By Bruce Burk
Recently, industry expert Peter Rousmaniere explored how artificial intelligence (AI) could work for comp here. Artificial Intelligence is changing the way people work, receive information, and organize their lives. It is also changing how litigation is conducted and how people receive medical care. For that reason, workers’ compensation is also changing in the digital age through seven key ways outlined in this article.
Telehealth
Telehealth is the combination of telecommunications to healthcare. An example that I have used recently is AmWell, which is a service that allows patients to see a doctor on their cell phones or tablets to be diagnosed and receive prescriptions. The combination of telehealth and AI is allowing workers’ compensation claimants to get better and faster access to healthcare. Artificial Intelligence prompts could listen to the worker’s complaints and determine what specialist to schedule an appointment. Telehealth and AI together can also make it easier for a PCP (Primary Care Physician) to get in contact with specialists so that they can treat the patient together rather than on an individual basis. Telehealth can also help claimants who need therapists for conditions such as PTSD. AI can also help attorneys schedule conferences and depositions with doctors which can be a grueling task. In the future, telehealth will combine with automation to allow doctors to use mechanical devices to treat their patients remotely.
Predicate Calculus
Predicate calculus is a collection of information that allows a computer to perform logical analysis of quantifiable variables. Predicate calculus is capable of performing analysis in sentence-based syllogisms to arrive at a conclusion. Predicate calculus can assist adjusters in knowing when a case should be reviewed for excess insurance that have high medical costs. It can also be used to identify the factors that would make a patient permanently and totally disabled by analyzing their work history and physical limitations. This can help attorneys and adjusters know when it is time to request a functional capacity evaluation. Predicate calculus can also help search formularies for the correct drug for doctors to prescribe.
Diagnosis
Artificial Intelligence is helping with the diagnostic process and assisting doctors in understanding the levels of uncertainty about the patient’s condition. AI seeks to solve the problem of medical error, which is the third highest cause of death in the United States. The truth is that AI systems have far greater ability to recall information than a normal doctor. AI can assist with tasks such as detecting adverse reactions to medication, creating treatment plans, monitoring patients at home, and diagnosing cancer patients. This technology should help save carriers money in authorizing diagnostic testing and increase the probability of saving money on medical care in the long run, by having a correct diagnosis. AI can also help lawyers make determinations in the rule-in/rule-out doctrine that will be an issue in the case.
Review of Past Cases
Artificial intelligence is impacting how insurance adjusters perform their jobs. AI can help adjusters review how past cases were handled by using predicate calculus and search functions to review past cases with similar variables. Insurance adjusters handle hundreds of files at a time and it is difficult to remember how past cases were handled. For example, AI can assist with reviewing the average length of time it takes a patient with a lumbar herniated disc to reach MMI or how many injections were usually prescribed in a patient with a tear in their shoulder. This would be accomplished by storing variables of past case in cloud-based data tables that allow AI systems to review all of the information. This can help lawyers as well if they are using cloud-based case management software to pull up the case law and motions that were used in a similar case.
Machine Learning
Machine learning is the ability of computers to learn new information without having to be programmed. In workers’ compensation, IBM’s Watson has the potential to help doctors diagnose injured workers. Recently, Watson was able to diagnose a 60-year-old Japanese leukemia patient after her doctors were scratching their heads trying to figure out what was wrong with her. Machine learning can help chat bots, document drafting automation programs, and AI systems learn more about injured workers and their conditions over time in the same way that a healthcare provider does.
Chat Bots
Workers’ compensation claimants have the choice of representing themselves pro se, despite the courts describing pro se claimants as a tortoise flipped over on its back. However, chat bots that possess artificial intelligence are beginning to be able to answer basic questions that can help them. Florence is a chat bot nurse that helps remind you to take your medicine and can help you book appointments with doctors in your area. Safedrugbot is messaging app that helps doctors check whether medication is safe to take while breastfeeding. The power of chat bots should not be underestimated because a free chat bot lawyer overturned 160,000 parking tickets in London and New York.
Document Drafting
Although attorneys do not like to admit it, artificial intelligence is helping claimants be more independent when it comes to drafting basic legal documents. However, AI can also help defense counsel as well. Companies like Law Geex and Legal Robot are already assisting attorneys to automate document drafting in other areas of the law. Some AI programs can assist lawyers in preparing standardized documents like motions, settlement papers, or letters. It is an interesting concept as to what attorney fee hearings would be like by someone who is using AI programs to automate legal processes and whether a judge can order reimbursement of them as prevailing party fees.
