mlcoa VIC Updates
Why Evidence-Based Medicine? An Introduction To The Official Disability Guidelines (ODG)
Because it works.
Evidence Based Medicine (EBM) is an approach in medical practice that intends to optimise clinical decision making by applying the evidence from well-designed and validated scientific studies and research.
The best practice approach of applying EBM involves integrating individual clinical expertise with the most reliable clinical evidence available from systematic research and applying this evidence to individual patient clinical problems and circumstances.
EBM guidelines have undergone considerable transformation over the last number of years. Significant advances include specific linkages of systemic research evidence summaries to the strength and direction of recommendations, consideration of important individual ‘patient’ factors and the transparent reporting of clinical practice guidelines in simple and clear language.
Various studies are showing a growing acceptance amongst health practitioners and insurance authorities in viewing EBM as the most rational and objective method of effectively guiding better health and return to work outcomes, and reducing disability durations.
By understanding EBM, it is logical that we draw your attention to an evidence based resource which is increasingly gaining acceptance and implementation in Australia from a number of Insurers and compensation schemes. The resource we refer to is the Official Disability Guidelines (ODG). ODG is an electronic EBM guideline tool and is “the most widely adopted guideline in the workers’ compensation setting” in the US and overseas. It is also being recognised and utilised in other healthcare compensation settings.
Although the benefits of using evidence-based medicine (EBM) are often extolled due to improved outcomes in healthcare systems that have adopted medical treatment guidelines, up until last year there had never been an academic study published in a peer-reviewed medical journal that proved if EBM could deliver these results from a compliance standpoint on a closed claim file.
In May 2016, the independent, retrospective study, entitled, “A New Method of Assessing the Impact of Evidence-Based Medicine on Claim Outcomes” (Bernacki, et al), was published, with results that demonstrated what EBM users have been saying all along: It works. The study compared the relationship between outcomes for 45,951 indemnity claims filed between 2008 and 2013 in terms of duration and medical utilisation and costs, to their adherence to EBM guidelines. The authors sought to challenge or confirm the following:
The goal of EBM guidelines in workers’ compensation is to improve the quality of care for injured workers by using an objective standard for treatment. The philosophy is that properly constituted guidelines -
Achieve better and more predictable results for the majority of patients;
Establish a standard of care with projected disability duration;
Define necessity and appropriateness of medical treatments;
Provide expectations for recovery, cost, and risks for complications.
To do so, the authors chose the ODG published by the Work Loss Data Institute. The question the investigation assessed was, “If injured workers are managed under EBM guidelines as defined by ODG, do they have better outcomes in terms of absence from work and total medical care cost?” As it turns out, they do.
The mlcoa Team