Michelle Kerr

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]

Wearable Technology

Putting Wearables to Work

Wearable technology can have a meaningful impact on costs through injury prevention and creative case management.
By: | June 1, 2015 • 9 min read
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Before long, you’ll be reading about all kinds of quirky wearable technology — like false eyelashes that can change your TV channels or even launch drones. Most of it, though, is far less fanciful.

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The wearable space now extends to jewelry, watches, clothing, shoes, glasses, hats, helmets — you name it. These accessories carry embedded biosensors, actuators and gyroscopes to follow movement, heart rate, stress level, fatigue, and countless other metrics … all of it connected wirelessly to mobile devices and computers. Shipments of smart wearables are expected to grow from 9.7 million in 2013 to 135 million in 2018, according to analysts at CCS Insight.

But this amazing itty bitty tech is no longer just fodder for making tech bloggers swoon — it’s beginning to drive safer workplaces and improve workplace injury outcomes, even making a dramatic difference in the lives of workers with catastrophic injuries.

On the safety side, high-hazard industries such as energy and construction are already exploring the possibilities, with applications for Google Glass, smart safety helmets and any number of sensor-enabled devices that can identify hazardous conditions such as toxic chemical fumes or equipment under excessive pressure.

Clothes with embedded technology such as the shirts Ralph Lauren debuted at the U.S. Open last year could help supervisors monitor their crews’ stress levels, respiration, heartbeat, and energy output. A company called MC10 in Cambridge, Mass., is testing a small translucent patch that can detect body temperature and measure hydration levels — both ideal tools for reducing the risk of injuries for outdoor crews or those that work in extreme-temperature environments.

“If a doctor says, ‘I want you to get up and move every hour,’ there are certainly wearables that can report back to a physician or a case manager about activity levels.” — Kimberly George, senior vice president, corporate development, M&A and healthcare, Sedgwick

Conscious Clothing, the winner of a $100,000 Department of Health and Human Services and Environmental Protection Agency prize, developed a shirt that will monitor the wearer’s breathing and the surrounding air quality.

Smart glasses add the practical dimension of visual display and video capture. Imagine a complex construction task in a hard to reach location. An older, more experienced worker might be at physical risk trying to reach it, while a younger worker could get there, but not have the experience to perform the task safely.

With a pair of smart glasses and an earpiece, however, the young worker can allow the experienced worker to see the task through his eyes, and the veteran can give guidance on how to do the task safely. Added bonus: The entire task can be recorded and used for future training purposes.

The potential wearable applications for injury reduction are practically limitless. Sensor equipped smart shoes can help measure flooring conditions, alerting both workers and supervisors to potential hazards. Even for office workers, there’s a pin that helps reduce neck and back injuries by alerting the wearer of poor posture.

Where things really get interesting is where wearable sensors begin to interact with environmental sensors. Try to imagine lighting on the assembly line that automatically adjusts for the specific needs of the person working below it, or wristbands that send human proximity alerts messages to machines, automatically shutting down or overriding an accidental start-up if there’s a person within 12 inches of a moving part.

The potential for eliminating entire categories of injuries is actually within reach.

Driving Compliance

Wearables have plenty of roles to play in injury management and return-to-work as well. The simplest applications come in the form of alerts sent to a smart watch, reminding an injured worker about a doctor’s appointment, or that it’s time to do the stretches prescribed by the physical therapist.

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The video chat capability of a smart watch could be an easy means for supervisors to check in with injured workers recovering at home, keeping the connection to the workplace strong and reducing feelings of isolation.
The now ubiquitous fitness trackers are increasingly popular as wellness tools, but have a significant place in comp as well, said experts including Sedgwick’s Kimberly George, senior vice president, corporate development, M&A and healthcare.

In a case where the outcome for a worker’s knee surgery or back surgery would be improved by the loss of 40 pounds, for example, a fitness tracker band affords an opportunity to help motivate the worker, and also track whether he or she is complying with the treatment plan’s activity goals. The bands could be equally useful post-surgically — not to be punitive, but to give case managers the opportunity to nip problems in the bud.

Kimberly George senior vice president, corporate development, M&A, and healthcare, Sedgwick

Kimberly George
Senior vice president, corporate development, M&A, and healthcare, Sedgwick

“If a doctor says, ‘I want you to get up and move every hour,’ there are certainly wearables that can report back to a physician or a case manager about activity levels,” said George.

“Now could someone manipulate it? Yes. But the point is that you want to be able to use it to empower that patient, rather than as a ‘gotcha.’ ”

Other types of sensor driven trackers could be useful in ensuring that workers in light duty assignments don’t jeopardize their recovery. Sensors in shoe inserts, for instance, could vibrate or send a smart watch alert if a worker exceeds a 10 pound lifting restriction. Motion-sensing trackers could let a recovering worker know when it’s time to switch to a less repetitive task.

Different varieties of smart T-shirts and vests are being tested, to help support the muscles of a worker with a back injury or recovering from surgery, and also to send gentle vibrations whenever the wearers’ posture may be compromising the safety of their back or neck.

George said she sees the full potential of wearables coming when people learn how to use them to get ahead of injuries before they become cost drivers. Some examples might be shoes that detect gait and wear patterns and send alerts if workers could be at risk for knee injuries, or sensors that detect if the way a worker is moving is putting him or her at greater risk for a fall.

“The problem with comp is that we wait until something’s happened,” said George.

“When I think about the wearable space … the best [possibility] is that we can engage them earlier — even before a workers’ comp injury has occurred.”

Help for the Toughest Comp Cases

The impact of wearable technology is most dramatic as it can be applied in cases of catastrophic workplace injuries, including those suffering from brain injuries or who are paraplegic or quadriplegic.

“With wearable tech … I’m able to give them the control to their world.” — Zack Craft, vice president of rehab solutions and complex care, One Call Care Management

Connected technology — including smart watches and Google Glass, combined with a bevvy of mobile apps and environmental sensors — is opening doors for these workers that were closed only a few short years ago.

“When we look at catastrophic cases, especially our paras and quads, they do lose control — they have to ask somebody to do for them all the time,” explained Zack Craft, vice president of rehab solutions and complex care at One Call Care Management.

“With wearable tech … I’m able to give them the control to their world.”

A person with the ability to at least move a finger, said Craft, can use a smart watch to operate lights and a thermostat or even drive a powered chair more efficiently.

Wearables and mobile apps are even helping those unable to speak, by way of an interface where users touch pictures to communicate.

“An old system that would give someone the ability to speak used to run around $10,000,” said Craft.

“Now I’m able to give that person a smartwatch and download some simple applications, and for under $1,000 I can give someone who lost his voice because of heat stroke the ability to communicate. We can even put it in his native language.”

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Not only are the new wearable technologies far cheaper than systems available in the past for catastrophic injuries, they’re also more universally accessible, he added.

“A lot of our injuries are labor-based injuries, and the level of education may be limited. So when you’re looking at high-tech … they just didn’t have the [skills] to operate those systems.”

Weighing Risks and Rewards

There is an enormous amount of potential in the wearables space for safety and comp — potential for reducing injuries and improving patient outcomes. But with that potential comes a degree of risk and a lot of questions that can’t be answered until the technology is more widely utilized. First and foremost, say experts, is whether or not companies can get buy-in from employees.

“It all comes back with the human being — are they willing to accept those kinds of things from their company … it’s kind of the Big Brother concern,” said Paul Braun, managing director with Aon Global Risk Consulting.

“If you’re wearing something that’s going to tell your employer what you do every minute of the day, are you going to accept that and are you going to operate that way? Because that’s really where the challenge on the workers’ comp side is.”

There are also concerns that collecting certain types of data will ultimately backfire on employers. What if, for instance, sensor-enabled wearables recorded a significant amount of unsafe movement or actions by employees? There’s a worry that some employers could suddenly find themselves the target of unsafe workplace accusations.

Braun used the example of a client that was considering the use of athletic helmets that could record and track impact to the head during the playing career of each student.

“The concern that the group had was, ‘OK, what if you’ve got all of this information and you didn’t do anything about it? Or what if a lawyer got a hold of it … what happens if they subpoena the database and our team didn’t take any corrective action?’ ”

Another question raised was what if a crafty lawyer hacked into the database or hired someone to do so.

“Now he’s got a pure list of potential clients,” said Braun.

For most employers though, the more immediate question will be how to take all of this new data and turn it into meaningful information that will inform action. The data, said Sedgwick’s George, is only as good as its ability to change behavior or to improve someone’s health.

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“Don’t just think you can throw all these trackers out there and it will improve health,” said George.

“There has to be a meaningful way in which the [provider] and the patient benefit, or it’s just another device.”

Interoperability is key, said George, particularly given the changing health care landscape, and the fact that the management of wellness may not need to be at the physician level.

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“We have to think about having more nurse practitioners, athletic trainers, physician assistants and nutritionists, with some of these wearables monitoring the maintenance of chronic disease or healing of wounds after surgery. … Interoperability and how the device is actually meaningful both to the patient and to the care team is important.”

Clearly, the industry is going to have to address some of these issues sooner rather than later, or risk falling behind.

Said One Call’s Craft, “The technology is moving so fast that it seems like weekly, if not daily, something new is coming out — something that gives us more capability than we even had eight hours ago.

How do you keep up with that? And who’s keeping up with it? The industry is getting bombarded by it.”

“It’s not that far out,” agreed George. “When you begin to factor in the genomics, the sensors, the nanotechnology — it’s a little overwhelming but it’s pretty amazing.”

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]
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RIMS 2015

Employers Navigate Risks of Unconventional Medicine

As treatments including medical marijuana gain traction in the workers’ comp space, employers need new strategies to manage the risks and contain costs.
By: | April 13, 2015 • 3 min read
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Nearly two years ago, a demolition project in downtown Philadelphia ended in tragedy when a heavy machine operator accidentally caused the collapse of an adjoining Salvation Army store, killing six people and injuring at least 14 others.

The excavator operator on the project was high as a kite, according to allegations.

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Fear of that kind of tragedy has been gnawing at risk managers as medical marijuana legalization has spread in states across the country.

“The deadly impact is the same, no matter what the industry is,” said Sandy Little, risk manager for the Bar-S Food Company, at a presentation at RIMS 2015 in New Orleans.

Even in workplaces with a low risk of fatalities, mistakes made by impaired workers can cost employers dearly and even jeopardize reputations.

Little, along with attorney Bob Balkenbush of Thorndal Armstrong Delk Balkenbush & Eisinger, stressed that the current federal law remains clear, and employers should look at it as a resource.

Even in cities or states where medical or recreational marijuana is legal, the substance is still a Schedule I illegal drug at the federal level, and employers have no obligation to bend on policies prohibiting its use.

So far, said Balkenbush, most challenges brought by medical marijuana users have been shot down in the courts.

In James v. City of Costa Mesa (2012), a group of disabled individuals filed an ADA claim against the city for trying to shut down a collective that legally dispensed medical marijuana. The court ruled that under federal law, the group was illegally using marijuana; therefore the claim against the federal ADA was invalid.

In Ross v. RagingWire Telecommunications (2008), an employee was fired after his pre-employment drug test came back positive for marijuana. He sued the employer, claiming the company failed to accommodate him under the state’s Compassionate Use Act.

The court ruled in favor of the employer, indicating that the Compassionate Use Act was not intended to interfere with the right of employers to require pre-employment drug testing or to take drug use into consideration when making employment decisions.

Balkenbush cited several other cases where courts came down firmly on the side of employers, including cases where employers denied unemployment benefits to terminated marijuana users.

Most states, he said, are not allowing unemployment benefits for employees fired for violation of zero tolerance policies.

“Employers, for the time being, are protected,” he said.

Regardless of how many states eventually decriminalize marijuana, the law does not say that employers cannot have zero tolerance policies or fire individuals who test positive.

Of course, there are exceptions, Balkenbush and Little said. In a recent New Mexico case, the court required an employer to cover the cost of medical marijuana for the treatment of a work-related injury.

There’s also a possibility that the federal law could change within the next few years, Balkenbush cautioned, depending upon changes in the political climate.

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For the time being, a well-written drug policy, frequently updated and consistently applied is key for all employers, said presenters. But it’s important to keep in mind that drug testing doesn’t always cast a wide enough net to detect whether an employee is a problem user.

It’s up to managers to be observant, Little said, and to pay attention to employees’ interactions with co-workers and customers.

She also stressed the importance of keeping the lines of communication open with employees regarding such substances. Make sure they’re aware of resources available to help, such as an employee assistance program.

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]
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2015 Most Dangerous Emerging Risks

Corporate Privacy: Nowhere to Hide

Companies can no longer expect to conduct business out of the gaze of prying eyes.
By: | April 8, 2015 • 6 min read
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SCENARIO: In a small apartment in Atlanta, Pete scanned the hardware in front of him. His fingers flew as he deftly navigated multiple windows. A former defense contractor employee, Pete possessed a highly specialized set of skills.

He knew how to hack into almost anything, from network servers and credit card databases, to VoIP phone systems and video conferencing systems. An encryption expert, he knew how to exploit every weakness and sniff out every back door. Pete never met a digital lock he couldn’t pick.

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Pete’s talents — and his reputation for discretion — kept him in demand, especially in certain circles.

His latest gig was gathering intel on Odyssey International for one of Odysseys’ top competitors, especially an inside track on any mergers or acquisitions Odyssey might have up its sleeve.

Pete pulled up his files for several key Odyssey execs and smiled smugly. People like Garry Buchanan made Pete’s job way too easy.

An encryption expert, he knew how to exploit every weakness and sniff out every back door. Pete never met a digital lock he couldn’t pick.

Odyssey’s U.S. head of new business development, Buchanan was tech-obsessed. From the moment Buchanan hopped into his Tesla Model S and engaged the autopilot until he arrived at work, Pete could peek at every email, calendar entry and company report. Buchanan’s smartphone let Pete keep track of him out of the car too, whether he was picking up a latte or checking in for a flight.

Accessing Odyssey’s network was a little tougher than Pete expected — its security was more sophisticated than most. But, like most companies, it spent more time protecting its customer and finance data. Its email server was far less secure. Its phone system was barely protected at all.

Around 8:15 a.m., Pete’s system alert let him know that Buchanan was on the phone. It sounded like Odyssey was researching a potential acquisition.

Pete tapped the screen to record the call and sent an encrypted file to the man who’d hired him.

Buchanan’s flight to London arrived on time. He’d checked into his hotel and stayed there all night. But Pete was drumming his fingers on his desk, aggravated. There were meetings on Buchanan’s calendar. But with whom? There was no data.

There had been a few vague email references, but nothing that had given Pete a clear picture of what was up. Buchanan seemed to be deliberately keeping the details under wraps.

“We’ll see about that,” said Pete, firing up more hardware. He checked the time and calculated the time difference. Buchanan would probably be leaving the hotel soon.

He’d found Buchanan’s Uber account the day before and guessed he’d be using the service. Sure enough, he’d already been picked up. “Gotcha,” said Pete, gaining unauthorized access to Uber’s “God View” and tracking the car’s route.

Ten minutes later, Buchanan walked into a café and was seated at a table out front. Pete watched in real time as Buchanan took a moment to take in the London scenery while waiting for his breakfast companions.

“Bless those Brits,” thought Pete. “And their millions upon millions of CCTVs.”

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Buchanan’s two guests arrived a few minutes later. Pete was pleased to have a good angle on both of them. He locked on their faces and dragged the images into his facial recognition program. He got a match on both and searched their records. One was a visiting fellow at the University of Cambridge in the department of engineering. Interesting.

Pete kept digging. An hour later, Pete had enough data on both of them to get a picture of what Buchanan was up to and why Odyssey wanted this little excursion to be kept under wraps.

Time for another file upload to his new corporate benefactor. This info was hot.

“I should’ve charged him twice as much,” Pete thought ruefully as he sent his customer the information on his competitor’s latest move.

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ANALYSIS: There are no more secrets. The lesson brought home by WikiLeaks and later by Edward Snowden is that privacy is a quaint notion of a bygone era. We are in, as it has been dubbed, the “Golden Age of Spying.”

Everyone now knows that the U.S. National Security Agency (NSA) has access — on a massive scale — to chat logs, stored data, voice traffic, file transfers, phone records, email and social networking data. It can also access web chats, Internet searches, text messages … the list goes on.

The agency has long had a certain amount of cooperation from major technology companies including Microsoft, Yahoo, Google, Facebook and Apple. Unbeknownst to some, it also engineered a weakness in an encryption standard, allowing back-door access to those companies, and their data.

Problem is, if you leave the back door open, you can’t guarantee that others won’t find their way in.

Now factor in the Internet of Things. Estimates suggest there could be up to 80 billion connected devices in use five years from now — devices that can monitor anything from the climate quality in your delivery trucks to whether the plant in your window needs more sun.

From your digital world to your physical world, everything will be hackable, trackable, visible. Everything will have the potential to be seen by someone you never intended to share it with.

That’s happy news for those set on malfeasance, either to steal corporate secrets or engage in disruption for fun or profit. But it’s troubling for businesses of all sizes as they face the challenge of protecting what they can and managing the rest.

Randy Nornes, executive vice president, Aon Risk Solutions

Randy Nornes, executive vice president, Aon Risk Solutions

“What you’re going to see is a more formalized way of communicating sensitive information and housing sensitive information,” said Randy Nornes, executive vice president with Aon Risk Solutions.

“So if you have key data that creates value for your firm, I think you’re going to see that the fundamental technology architecture that people use to store the really important stuff will be remote and distant, and it won’t be readily accessible through the Internet.”

But it’s the day-to-day actions of conducting business that organizations will have more trouble keeping behind locked doors.

“In a fully transparent world … companies will have to behave as if every action will be reported on the front page of their local paper,” said Nornes’ colleague Paul Kim, co-CBO of Aon Risk Solutions U.S. Retail operations.

Futurist and author David Brin said in a recent interview with “Variety,” that organizations can’t “count on anything staying secret for more than 10 years, that’s delusional on the border of psychosis.

“Get used to the notion that some day, someone is going to hear this conversation or read this document. And live and work as if anybody might be watching now,” Brin added.

Along with those inevitable leaks come serious risks to brand and reputation, which is why reputation risk management will need to develop at least as fast as privacy erodes.

That means using an extremely thorough process of scenario planning, and understanding exactly how any kind of breach, leak or competitive attack could affect the company’s value and its ability to conduct business.

“It’s not something that’s limited to the public relations team; it’s not something that’s limited to a chief communications officer,” said Chris Lukach, president of Anne Klein Communications Group, LLC.

“It’s something that needs to be shared among risk management, legal, HR, operations … . That to me is what makes companies prepared.”

There are multiple points at which hyper-transparency can result in a business loss, and insurance products will no doubt keep evolving to meet those needs. In a case where a release of confidential information might damage a company’s image, for instance, Tokio Marine Kiln is already underwriting a product that goes beyond traditional cyber insurance and helps companies insure against that spectrum of losses.

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Explained Tom Hoad, underwriter at Tokio Marine Kiln, a Lloyd’s syndicate, risk managers have become increasingly sophisticated in the way they think about their exposures.

“[They’re asking], ‘Where are the key performance indicators for the company and what sorts of things can affect our ability to deliver on those things?’ … The preservation of brand equity, is very much at the forefront of that process.”

BlackBar

Complete coverage of 2015’s Most Dangerous Emerging Risks:

Corporate Privacy: Nowhere to Hide. Rapid advances in technology are ushering in an era of hyper-transparency.

04012015_04B_implant_devices_150px_mainImplantable Devices: Medical Devices Open to Cyber Threats. The threat of hacking implantable defibrillators and other devices is growing.

04012015_03_concussions_150px_mainAthletic Head Injuries: An Increasing Liability. Liability for brain injury and disease isn’t limited to professional sports organizations.

04012015_04_vaping_150px_mainVaping: Smoking Gun. As e-cigarette usage rises, danger lies in the lack of regulations and unknown long-term health effects.

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Aquifer: Nothing in the Bank. Once we deplete our aquifers, there is nothing helping us get through extended droughts.

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Most Dangerous Emerging Risks: A Look Back. Each year since 2011, we identified and reported on the Most Dangerous Emerging Risks. Here’s how we did on some of them.

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]
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