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Benefits Column

http://www.hreonline.com/HRE/images/CarolHarnett106x106.jpgReconstructing the Employee Experience

Last July, our benefits columnist gained firsthand knowledge of what it's like to move through the healthcare system after surviving being struck by a car. Here are a few of the lessons that accident taught her about the healthcare experience and what needs to change.

Monday, September 28, 2015
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About six weeks ago a car hit me as I was crossing the street at a green light. The driver, identifying himself as being from a ride-sharing service, said he never saw me as he made an illegal left-hand turn into the crosswalk.

On a personal level, it felt slightly like a self-fulfilling prophecy. I inherited my dad's great cardiovascular genes, so concerning myself with my blood pressure or cholesterol levels is a foreign concept. To make the people who know this about me feel better, I've always said: "While I probably won't die from a heart attack or stroke, there's always a bus somewhere with my name on it." Right concept, wrong vehicle.

On a professional level, even as firefighters and paramedics were treating me while I lay on the ground, I realized I was gaining firsthand experience on moving -- and often tumbling through -- the healthcare continuum. My understanding continued with the claim process, correcting diagnoses, advocating for myself, and managing how I would handle work in tandem with my recovery.

To meet the constraints of this column, I will highlight three lessons I took away as discussion points for HR, benefits, insurance, consulting, heathcare and vendor professionals to mull over. There are four other major takeaways, but I will save those for a keynote session I will be doing at the 2016 Health & Benefits Leadership Conference.  

Lesson One: Do you have someone you can call? Whether you've experienced a traumatic injury like I did or been given bad news about your health, medical professionals will often ask if you want someone with you. Having been the person dispensing bad news in another part of my life, I know we ask a patient, client or victim this question to bring emotional support to the person, while deflecting the messy realities of the situation away from ourselves.

In my case, my accident took place during the first day of a 12-day, multi-city business trip. I didn't really have anyone I could call in Portland, Ore. After having the question repeated to me half a dozen times while I was at the accident scene, I decided to text message the conference organizer and a friend I don't see very often who lived in the area.

While no clean answer exists as to how we can help an employee who is asked this question, there is emerging technology that might help someone. Wearsafe Labs recently used Kickstarter to release its “wearable personal safety button” designed to alert a trusted network you identify when you press it. As coincidence would have it, I supported Wearsafe's campaign prior to this accident and immediately realized how helpful this device would have been to me.

Lesson Two: What hospital do you want to go to? I had no idea. The paramedics pressed me over and over for an answer without much direction as to my options. 

Then I remembered the Leapfrog Group's hospital-safety-score app on my smartphone. I typed in Portland, Ore., and immediately received a list of six hospitals close to my location: three rated A and three rated C. Very proud of my newly-found-consumer-driven knowledge, I held up my phone to the EMTs and asked to go to the nearest A-rated hospital. They deemed it too far away. After some coaching from the firefighters, I “chose” the C-rated trauma center. Due to rush-hour traffic, it took more than one hour to drive the 2.3-mile distance to get there.

Hopefully, most of your employees will never find themselves in an emergency situation 2,994 miles from their homes, but there's a good chance they're not aware of their local hospitals' safety scores. Janet McNichol, the human resources director at Rockville, Md.-based American Speech-Hearing-Language Association, often says employees will travel farther to go to a good restaurant than they will to be treated at a good chemotherapy center. I believe McNichol's three-stage approach to getting her employees to the best-quality hospitals makes sense: First, educate and nudge them to use higher-quality hospitals; second, offer incentives, and third, eliminate the poor-quality hospitals from your network.

Lesson Three: Do you have any concerns? From the moment I landed on the ground to immediately before my discharge from the emergency department, I was asked this question. Many, many times I answered: "I have a headache of increasing intensity." Each time, the medical professional asked if I hit my head. I honestly didn't remember. Each time, I was told with a wave of the hand that it was most likely a tension headache related to being struck by a car. I probably should have asked to see the hospital's patient advocate, but I didn't recall that option at the time.

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The two airline flights home three days later drove my headache from a three on a scale of zero to 10 to nine. My primary-care physician diagnosed me with post-concussion syndrome, which impacted my ability to work, socialize and function more than my physical injuries. Most of you are well aware of concussions in youth, college and professional athletes. This injury more often occurs outside this group and is even more likely to be dismissed.

In my situation, I had to push the claim examiner to allow my physician to further evaluate my headache because my ED discharge papers did not list that complaint.

My message for HR leaders is this. Initial diagnoses are often that -- initial. I've looked at workers' compensation, disability and health-claim data throughout my career and witnessed initial diagnoses eventually updated about 50 percent of the time. Too often, however, workers remain under care related to their first assessment far too long. Most employees don't understand that. We need to find a better way to speed up the re-evaluation process.

The rest of my story has elements that are fairly typical for most employees. They involve navigating the insurance matrix (in my case, auto, workers' compensation and health), figuring out how to get the treatment I needed, trying to work (even when I was on concussion protocol) and dealing with calls from the ride-sharing service. Well, that last one is probably not routine.

Let me leave you with this one challenge that still hangs with me.

The first week after my accident, everyone was incredibly supportive. It's not that people became less caring after that. The simple reality is most people want you back in their lives in the role you normally play after about seven days. They're not bad people; it's simply human nature. I witnessed this in the past with thousands of patients, clients and claimants.

So, as HR executives, keep the words of my former colleague, Steve Clark, in mind: "You are in an honorable and important profession. But with honor comes responsibility. So, please always be mindful that I am the voice on the phone, the name on the list, the error on the exception report or the statistic in the report -- and what I need is for you to help me cope."

Carol Harnett is a widely respected consultant, speaker, writer and trendspotter in the fields of employee benefits, health and productivity management, health and performance innovation, and value-based health. Follow her on Twitter via @carolharnett and on her video blog, The Work.Love.Play.Daily.

 

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