WHAT IS AN ONSITE OCCUPATIONAL HEALTH CLINIC?

Occupational medicine, also referred to as occupational health, is a medical specialty that focuses on the treatment and prevention of work-related injuries and illnesses. Unlike an employee onsite health clinic that offers primary care and urgent care services to employees and their dependents, an onsite occupational health clinic may offer comprehensive health care exclusively to employees. Onsite occupational health services include but are not limited to:

• Work injury care
• Injury prevention
• Physical examinations
• Drug screenings
• Physical therapy

Why onsite occupational health?

Perhaps the most common reason employers invest in onsite occupational health is work-related injury and illness avoidance. The direct and indirect costs associated with work-related injuries and illnesses continue to soar, making workers’ compensation insurance a sore and costly topic businesses continually face. To improve workforce health and safety, promote productivity, and reduce workers’ compensation spend, more employers are soliciting the expertise of occupational health care providers and the preventive health measures they can help develop and implement in the workplace.

Other onsite occupational health benefits

• Care access: Having onsite occupational health services not only helps to reduce lost duty time; it also helps ensure employees who need care actually seek the appropriate care without barriers such as time, location, or transportation. Having onsite occupational health services not only benefits the workforce; it also gives the clinical staff a greater advantage. Onsite clinicians have access to employees’ actual work environment. This access offers clinicians a unique perspective on what causes some occupational injuries and illnesses, and what solutions can keep employees healthy and safe.
• Convenience: An employer may determine its onsite clinic hours based on factors such as the company’s operating hours or even workforce health trends. For example, a worksite that operates 24 hours a day, seven days a week, may experience a high volume of work-related injuries during the overnight shift. This trend could prompt the need for an employer to operate its onsite occupational health clinic during the late shift or as an after-hours care option. Just like many places of business, work-related injuries and illnesses do not keep conventional, daytime hours. Having onsite occupational health expertise available when needed can be a true workforce health advantage.
• Expertise: Clinicians who are board-certified in occupational medicine are better equipped to evaluate, diagnose, and treat common and complex occupational conditions. These clinicians have a greater understanding of the workers’ compensation arena, which enables them to help streamline the workers’ compensation process. Occupational health clinicians must remain current on Occupational Safety and Health Administration (OSHA) and Department of Transportation (DOT) regulations, as well as federal and state occupational health and safety guidelines — standards that employers of varying industries must comply with to operate and preserve the health, safety, and well-being of their workforce.
• Early intervention: Occupational health clinicians are typically more adept at treating common occupational health conditions. Having this level of expertise in-house means employees can receive the appropriate medical action sooner and return to work faster.
• Cost savings: Many employers understand the value of occupational health but elect to outsource their services as a cost-saving measure. By outsourcing occupational health services, an employer is placing its workforce in the hands of individuals who may lack familiarity with the company’s work environment. Onsite occupational health clinicians can leverage their expertise and worksite knowledge to deliver timely care for fewer care delays and shorter injury case durations. The sooner a workers’ compensation injury case can be closed, the less an employer may pay in related health care costs.

Onsite occupational health care models

Scalability is perhaps another key advantage to having onsite occupational health services. Many occupational health care providers offer multiple care models, allowing employers to select and successfully implement a care model that meets their unique business and workforce health needs. Examples of onsite occupational health care models may include:

• Clinician: The clinician model allows a business to offer a more all-inclusive level of care. A team of clinicians (e.g., physicians, physician assistants) may work in an onsite clinic offering services that could range from work injury care to drug screenings and employee physicals. Some clinician models may include primary care along with occupational health services.
• Registered nurse: Another cost-effective alternative to a fully staffed onsite clinic features a registered nurse (RN). RNs can provide a wide range of workforce health and wellness services, including employee vaccinations, health screenings, first aid, and drug testing. An onsite RN may also assess an employee’s work injury to determine the need for emergency or urgent medical care. For minor injuries/illnesses, an RN may coordinate an employee’s return-to-work treatment plan.
• Athletic trainer/physical therapist: Fully staffed onsite clinics may be more than many businesses can afford. An onsite model featuring an athletic trainer (AT) or physical therapist (PT) enables a business to focus on preventive health and workforce performance. From ergonomic assessments to functional testing, a certified trainer or therapist can provide workplace-specific recommendations and techniques designed to help employees work more efficiently, avoid injury, and reduce injury risk (or reinjury). For some work injuries, a trainer or therapist can a develop return-to-work treatment plan and perform rehabilitation services in the onsite clinic while the employee works under modified duty restrictions.
• Episodic: Episodic services deliver onsite health to worksites in which no brick-and-mortar onsite facility exists. An episodic onsite care model allows employers to request occupational health preventive services on a one-time or recurring basis, based on the company’s wants and needs. These services can include worksite cancer screenings, vaccinations, biometric screenings, respirator fit tests, drug/alcohol tests, etc.

Selecting an onsite occupational health model for your business

Onsite occupational health centers provide workforce health expertise and convenience that can lead to significant health care cost savings in the short and long term for employers. Selecting the right onsite occupational health care model will depend on several determining factors, such as company size, workforce health priorities, and budget. There are features every business should consider when selecting an occupational health partner. Some talking points when vetting a provider could include:

• Scope of service: Does the onsite health provider offer multiple care models to meet your company’s current and/or future occupational health needs? Along with scalability, the occupational health provider should also offer a comprehensive suite of services. From workplace injury management to preventive care, a provider with a wide range of services can help reduce the need to outsource.
• Industry experience: Experience matters regardless of medical specialty, but this is especially true in occupational medicine. Some work-related conditions are unique in nature and require clinicians to have a successful track record of collaborating with businesses to establish and meet workforce health and safety objectives.
• Clinical staff training: Does the health care provider employ licensed occupational medicine professionals? Are continuing education course requirements in place to ensure clinicians stay abreast of industry standards and innovation that influence care delivery?
• Service reach: Does the care provider have brick-and-mortar clinics in the area? What other businesses utilize the provider’s onsite occupational health services? Does the provider have a strong reputation for providing onsite health services to companies of varying industries and sizes?
• Technological capabilities: An onsite health provider’s technological capabilities either enhance or limit the customer experience. Can the provider offer seamless integration to your company’s existing electronic medical record system? Does the provider offer a user-friendly business account portal that reduces administrative burden and improves provider/customer communications? Does the provider collect, analyze, and share data insights that can help improve patient care?

Partnering with an occupational health provider for onsite health care means a company is making a commitment to offer specialized care designed to meet its distinct workforce health needs. Every worksite offers something different in terms of health and safety risks. Having an onsite occupational health provider can offer a business a resource designed to minimize those risks and improve overall health and safety outcomes.

Should occupational health services be separate or integrated into an existing or planned onsite clinic?

Each employer needs to decide whether it makes sense in its situation to integrate occupational health services into an existing or planned onsite or near-site clinic that offer primary care, acute care, chronic disease management and behavioral health services.

Factors to consider include:

• Space: Do you have space for additional clinicians to deliver services? If the occupational health providers will be full-time and, in the clinic, daily, you’ll need extra offices/exam rooms.
• Providers: Do you want your current providers in the onsite/near-site clinic to offer occupational health services? Not all physicians, nurses and other primary care providers are trained, capable and interested in offering occupational health services. Alternatively, not all occupational health providers are interested in or trained to provide primary care or disease management services.
• Medical Record Systems: State laws typically allow occupational health providers to inform an employee’s supervisor/manager/employer of their clinical condition and ability to return to work following treatment of a workplace accident or illness, while different state laws prohibit the release of an individual’s personal medical information to their employer. You need to make sure your clinic’s medical record system can product separate reports depending on the nature of the injury and situation.
• Trust and Confidentiality: If you have the same providers deliver primary care, workers are often concerned about their confidential medical and mental health information being share with their employers. In some workplaces, there is trust in the employer and this may not be a problem, but it makes sense to ask workers about their level of trust in such situations.

o If you do integrate services, promote the protections in place to ensure the employer only sees an individual’s treatment for worksite injuries or illness, while it sees only aggregate reports on the health of the workforce and not individual medical reports.