Tag Archives: psychosocial

Psychology’s Relevance in Security

The best way to defeat or at least largely mitigate hackers is with a dynamic defense system. When combined effectively, anti-virus software, NGFWs and the products and services from cybersecurity companies like CyberArk and FireEye can provide an organization with a resilient cybersecurity framework. However, such security measures are expensive and are dependent on companies that employ IT professionals, which is why many organizations try to fend off cyber attacks only with anti-virus software and a NGFW. Yet there is another method with which to mitigate or prevent cyber breaches, and it is a method that cyber liability and technology E&O insurers need to understand and immediately employ: human psychology.

The most common meeting of psychology and the binary world is the door to the binary world: the password. Most, if not all, underwriters have read an article or heard a lecture about how “password” and “123456” are the most frequently used keys when people attach a password to anything. Moreover, the commonality of those two keys has been a fact for decades, but the insecurity of using commonly known passwords as a passport remains virtually immune to change.

The longevity of weak keys is due to many factors, but at the heart of all the factors is human psychology. It is a behavior that does not want to be bothered with memorizing a multitude of passwords, and one that tries to find the easiest way to meet a password requirement instead of trying to create a strong passport. Most importantly, it is risk and reward psychology that governs the creation of any password. Who cares in the professional world what a person’s password is as long as the work gets done and a person gets paid?

Yet current cyber liability and technology E&O wording does not even try to tackle this most basic insecurity, one that costs insurers large amounts of currency time and again. Insurers will continue to lose vast amounts of money due to the insecurity of a key like “123456” until insurers decide to tackle human psychology and work with technology companies to create a safe path forward out of the current mess with which the digital community finds itself.

See also: How to Identify Psychosocial Risks  

If passwords were the only element of enterprise cybersecurity that needed to be reformed, then, to a high degree, the issue would not have far-reaching implications. However, the fact is that the weakness of keys is only a symptom of a larger problem.

Cybersecurity may be a topic that crops up in news headlines on a regular basis, but it is a topic that also is generally viewed as a fringe area of thought. At the enterprise level, this can be seen in one prominent way beyond dysfunctional passports, and that is in individual cybersecurity responsibility. Cyber breaches have cost the global economy no less than $400 billion each year since 2013, have affected essentially every part of the professional sphere, and are bringing governments around the world into conflict with their taxpayers as represented, in one way, when a government, like the U.S. government, tried to force Apple to make its products less secure.

Nonetheless, to this day a majority of the companies around the world do not put part of the onus on individual employees for a company’s cybersecurity posture. Most companies do not include, in annual employee reviews, an area that deals with how the individual contributed to the strength or weakness of the company’s cybersecurity approach.

Did the employee use a strong password over the past year? Did the employee lock her computer each time she stepped away from her desk? Was the employee’s company computer linked to any cyber attacks? If the employee’s computer was linked to a cyber attack, then had the employee shown an appreciable improvement of her cybersecurity awareness?

By not enforcing the need for every employee to contribute to the cyber safety of the company, employees at all levels are allowed to have a carefree outlook, which is clearly detrimental to the cybersecurity posture of every organization. Even potential employees are not vetted for their sense of healthy cybersecurity. Companies ask numerous questions when interviewing a potential candidate, but very few companies try to assess the individual’s sense of responsibility when it comes to cybersecurity. If employees, and even applicants, are not expected to carry part of the responsibility, then what reason does any employee have to be responsible from a cybersecurity standpoint?

Perhaps more disturbing than the previous issues is that cyber liability and technology E&O insurers do not account for how human behavior influences the development of computer hardware and software. From about 1990 to the present, there has been a relentless movement by technology companies to get products to market at breakneck speed.

While a hardware company like Intel has produced some products of dubious quality, like trying to push its Pentium III processor beyond the 1Ghz level and the Rambus fiasco, hardware producers have largely avoided major mistakes. However, software developers are almost entirely responsible for the creation of a binary world where security has almost always been an afterthought, and human psychology is at the heart of this issue as well.

Since 1990, constant pressure has been placed on software engineers to meet deadlines set by a management system that is focused on everything but cybersecurity, which means that quality is almost always sacrificed to include a flashy software feature or simply to get a product to market quickly. Windows Me, Windows Vista, and Windows 8 are the results of a management system that showed great disregard for the safety of the end user.

Moreover, software engineers themselves also have the psychological outlook that, if an issue does comes up after a piece of software is released, it can always be patched at a later date. Perhaps the most obvious example of the patching system in overdrive is that of smartphone operating systems and applications. It is not uncommon for one smartphone application to receive updates two or three times each month. However, the present wording of technology E&O policies and the questions asked in technology E&O applications continues to demonstrate a severe lack of understanding on the part of insurers as to how human behavior gives rise to technology E&O claims.

When it comes to human psychology, it seems that the most egregious lack of understanding by insurers is not comprehending their most prominent adversary: hackers. However, hackers are not all the same, which means that they are driven by different attitudes, thought processes and rewards. More than that, hacking is an art and, just like any other art, there are “newbies,” and there are actual artisans.

In the first of the four hacker tiers are elementary hackers, meaning those people under the age of 14. For the most part, elementary hackers are going to focus on their local geographical community. This is partly due to the experimenting nature of such a young hacker, because a 10- or 12-year-old is still trying to figure out how to hack. Therefore, locally geographical targets present the best chances to hone a person’s skills. After all, the basic educational system, especially in the U/S., but elsewhere, too, spends very little on defensive technologies of any kind.

The local courthouse and sheriff’s office spend only slightly more than the educational system, and local merchants still largely maintain the attitude that they somehow do not appear on the radar of any hacker. Therefore, local venues often are the best targets because they often have the least security, in all forms, and consequently are the easiest ones on which to test a person’s skills.

However, insurers largely ignore this first tier and appear to have the mindset that these hackers are unworthy of recognition and that no solution as to how to engage with this group is needed.

The next tier contains the rookie hackers. These are the hackers who successfully “graduated,” unopposed, from the elementary group and who are generally 14 to 22 years old. For this next tier, the motivation is still whether the individual is capable of a hack, but now the target of the hack is going to extend, with ever greater frequency, beyond the immediate geographical location. It will also increasingly encompass working with and learning from others.

This is often the stage where hacktivists are going to begin to form and where the psychology of the hack is going to extend to obtaining items like currency and prestige. As hackers in this group encounter other hackers, they often start to form a set of ethics that make sense, but that are hard for a majority of people to understand. This same group is also going to start to attack national law enforcement institutions, yet even this tier is largely ignored by insurers around the world even though attacks from this group often involve PII, PHI, and payment card data.

Tier three is the first tier that has widespread acknowledgment from all insurers, and this tier encompasses both artisan and professional hackers. The hackers in this tier are often going to be 23 years old and older. One factor that makes this tier of hackers so effective in entering systems where they are not welcome is that they have been able to hone their skills from the age of 10 to 23.

Most people who build and hone a skill set over the course of 13 years will be fairly capable. Another factor is that this tier is composed of people who have a sense of identity, which means that this group has formed its own moral compass and conforms to ethics and outlooks that often fall outside of the global mainstream. This sense of identity and associated ethics gives rise to groups like the FireEye branded FIN6 group, or the hacktivist group Anonymous.

A group like FIN6 is capable of inflicting hundreds of millions of dollars in damage on the global economy, but, because cyber liability and technology E&O insurers have ignored the first two tiers of
hackers, they are unable to appreciate the depth and abilities of tier three hackers.

The fourth tier of hackers have been known to insurers for years now ,as well as law enforcement organizations around the world. This tier is also composed of hackers who work for effective cybercrime groups, like FIN6, or larger cybercrime groups, hackers who are ardent supporters of a sociological or political philosophy (hackers for ISIS are a current example of this) and hackers who work for nation-states, whether directly employed or occasionally contracted to work.

These hackers have narrow views of the world, their ethics often fall outside of the norm of most hackers, and they are constantly trying to expand ways by which to wage cyber warfare (Stutnex is a recent successful example) and are the embodiment of ghosts in the network. Tier four hackers are almost always the hackers who cause the most damage while leaving virtually no trace of their activities, and they are beyond insurers’ ability to engage with in any reformative manner.

Human behavior is at the core of every single data breach initiated by a human. In perhaps the most recent egregious example, the hacking of Equifax is a foul example of this. The Equifax hack occurred because of a psychological company mindset of complacency as well as the hackers’ own psychological reasons. Complacency is clearly demonstrated in the cybersecurity posture that the company was maintaining: It can be done later.

The hole that allowed the hackers to gain access and successfully acquire copious amounts of non-public data had a fix that was released in March 2017, but by May 2017 Equifax still had not patched the vulnerability. There is also evidence that Equifax was notified as early as December 2016 that its systems were not secure.

With the PII that a credit rating agency has, such a delay in updating critical data is unacceptable. However, with no government or market pressure to behave responsibly, Equifax and its ilk will continue to suffer data breaches time and again, and time and
again consumers, and ironically insurers, will continue to exist in a world of ever-increasing uncertainty as to which direction financial harm will arrive from.

See also: The Costs of Inaction on Encryption  

While the undeniable importance of accounting for human psychology is a severe oversight on the part of insurers, the path forward is equally undeniable: Engage with as many tier one and tier two hackers as possible and ensure that cyber liability and technology E&O applications allow insurers to assess the psychological outlook an applicant has with regard to cybersecurity.

In the April 2016 edition of the PLUS Journal, it was argued that insurers need to work with other companies involved in technology, marketing and lending and in other parts of the private sector to create an international competition. This competition would give students a creative outlet to display their skills whether they be in coding, design or writing. By establishing such a competition and working with educators, world wide insurers and other companies can give potential tier one and two hackers a creative outlet for their skills as well as an affirmation that their skills can lead to healthy career paths.

By finding these individuals through an international competition, not only can insurers reduce the risk to their insureds of being hacked by the reduction in numbers of hackers, but they can also find the people who are capable of creating next-generation products.

Without spending the needed effort, though, insurers will continue to lose money at unsustainable levels to cyber liability and technology E&O claims, claims that could have been avoided by investing in adolescents, who, after all, are the future, but who also are the most vulnerable to negative influences.

By also asking the right questions in a cyber liability and technology E&O application, insurers can assess the psychological outlook of a corporate applicant and make a far more informed decision as to whether to underwrite the risk. Had insurers asked Equifax questions that appropriately gauged its perception of the importance of cybersecurity, they could have avoided the risk of underwriting the firm.

Surely, asking eight psychological questions to save $100 million is better than accepting $300,000 in insurance premium and all the uncertainty attached to that premium.

Over the past four thousand years, battles and wars have often been won by the continued incorporation into the battlefield of new technology, whether the technology was metallurgical or
mechanical, but understanding the psychological mindset of the enemy has also been a determining factor. The ever-present value of human behavior has not been lost on most of the private sector, either. Psychology is at the core of a multibillion-dollar industry like advertising, and it is represented daily in the greed and fear index on Wall Street. Understanding the psychological mindset of a company as it concerns its cybersecurity posture and understanding hackers without question must be embraced by insurers.

However, until insurers realize the virtual relevancy of human psychology they, and their insureds, will continue to lose substantial amounts of currency, time and sense of security, and the stability of the global economy will continue to be destabilized.

How to Identify Psychosocial Risks

We know that early intervention is critical to prevent delayed recoveries for injured workers. One of the challenges has been to identify those at higher risk of poor outcomes.

Fortunately, we have the tools to determine which patients are more likely to develop chronic pain and languish in a disability mindset. The process is fairly simple and backed by strong, research-based evidence. With increased awareness among payers, providers and other industry stakeholders, we can prevent creeping catastrophic claims, help injured workers regain function quicker and significantly reduce workers’ compensation costs.

Reasons for Getting Stuck

Psychosocial risk factors used to be little more than a buzz term among workers’ compensation professionals. While those of us who’ve worked extensively with chronic pain patients understood that psychological issues can easily derail a workers’ compensation claim, the research that proves this to be true has become widespread only in recent years.

In fact, some of the most recent research says that psychological factors can be more of a predictor of poor outcomes than the underlying medical conditions. We now know for certain that the biomedical model of disease does not hold true for everyone, and the biopsychosocial model of illness must be considered.

Where the first is based on the idea that a physical ailment can be cured through medical solutions, the second acknowledges that some people have an underlying psychobiological dysfunction that has clinically significant distress or disability. They are the injured workers who can greatly benefit from early identification and intervention.

Inadequate coping skills and a lack of knowledge of what is causing their pain can drive delayed recoveries and overuse of treatments and medications. Chronic pain is the final common pathway of this delayed recovery.

See also: A Biopsychosocial Approach to Recovery  

Research validated through meta analyses, prospective studies and control group studies shows that injured workers with delayed recoveries typically have:

  • Catastrophic thinking
  • A history of anxiety or depression
  • Anger and perceived injustice about their plight
  • An external locus of control
  • Minimal resilience

They may also have fear avoidance, meaning they engage in little to no physical activity out of fear they will injure themselves more and experience increased pain.

There are myriad reasons why some people have these issues. The cause could be childhood and life experiences, their relationship and interactions with their environments, issues in the workplace or home or other reasons altogether. It’s important that we identify injured workers with these issues as soon as possible after their injuries.

Pain Screening Questionnaires

One of the most effective ways to pinpoint injured workers with psychological issues is through specially designed, self-administered questionnaires. The one we use to identify patients at risk of developing chronic pain and disability is the Pain Screening Questionnaire (PSQ).

The PSQ was developed by a Swedish professor of clinical psychology and is used in many countries. It has been shown through studies to accurately predict time loss, medical spending and function — but not pain.

The PSQ takes about five minutes to complete and consists of 21 questions that focus on the injured worker’s:

  • Pain attitudes, beliefs and perceptions
  • Catastrophizing
  • Perception of work
  • Mood/affect
  • Behavioral response to pain
  • Activities of daily living

The injured worker is asked to rate on a scale of 1 to 10 things such as, “How would you rate the pain you have had during the past week?”; “In your view, how large is the risk that your current pain may become permanent?”; and “An increase in pain is an indication that I should stop what I’m doing until the pain decreases.”

Depending on the score, the injured worker is categorized as low risk, moderate risk, high risk, or very high risk. Those on the lower end of the scale are most appropriately managed through take-home educational materials on chronic pain. Moderate-risk injured workers are good prospects for a self-managed workbook style intervention. High- and very-high-risk injured workers should be referred for additional assessment and an intervention program, such as cognitive behavioral therapy (CBT).

See also: Impact on Mental Health in Work Comp  

In a program of early identification and intervention, Albertson’s Safeway found 12% of injured workers scored high. Those affected were referred to CBT. After an average of just six CBT sessions, a large percentage of them were able to return to work. Because of the results, primary treating physicians who work with Albertson’s injured workers have been referring them to the program earlier in the claims process.

Conclusion

It is estimated that 10% of workers’ compensation claims consume at least 80% of medical and indemnity resources. The vast majority of these are injured workers with delayed recoveries due to psychosocial risk factors.

With solid science backing up the successful identification and interventions of these employees, we can prevent needless disability and substantially reduce workers’ compensation costs.

Claims Advocacy’s Biggest Opportunity

We know the single greatest roadblock to timely work injury recovery and controlling claim costs. And it’s not overpriced care, or doubtful medical provider quality or even litigation. It is the negative impact of personal expectations, behaviors and predicaments that can come with the injured worker or can grow out of work injury.

This suite of roadblocks is classified as “psychosocial” issues – issues that claims leaders now rank as the No. 1 barrier to successful claim outcomes, according to Rising Medical Solutions’ 2016 Workers’ Compensation Benchmarking Study survey.

Psychosocial roadblocks drive up claim costs far more than catastrophic claims, mostly due to delayed recovery, and claims executives told us they occur regardless of the nature of injury. In other words, one cannot predict from medical data the presence of a psychosocial issue; one has to listen to the injured worker with a fresh mind.

See also: Power of ‘Claims Advocacy’  

It’s likely no coincidence that, while the industry has progressively paid more attention to psychosocial issues this past decade, there’s also been a shift toward advocacy-based claims models over adversarial, compliance- and task-based processing styles. Simply put, advocacy models – which treat the worker as a whole person – are better equipped to control or eliminate psychosocial factors during recovery. According to the 2016 Benchmarking Study survey, claims advocacy and greater training in communication and soft skills, like empathy, are associated with higher-performing claims organizations.

Psychosocial – What It Is, What It Is Not

The Hartford’s medical director, Dr. Marcos Iglesias, says that the “psych” part does not mean psychiatric issues, such as schizophrenia, personality disorders or major depressive disorders. Instead, he points out, “We are talking about behavioral issues, the way we think, feel and act. An example is fear of physical movement, as it may worsen one’s impairment or cause pain, or fear of judgment by coworkers.”

The Hartford’s text mining has found the presence of “fear” in claim notes was predictive of poor outcomes. Similar findings were recently cited by both Lockton (“Leading with Empathy: How Data Analytics Uncovered Claimants’ Fears”) and the Workers’ Compensation Research Institute (“Predictors of Worker Outcomes”).

Emotional distress, such as catastrophic reaction to pain and activity avoidance, is predictive of poor outcomes. Other conditions, behaviors and predicaments include obesity, hard feelings about coworkers, troubled home life, the lack of temporary modified work assignments, limited English proficiency and – most commonly noted – poor coping skills. Additionally, being out of work can lead to increased rates of smoking, alcohol abuse, illicit drug use, risky sexual behavior and suicide.

When peeling back the psychosocial onion, one can see how adversarial, compliance- and task-driven claim styles are 1) ill-suited for addressing fears, beliefs, perceptions and poor coping skills and 2) less likely to effectively address these roadblocks due to the disruption they pose to workflows and task timelines.

Screening and the One Big Question

Albertsons, with more than 285,000 employees in retail food and related businesses, screens injured workers for psychosocial comorbidities. To ensure workers are comfortable and honest, the company enlists a third-party telephonic triage firm to perform screenings. “It’s voluntary and confidential in details, with only a summary score shared with claims adjusters and case managers,” says Denise Algire, the company’s director of risk initiatives and national medical director.

At The Hartford, Iglesias says claims adjusters ask one very important question of the injured worker, “Jim, when do you expect to return to work?” Any answer of less than 10 days indicates that the worker has good coping skills and that the risk of delayed recovery is low. That kind of answer is a positive flag for timely recovery. If the worker answers with a longer duration, the adjuster explores why the worker believes recovery will be more difficult. For example, the injured worker may identify a barrier of which the adjuster is unaware: His car may have been totaled in an accident. This lack of transportation, and not the injury, may be the return-to-work barrier.

It Takes a Village

Trecia Sigle, Nationwide Insurance’s new associate vice president of workers’ compensation claims, is building a specialized team to address psychosocial roadblocks. Nationwide’s intake process will consist of a combination of manual scoring and predictive modeling, and then adjusters will refer certain workers to specialists with the “right skill set.”

Albertsons invites screened injured workers to receive specialist intervention, usually performed by a network of psychologists who provide health coaching consistent with cognitive behavioral therapy (CBT) principles. This intervention method is short in duration and focuses on active problem-solving with the patient. The Hartford also transfers cases with important psychosocial issues to a specialist team, selected for their listening, empathy, communication skills and past claims experience.

Emotional Intelligence – Can It Be Learned?

Industry professionals are of mixed minds about how and if frontline claims adjusters can improve their interpersonal skills – sometimes called “emotional intelligence” – through training. These soft skills include customer service, communication, critical thinking, active listening and empathy. Experts interviewed agree that some claims adjusters have innately better soft skills. But they also concur that training and coaching can only enhance these skills among claims staff.

See also: The 2 Types of Claims Managers  

Pamela Highsmith-Johnson, national director of case management at CNA, says the insurer introduced a “trusted adviser” training program for all employees who come into contact with injured workers. Small groups use role-playing and share ideas. An online training component is also included.

Advocacy – The Missing Link to Recovery

Could it be that advocacy – treating the injured worker as a whole person and customer at the center of a claim – is the “missing link” for many existing claim practices to work, or work better? Whether for psychosocial issues or other barriers, organizations like The Hartford, Nationwide, CNA and Albertsons are paving the road to a more effective approach for overcoming pervasive barriers to recovery. Participants in the 2016 Workers’ Compensation Benchmarking Study confirm that higher-performing claims organizations are taking this road.

The coming 2017 study will continue to survey claims leaders on advocacy topics. A copy of that report may be pre-ordered here.

Industry Trends for 2017

Every day, our colleagues take care of people facing uncertain situations. Whether they have a workplace injury, need time away for the birth of a child, experience a medical situation that will lead to time off, are in an auto accident or suffer product or property damage, we are here to let them know that it’s going to be okay.

Part of our job in caring for these people is to simplify and clarify the process and to explain what consumers can expect. An evolving system, shifting regulations, rapidly advancing technology and economic uncertainties add to the complexities they face. Key areas in the spotlight for the coming year include good health empowerments, regulation transformations, consumer-centric progressions, risk circumventions and tech modernisms.

We will continue to offer our insights as we monitor the following business advancements and challenges throughout 2017:

Good health empowerments

Accessing care via technology

Technology advancements will continue to influence healthcare delivery. Connecting a specific injury or condition with a quality provider in a virtual setting for more immediate treatment will make these advancements more readily acceptable and increase demand.

Balancing the scale of pain management

Increasing opioid addiction and the legalization of medical marijuana will ensure pain management remains at the forefront of industry discussions. Increased education about the dangers of opioid abuse, the availability of marijuana as a medical alternative and the introduction of alternative pain management techniques will continue to dominate the conversation.

Supporting mental health initiatives

The pressures to reduce stigma and strengthen initiatives aimed at psychosocial issues and behavioral health will continue to mount. The linkage between absence at the workplace and mental health will continue to be highlighted.

See also: 10 Insurance Questions for 2017  

Regulation transformations

Compliance enforcement

Employers will continue to manage compliance-related issues as they respond to changes in the ADA/ADAAA, FMLA and other federal and state laws affecting our industry. Political reorganization and shifting administrative priorities may also create regulatory shifts for OSHA and the EEOC.

Navigating regulatory changes

Assessing the impact of provisions introduced by newly elected officials from the federal and state level in the areas of healthcare, workers’ compensation and parental leave will be at the forefront. It will be necessary to monitor newly introduced legislation in key states such as California, New York and Florida to determine how best to respond and comply with new regulations.

Workers’ compensation strategies

Primary steps among industry leaders include finding common ground and developing strategies focused on benefiting all key stakeholders. Those who favor a federal workers’ compensation option point to inconsistent benefits, rules and regulations among the states. Others believe the state systems have proven to be effective and simply need to be updated. By understanding what should be changed or replicated, legislators can work to revitalize workers’ compensation and help ensure that it continues to fulfill its original purpose.

Consumer-centric progressions

Enhancing the claims experience

The current claims paradigm will continue to shift and be characterized by an increasing focus on the consumer. The needs of injured or ill employees and other consumers will assume center stage. Claims expectations will be established early on; information and resources to support the consumers’ needs will become more readily available; and care and concern will drive and transform the claims experience.

Bridging benefit models

Integrated benefit plans have long been discussed, but not widely implemented. Pushing the boundary between various benefit providers, administrators, payers and employers through advanced online platforms could be at the forefront of many discussions. In addition to technology advancements, there is a renewed health, wellness and compliance mindset that is fostering increased interest in integration.

On-demand consumerism

Consumer and customer expectations are on the rise, and providing an immediate response has become expected in many industries. Increased connectivity and immediate communication are now the standard. In the past, it was enough to provide claim and case details through push technology, seamless payment processing and direct bank deposits. Now, the gold standard is to provide a consumer-focused experience where access to resources and data are a click away. With enhanced consumer engagement comes faster resolution, reduced litigation and reallocation of resources to focus on more complex matters.

Risk circumventions

Crisis plans

Building resiliency through new predictive models in pre-catastrophic events and using new technologies in post-disaster recoveries is on the mind of many employers. Whether the emergency is natural or man-made, cyber- or product-related or a supply chain interruption, having the right pre-catastrophe plan in place continues to be a discussion among employers, brokers, carriers and payers.

Geo risks

More organizations are likely to consider an enterprise-wide response to growing political, economic and global risks as customer markets expand. There is also an increasing need to address travel risks for employees servicing global customers on a short-term or interim basis, and ensure preparedness plans are in place.

Talent strategies

There continues to be a need to attract, train and retain new talent as baby boomers enter retirement years. Employers must learn how to accommodate multiple generations with varied preferences – from telecommuting to technology – and ensure successful integration with the existing workforce. Creating strategies and using new tools for knowledge sharing will help enhance communication and understanding.

See also: 2017 Priorities for Innovation, Automation  

Tech modernisms

Artificial and emotional intelligence

The rapid advancement of technology has led to conversations and interest in artificial and emotional intelligence. Developments in these areas and others such as new connected health technologies, Internet of Things, drones, driverless cars and services using virtual technology are contributing to privacy law and ethical guideline debates.

Explosion in actionable data

With today’s technology advancements and increasing number of connected devices come an explosion in actionable data, creating a need for more data miners. There is a growing demand for data scientists and engineers who can interpret actionable information. The use and expectation of having more refined predictive analytics to drive decisions will continue to increase and underscore the need for this specialized talent. Deciphering actionable insights as more data pours in from various connected devices will continue to be an important topic of discussion.

Self-service innovations

Having been introduced in the banking and airlines industries early on, consumer self-service options are becoming increasingly popular in the risk and benefits industry. Consumers of claims services are seeking the same user experiences that they have become accustomed to in the B2C world, including instant information access, connectivity to tech support and two-way communication when and how they want it.

You can find the original report here.

A Biopsychosocial Approach to Recovery

Watching people try to recover from injury can be baffling. Some recover function quickly; others do not. Why is there so much variability with severity and duration of disability, given similar injuries or illnesses? Why do some individuals get stuck in delayed recovery?

Our medical system has tended to focus on the physical: If there is back pain, there must be something going on in the disc, vertebrae or nerve roots. That approach isn’t bad. Medicine has made a lot of progress with that tactic. But sometimes a physical cause isn’t apparent.

If we examine what else may be happening in people’s lives, what they’re thinking and what they’re feeling, we start to uncover circumstances and behaviors that may be delaying their recovery.

The Hartford is focusing on a different and promising approach that looks beyond the physical aspects (such as symptoms, physical findings, test results) and looks at the whole person as a biopsychosocial being who may have non-physical barriers that are delaying recovery. The Hartford has developed a program that offers help to assist people in getting unstuck.

Internal data analytics indicate the presence of psychosocial risk factors can account for a two- to four-fold increase in disability duration of work-related injuries.

Background

The biomedical model has served as the traditional foundation of our understanding of the body and has formed the bedrock of modern Western medicine. In essence, this model reduces illness and injury to their most basic units; the body is seen as a machine that operates on the basis of physical and chemical processes. In other words, find out what’s wrong with the body and fix it.

The biopsychosocial model seeks to amplify the biomedical model by addressing an individual holistically as a physical, psychological and social being.

The 1970s saw pioneering work in the treatment of chronic pain by using psychological — or behavioral – principles. For instance, W.E. Fordyce at the University of Washington found that helping patients with pain behave normally (that is, getting them to stop displaying pain behaviors) led to improvements in function.

In the 1980s, cognitive behavioral therapy (CBT) began to be used in treating chronic pain patients. CBT tries to change patterns of thinking or behavior that are behind a person’s difficulties all to change how they feel.

In the past 20 years, some have shown the usefulness of interventions based on specific psychosocial risk factors for pain and disability. Much of this work has been carried out in Canada, Europe, Australia and New Zealand.

See also: Better Outcomes for Chronic Pain

The medical and research literature points to social and behavioral factors — like fear, expectation of recovery, catastrophic thinking and perceived injustice — as powerful forces that can delay recovery after an injury or illness. As one example, a 2015 WCRI study showed that fear of getting fired could affect a worker’s return to work after an injury.

The Hartford Approach

Armed with an understanding of these drivers of disability, The Hartford is using its advanced data analytics and developing innovative solutions to help workers at risk regain the function they had before an injury or illness.

A patented text mining technique allows us to look for psychosocial, comorbid and other risk factors to identify, early on, individuals who demonstrate a likelihood to have a prolonged disability. By combining this early identification tool with a growing toolkit of interventions, we are finding new ways to help individuals restore their lives after an injury or illness.

One such tool is a proprietary, telephonic coaching intervention. Having identified claimants who show an elevated risk for prolonged disability, we invite them to participate in a program that matches them with a specially trained coach who helps them overcome psychosocial barriers. By equipping individuals with skills and techniques to change the way they think, feel and act, we help them develop confidence to take control of their recovery. This confidence allows them to increase function in all areas of life, including return to work.

The voluntary program, called iRECOVER(SM) uses phone calls with the coach, along with a workbook and homework assignments. It can last several weeks.

Although still in its early days, iRECOVER shows promising results: earlier return to function and return to work.

Participant feedback has been very positive. For instance, we have received emails and letters from injured workers that say:

  • “There’s light at the end of the tunnel.”
  • “I feel confident going back to work. A good part of this is due to my participation in iRECOVER.”
  • “I think what you do is probably as important as medical treatment.”
  • “iRECOVER helped me be courageous and strong.”

See also: Data Science: Methods Matter (Part 1)

Conclusion

By considering the whole patient, applying potent data analytics and developing innovative solutions, we are getting to the root of delayed recovery for many individuals. The results will benefit all concerned, especially the injured worker, who just wants life to get back to normal.