity was piqued. At WorkCare we wondered if fewer work-related injuries were reported on the day after the Super Bowl because there are less people at work. So, the WorkCare analytics team checked the number of injuries reported to WorkCare’s Incident Intervention 24/7 telehealth triage center on Super Bowl Monday in comparison to non-holiday Mondays in January and February over a seven-year period (2013 to 2019). No significant difference was found.

    This inquiry leaves us to speculate about the reasons: Perhaps employees who watched the game are more susceptible to injury because they lost sleep or are recovering from celebratory over-indulgence. Some employees may push themselves to compensate for absent colleagues, or they may have worked hard on Sunday and are tired out from serving or filling in for football fans.

    Employers may want to consider conducting their own investigations to determine exactly how many and what types of employees show up for work on Monday, and for developing .interventions to reduce potentially negative consequences.

    The Super Bowl is an American institution that presents some unique challenges for employers, reminding us of the need for year-round injury prevention and absence management strategies that take into account company culture and workforce diversity. A solid game plan will likely help improve business results, employee morale and health outcomes.

  • In Recognition of Labor Day

    In Recognition of Labor Day

    On Labor Day, we invite you to join WorkCare in deep reflection on the importance of protecting and promoting the health of the employees we depend on to sustain our businesses, families and communities across the country.

    We are currently experiencing – and anticipating a growing emphasis on – the implementation of Total Worker Health programs.that address physical and mental health aspects of employee fitness on and off the job. In essence, the customary pledge to send employees home in the same condition in which they arrived at work is undergoing re-examination.

    Employees who are tired, have chronic diseases, are depressed or anxious, have drug and alcohol addictions, or who are in pain tend to be less productive and have higher rates of accidents and injuries than those who are not. Conversely, those who make healthy lifestyle choices such as getting regular exercise, eating nutritious foods, sleeping seven to nine hours a night, and not smoking benefit from being in a workplace that supports their goals. Consequently, the “whole person” approach to employee health management is gaining momentum.

    The Centers for Disease Control and Prevention and National Institute for Occupational Safety and Health promote programs that combine health protection with health promotion. An understanding of both physical and mental health aspects of health and how to best manage them is required.

    We believe astute employers will be investing in technological solutions, including artificial intelligence, to help identify and mitigate injury and illness risk to control their costs while improving quality of life for employees. Primary, secondary and tertiary interventions that span the care continuum can be customized to meet specific needs, such as those of older employees or people with chronic diseases or pain that impairs function.

    The goal is to reduce exposure risk and protect employees from harm with effective preventive strategies. When an injury or illness occurs, it’s important to intervene in a way that decreases the likelihood of an individual getting sucked into the vortex of avoidable disability.

    Work-related disability is often not medically justified, yet it is a relatively frequent occurrence. Unnecessary lost work time costs employers millions of dollars each year while simultaneously setting workers back financially, socially, psychologically and physically.

    The evidence clearly shows that most injured employees get better faster if they keep working through their recovery period. Data show that injured or ill employees who never lose time from work have better long-term outcomes than those who do. For those who miss work, the odds for a return to full employment after six months of absence because of a work-related disability are less than 50 percent.

    The fast-paced, rapidly changing workplace presents a complex set of demands that requires employers to take innovative approaches to employee health management in conjunction with proven environment, health and safety (EH&S) programs.

    Employers have the power to promote healthy lifestyle choices and influence change in human behavior. In the workplace, there are daily opportunities to educate and incentivize employees in ways that encourage them to take responsibility for their own health. To engage and empower employees as health care consumers, experts say employers must implement innovative technology and communication strategies that interface seamlessly with vendor resources across the care continuum.

  • Telemedicine is When Technology Touches You

    Telemedicine is When Technology Touches You

    A general sense of ambivalence surrounds the use of telemedicine. There is a perception that a meaningful physician-patient relationship cannot be developed when the physician doesn’t physically touch the person in need of care.

    According to some experts, communications technology, in general, is impeding human connection. For example, in her book Alone Together, sociologist Sherry Turkle correlates our technologically networked society with the decline of empathy and relationship. Touch is believed to be integral to forming associations, and it has been found to have healing properties when used with the deliberate intent to impart warmth, understanding and compassion.

    Health care delivery today is less deliberate and more distracted than it once was, regardless of whether touch is part of an encounter. We have evidence that physician-patient partnerships are not being actualized, and that healing is impaired as a result.

    Oxytocin and Human Connection

    I believe that telemedicine can help bridge the gap between patient and physician, and restore healing to the practice of medicine. Oxytocin is a key contributor to the formulation of human connection.

    Oxytocin is a neurotransmitter that functions in our internal calm-and-connect system. This system works in opposition to the fight-or-flight response that is triggered in times of stress, including injury and illness. Oxytocin levels increase when we are gently or lovingly touched by a person with whom we intend to affect a connection. It has been widely studied in bonding between mother and infant, and it is often referred to as the “cuddle hormone.”

    Activation of the calm-and-connect system is important to the practice of medicine because it moves people toward a state of relaxation, receptivity and healing.

    Making Eye Contact

    Intentional touch is not the only trigger for the release of oxytocin. According to Dr. Kerstin Uvas, author of The Oxytocin Factor, eye contact has the same physiologic effect as touch. Mutual gaze has been found to be as important as physical touch in mother-child bonding.

    Researchers typically study these correlations indirectly by introducing the hormone oxytocin as an exogenous substance because it is nearly impossible to study the release of the neurotransmitter within tissues of the human body. Studies in which men have been given oxytocin suggest the extended length of eye contact and increased amounts of oxytocin are directly correlated.

    Eye contact can also help build alliances because it signals to the receiver that the speaker is available and confident. It is difficult to lie about our emotions from the nose up; the eyes are typically a “tell” for insincerity or lying, or for authentic empathy, compassion, interest and intent. Direct and brief eye contact attunes the brain to a mode that encourages interaction between people. The amount of eye contact someone receives during a conversation has been shown to be directly proportional to the amount he or she will engage in discussion.

    Because eye contact is just as important to building an alliance and communicating empathy as a physical touch, it is a meaningful substitute for creating a partnership in the physician-patient relationship. The use of tele-video is an adaptation of technology in a way that propels meaningful exchange forward.

    Rather than being distracted by an electronic medical record on a laptop in the treatment room, the telemedicine physician is able to make eye contact with the patient, creating an atmosphere of receptivity despite the virtual connection. In this way, all of the benefits of eye-contact can be fully realized by a physician who is adequately trained in the art of empathic communication: There is a forging of alliance, an exchange of information, an increase in the receptivity and interaction of the patient, and adherence to treatment plans and overall improved outcomes.

    Telemedicine physicians touch patients – not physically but meaningfully and directly. In this way, telemedicine is improving the practice of medicine.