Follow directions carefully with at-home health tests

Following instructions a lifesaver
Following instructions a lifesaver

From the Los Angeles Times, August 31, 2009

At-home test kits adhere to the same basic formula. For collection kits, patients apply blood, saliva, stool samples or bodily secretions to a paper or swab included in a kit. The specimen is sealed in a container and the packet is mailed to the lab noted on the outside of the package. Lab results are sent either directly to the patient (depending on respective state law) or in some cases, to a healthcare provider.

In California, only results of cholesterol, pregnancy, fecal occult, glucose and over-the-counter HIV-collection tests can be given directly to patients; other tests must go through a healthcare practitioner. About half the nation’s states allow labs to send results to patients.

Although health insurance companies don’t pay for over-the-counter home-health tests (unless a physician orders them or sends one home with a patient as with fecal occult tests), consumers can use flex-spending account money to pay for them. Prescription drug treatments are paid for by insurance. The cost for the tests ranges from about $13 (cholesterol, urinary tract infection kits) to about $48 (HIV collection kit and test).

The simplest tests use chemical-reaction strips such as those found in urinary tract infection tests — and the results are almost immediately available. In that example, the strips turn a certain color within minutes if nitrites and leukocytes (white blood cells) are present in urine; for treatment, the patient must then contact a doctor for a follow-up appointment.

But test results, even from an FDA-approved home test, should not always be considered a definitive diagnosis. Continue reading Follow directions carefully with at-home health tests

Fall Down Go Boom, Still #1

Falling Still the #1 Injury
Falling on ASSE list

Workplace Safety Addressed with Fall Reduction Standards by ASSE

Republished with permission from

As slips, trips and falls continue to represent significant exposures and hazards driving costs up in the workplace, the ASSE announced the approval of three new fall protection standards by the American National Standards Institute (ANSI), aimed at preventing these workplace hazards.

Of the 5,657 fatal on-the-job injuries occurring in 2007, 847 were attributed to falls according to the Bureau of Labor Statistics (BLS)

The ASSE standards (effective November 16, 2009) aimed at preventing injuries and death due to falls are:

1.  “Specification and Design Requirements for Active Fall Protection Systems” (ANSI/ASSE Z359.6-2009).
Specifies requirements for the design and performance of complete active fall-protection systems, including travel-restraint and vertical horizontal fall-arrest systems.
2.  “Connecting Components for Personal Fall Arrest Systems” (ANSI/ASSE Z359.12-2009).
Establishes requirements for the performance, design, marking, qualification, test methods and removal from service connectors.
3.  “Personal Energy Absorbers and Energy Absorbing Lanyards” (ANSI/ASSE Z359.13-2009).
Requires all energy-absorbing lanyards and personal energy absorbers to reduce the forces implied on the user to less than 10 times the normal gravitational pull of the earth. In addition, users of energy absorbing lanyards must weigh within the range of 130 to 310 pounds (59 – 140 kg).
Continue reading Fall Down Go Boom, Still #1

Obesity a Crushing Weight on U.S.Health Care

Obesity Weighs Heavy on Health Care System
Obesity Weighs Heavy on Health Care System

Carolyn Lochhead, Chronicle Washington Bureau

Obesity is the elephant in the room of health care reform, a public health catastrophe that kills more than 100,000 Americans a year, cost the nation $147 billion last year and threatens to shorten U.S. life expectancy for the first time since the Civil War.

Whatever Washington does this year to reduce medical spending seems likely to be swamped by the nation’s rising weight. Obesity lurks behind the top chronic illnesses – heart disease, diabetes, stroke, and colon, breast and prostate cancers, among many others – whose treatments routinely cost hundreds of thousands of dollars.

One of every three Americans, and one of every four Californians, is obese and rates are rising at an alarming pace, particularly among children, experts say.

“Rising obesity rates are increasing health care expenditures per person in a way that is going to be very difficult to finance,” said Jay Bhattacharya, a doctor and health economist at Stanford University’s Center for Primary Care and Outcomes Research.

“Unless there is some vast improvement in the efficiency of the health care system – and I mean vast – we’re going to be spending a lot more just because a lot more people will have diabetes” and other obesity-related diseases, he said.

Obesity is all but impossible to treat. Prevention is the only cure. Yet while health care legislation in Congress would increase spending on prevention of chronic disease, it does\

little to tackle the underlying obesity epidemic directly. Most of the bills are silent on what many health experts contend would be one of the most effective weapons: a tax on soda. Continue reading Obesity a Crushing Weight on U.S.Health Care

House Call is a Home Page?

Increased use of online health help
Increased use of online health help

Web Is Becoming One-Stop Shopping for Health Help
By Dennis Thompson – HealthDay Reporter

SUNDAY, Aug. 16 (HealthDay News) — People regularly turn to the Internet for games and gossip, news and entertainment, essential information and high weirdness.

And now, apparently, for their health as well.

A number of successful online medical interventions have been reported in recent months, helping folks quit smoking, lower their blood pressure and deal with any number of ailments.

New York City cardiologist Dr. Nieca Goldberg figures it’s a great trend, as long as people are going to reliable and trusted sources for help.

“I think it is the wave of the future and, theoretically, it seems like a great idea,” said Goldberg, a spokeswoman for the American Heart Association, a clinical associate professor of medicine and medical director of the Women’s Heart Program at New York University Langone Medical Center and author of Dr. Nieca Goldberg’s Complete Guide to Women’s Health. “There could be multiple interactions with patients that are brief and effective.”

Online interventions have spanned a variety of medical issues. One program, for instance, used Internet and telephone interactions with heart attack survivors and cardiac patients to help improve their heart health. A study found that participants’ blood pressure and cholesterol levels fell, more of them quit smoking and they were one-third less likely to die than cardiac patients who did not receive the attention.

Several programs have popped up to help smokers quit. An analysis of 22 clinical trials found that Internet- and computer-based smoking cessation programs gave smokers nearly twice the chance of successfully quitting than if they had tried to quit without help. Continue reading House Call is a Home Page?

Seven Highly Effective Habits for Work Comp Return to Work Success

7 Is Your Lucky Number
7 Is Your Lucky Number

Republished with permission from

Making a Habit of Return-to-Work

Twenty years ago, Stephen Covey published what’s now an enormously popular book, The Seven Habits of Highly Effective People. More than 15 million copies of The Seven Habits have been sold in roughly 40 languages.

Before you write off Covey’s book as just more self-improvement hoopla, consider this: You can use the seven habits to build a highly effective return-to-work process. Ultimately, you can reduce your claim costs and improve your productivity.

Habits One and Two: Lay the Groundwork You will work with your employees to develop your return-to-work process. But first, you will lay the groundwork on your own.

Habit one teaches you to be proactive. Proactive people believe they are a product of their choices, not their circumstances. You should not accept injuries as a cost of doing business. You should choose to invest the time and resources to develop a return-to-work process. The goal of your process will be to help injured workers get well and back on the job.

In habit two, you learn to begin with the end in mind. Write a policy statement that confirms your commitment to the return-to-work process. Your policy should stress the importance of operating safely and getting immediate medical care for injured workers. It should also explain that the company will work with injured employees to help them recover and return to the job, either at full or modified duty, as soon as medically appropriate.

“A good return-to-work process eliminates surprises,” said Pat Crawford, return-to-work education coordinator at the Texas Department of Insurance’s Division of Workers’ Compensation. “Everyone should know what to expect if they get injured on the job. We encourage employers to post their return-to-work policy in high-traffic areas and give every employee a copy,” Crawford said.


On Again Off Again – Intermittent Leave

Walking the fine line between ADA and FMLA regs
Walking the fine line between ADA and FMLA regs

An understanding of where the Family and Medical Leave Act, the Americans with Disabilities Act and state regulations intersect is required when determining whether an employee is “entitled” to be intermittently absent from work because of a medical condition. Individualized assessment is necessary to determine if intermittent leave is required as a “reasonable accommodation” under the ADA, in part because repeated absences from work most likely mean the person is unable to perform “essential job functions.”

ADA evaluations must be job-related and consistent with business necessity. The FMLA, on the other hand, entitles employees to intermittent leave when “medically necessary,” a determination made through completion of the certification form DOL WH 380. An FMLA-qualified medical condition may or may not be work-related.

Under the FMLA, employees must provide advance notice of their need for intermittent leave, but only as much as is practical under the circumstances. Practicality remains open to legal interpretation. An evaluating occupational medicine physician may consult with an employee’s personal physician about an employee’s medical condition – such as depression or migraine headaches that may cause intermittent absences – but only after first getting the employee’s permission.

This tip courtesy of Francis P. Alvarez, J.D., Jackson Lewis LLP, White Plains, NY; email:

The professionals at Central Coast Industrial Care can help you with a lot of the answers.

In the meantime check out 5 FMLA Questions Almost All Managers Can’t Answer!

Physicians Strongly Favor Healthcare Reform

Rx for Health Care Reform by Ken Terry
Rx for Health Care Reform by Ken Terry

Here’s an interesting story from a former senior editor of Medical Economics Magazine and author of the book, Rx For Health Care Reform.

Physicians Know We Need Reform

By Ken Terry | August 3rd, 2009 @ 5:23 pm

America’s physicians favor healthcare reform much more strongly than the general public does. In the wake of the AMA’s pledge of support for Congressional reform proposals, a coalition of seven other physician organizations sent a letter backing reform to Senate Majority Leader Harry Reid last week. The medical societies, which included the American Academy of Family Physicians, the American College of Physicians, the American Academy of Pediatrics, and the American Osteopathic Association, said that they represent 450,000 physicians and medical students.

“In the best interest of our patients and this nation, we must pass strong and effective health care reform in 2009,” these organizations declared. “Americans need affordable choices, and stable coverage. Not passing health reform will result in continued rising costs, poorer quality of care, and more people uninsured.”

In contrast, recent poll results show that the percentage of all Americans who support reform is slipping. In mid-June, according to a Wall Street Journal/NBC News survey, the public was divided down the middle on whether President Obama’s reform proposal made sense. In a new poll conducted July 24-27, only 36 percent of respondents supported the plan, while 42 percent said it was a bad idea. The percentage of those with private insurance who disliked the plan rose from 37 percent to 47 percent. A New York Times/CBS News poll yielded similar results.

Although the national cost of the proposal to cover the uninsured is a concern, the central fear of Americans—and especially of those with private coverage—is that under reform, the quality of their own care would decline, while their own costs would rise. People are specifically afraid that their treatment options and their choice of physicians would be limited.

The physician societies, however, expressed the opposite view in their letter: “Some people believe that patients are better off in today’s disorganized insurance market. We believe that the health care our patients receive will be better within a reformed system. As physicians and future physicians, we stand in firm support of the patient-centered changes being outlined in Congress. We are confident that the reforms being proposed will allow us to provide better quality care to our patients, while preserving patient choice of plan and doctor.”


Controlling Drug Costs

Worth their weight in gold
Worth their weight in gold

According to the most recent research we’ve seen, prescription medicines account for 14% of Workers’ Comp costs.
So, of course, it makes sense to enlist the help of your medical services provider to be more efficient in this area.

Here’s some advice for employers on drug utilization controls from consultant Maddy Bowling:
1. Focus on the treating physician because he or she is the key to controlling pharmacy spending and length of disability.
2. Use data analytics to understand prescribing patterns and identify when, where and what is driving the company’s pharmacy spend as part of the claim in the first 30, 90, 90 to 120, and 120 days and beyond. Keep track of treating physicians, where treatment is provided, types of injuries and occupations involved, specific prescribed drugs and their associated costs. Use this information to intervene more proactively on the next claim.
3. Remember that network penetration is only as good as the company’s ability to control costs through fee management, utilization management and disability/lost work time management.
4. Connect the dots to other workers’ compensation cost containment efforts: Pharmacy management cannot be performed in a vacuum. For example, talk to providers about prescribed medications and their anticipated effects on return to work. Physicians play a critical role in return-to-work plans.
5. Use data and triggers to identify “creeping” catastrophic claims before they reach $50,000; intervene in cases over that limit. The goal is to get people back to work.

… and some tips From Dr. David Deitz of Liberty Mutual:
1. Pay attention to what the physician does. Control of physician prescribing behavior is much more important in workers’ compensation than it is in group-health settings.
2. Beware of regulatory loopholes. They abound, and vary from state to state.
3. Understand that diversion of prescription analgesics is a problem in both group health and workers’ compensation.
4. Workers’ compensation pharmacy management is labor intensive and requires clinical as well as claims-handling expertise.

And remember that the staff of Central Coast Industrial Care is your partner in achieving cost effective health care for your employees and insuring that we can get them back to work quickly and safely.