IPMI for remote workers in the oil and gas sector

A preventive approach

UnitedHealthcare Global has provided medical care in remote and hazardous locations for 40 years. As the medical needs of its clients have changed over that time, the company has adapted its offer, taking a more holistic approach to health and wellbeing, and adopting a model of preventive care.

“We are seeing a substantial increase in wellness intervention and health promotion for remote workers, with the aim of trying to reduce chronic conditions developing later in life and better manage – or reverse – illnesses that have developed,” said Dr Shoba Subramanian, UnitedHealthcare Global Medical Director for the Europe, Middle East and Africa regions.

In shifting the focus from treatment to prevention, insurers are seeking new ways of delivering health service models that better serve remote workforces. This preventive approach aims to minimise the risk of downtime for ill health, injury and mental health challenges.

The benefits of digital technology

The growing adoption of telemedicine is making it easier for employers to fulfil their duty of care to make sure workers are fit to carry out their roles. Medical assessments can be carried out more frequently and on-site in both on- and offshore locations. Programmes, such as health surveillance and health monitoring to check on environmental exposures and blood pressure, are also important. Secure, centralised digital medical records can be integral to these, enabling offshore medics to input clinical notes directly into employees’ records and giving authorised parties instant access to patients’ medical histories, all over the world.

“Telemedicine makes care more accessible, helping to enable workers to access diagnosis, manage existing conditions, and in some cases obtain prescriptions, wherever they are,” Subramanian said.

Digital technology is increasingly used in non-emergency primary and preventive care, as well as management of long-term conditions such as hypertension, diabetes and asthma. Significantly, these medical interventions can offer cost savings to clients by reducing the need to transport a patient to a new location to diagnose or administer care. Healthtech serves as a tool that on-site medical teams can utilise to treat non-emergency conditions and improve the quality of care for remote workers. Using the technology, the speed and accuracy of diagnoses can be improved, waiting times reduced and patient safety enhanced.

“UnitedHealthcare Global has used telemedicine technology for decades to support medical care on remote sites and offshore oil and gas platforms,” said Phil Hughes, Managing Director of UnitedHealthcare Global. “Our solutions have advanced to include video, real-time medical data transmission, and the sharing of health information and diagnostic images with specialised medical teams for evaluation and interpretation onshore.

“We understand the importance of providing employees with adequate healthcare, especially in high-risk and hazardous environments, where local medical care may be limited or not to expected standards.”

The healthtech programmes used by UnitedHealthcare Global include My Wellbeing and LiveWell, which provide remote workers with access to medical professionals, and Virtual Health Services, which offers immediate support, advice and guidance to companies facing medical emergencies, illnesses and injuries, regardless of location.

Insurers are seeking new ways of delivering health service models that better serve remote workforces

For insurers, greater use of digital technology can allow them to reach a larger customer base and improve healthcare outcomes. Data is used to analyse and ‘gain valuable insights into patient health trends, treatment outcomes, and population health’, explained Joe Cronin, President of International Citizens Insurance. “This information can help insurers make informed decisions and improve risk assessment and management.”

Enhancing the overall customer experience by providing convenient and timely access to healthcare services improves an insurer’s reputation as reliable, fast-acting and proactive. “This can lead to more efficient resource allocation, cost containment, increased customer satisfaction and loyalty,” said Cronin.

The courage to change

There may be some resistance from clients, however, who might prefer sticking to more traditional, face-to-face healthcare methods. It depends on ‘patient acceptance and willingness to use remote healthcare services’, Cronin said. “Educating and encouraging patients can be an ongoing challenge, particularly among older populations or those resistant to change.”

Even so, their reservations are not without credibility. Remote consultations may not provide the same level of detail or diagnostic accuracy that comes with a hands-on physical examination or in-person visit.

Moreover, effective healthtech services rely on robust technology infrastructure. In regions with limited access to high-speed internet or areas with inadequate technological infrastructure, delivering seamless services can prove problematic.

Frank Harrison, Regional Security Director, North America at World Travel Protection, highlighted the ‘issue of reliable internet connectivity, which can be lacking in remote oil and gas worksites, especially during exploration and pre-construction project phases’.

Evacuate or stay on-site?

Telemedicine also has the potential to help reduce the need for medical evacuation, which can be costly and present additional risk to patients. For offshore industries, medical evacuation requires the removal of a patient from the vessel or rig to shore. Given that healthcare quality can be lacking in remote locations, insurers will need to carry out due diligence to assess whether it is the best course of action to seek local care, or to evacuate a patient who needs specialist treatment that cannot be carried out in situ.

“In the event of an evacuation, and to help ensure the success of this process, the right assets and relationships must be identified and established beforehand, including payment,” said Pascaline Wolfermann, UnitedHealthcare Global’s Healthcare Intelligence Director. “Clinical quality and operational capability assessments must also be conducted for critical care providers managing complex patients and high-risk situations, such as medical transports.”

UnitedHealthcare Global uses Medical Emergency Response Plans (MERPs) to assign roles and responsibilities to those involved in coordinating assistance to the patient, as well as local and international destinations for further healthcare beyond stabilisation. These MERPs provide the framework for the primary and definitive evacuation, the destinations of which may vary depending on the citizenship of the workforce.

Wolfermann cites a recent incident where understanding the standards of care, capabilities and limitations was essential for patient safety. UnitedHealthcare Global’s Emergency Response Center and health intelligence teams conducted on-site surveys of the healthcare infrastructure in Papua New Guinea and Australia to ensure that, at every point of the patient’s journey, the local care providers best equipped to manage the patient were used, while international providers were identified in the event of a definitive evacuation. This localised approach helps ensure consistency of services, capabilities and outcomes while assuring provider quality and member safety at the country, city and facility level.

Workers may be involved in potentially dangerous tasks, while situated in extreme locations

Rapid response

Speed is of the essence, added Jody Baker, CEO of Charles Taylor Assistance. “It’s vital that oil and gas workers have access to an assistance provider who can manage medical trauma and evacuations in some of the most remote global areas, supported by a worldwide network of trusted medical and transport providers.

“A topside – offshore assistance – service should enable onboard medics to connect directly with medical specialists at any time of the day or night within minutes of a call, wherever they are in the world.”

“In addition, topside doctors in the UK should be General Medical Council (GMC) registered, and work at all times to [offshore trade body] OGUK guidance, whilst reputable topside providers will draw on procurement platforms, such as Achilles, to validate suppliers and mitigate risk,” he said.

Employers may also be advised to carry out pre-deployment risk mitigation, for instance by getting pre-deployment reports and advice from specialist intelligence gathering and medical risk assessment teams.

Secure solutions

It’s clear that a range of high-end solutions are available to support remote workers in the oil and gas industry, but insurance providers need to think outside of the box when dealing with this sector. This may mean examining their international insurance programmes and pricing structures, balancing cost considerations while maintaining affordability for customers.

Oil and gas companies, on their part, are looking for innovative insurance solutions to meet their changing needs. This provides scope for insurers to adapt their approach to medical care and health technology, specifically tailoring it to serve remote rotational workforces. Overall, insurers have opportunities to offer cost-effective solutions with flexible and bespoke pricing, structure and coverage in a range of policies for remote workers in the oil and gas sector. However, they must address the associated challenges, including regulatory compliance, reimbursement models, technology infrastructure, patient acceptance, and quality of care, to fully realise the potential benefits.