Prior to the coronavirus pandemic, business continuity planning was not exactly a household word among most Americans, and probably not among most small businesses.  Covid-19 has changed that.  Every organization, whether your local church, public school system, or neighborhood pizza joint, has shifted their operational model to deal with the impacts of illness, shelter-in-place orders, and reduced demand for services.

Traditionally, large organizations with multiple locations and geographic diversity have implemented some type of business continuity plan.  Common risks unique to their industry or location forced businesses to consider how they would conduct business in the event of a disruption to normal operations.  These risks include hurricane activity on the Gulf coast and Atlantic seaboard, forest fires on the west coast, and severe weather across the mid-western and northern states.  Other risks are unique to certain industries, such as the restaurant industry’s exposure to food borne illness outbreaks.  Many of these risks are insurable, and through risk management strategies and financial planning, companies have largely been able to withstand these periodic interruptions.

Companies with prior business continuity challenges know that an epidemic, or even a pandemic, can be approached with some of the same elements of planning used for a hurricane or wildfire.  This is not to minimize the unprecedented impacts of Covid-19, rather to say that companies with prior planning and experience are able to pivot more quickly as the situations develop.

Other companies, smaller in scope, and with limited geographic exposure, may have had partially-developed business continuity plans.  For example, my company, which is a corporate environment with limited remote-work access, had little prior exposure to common risks that would impact the normal operation of the business.  A large portion of the staff had the ability to work from home with high-speed internet access and personal computers, so it was relatively easy to transition those salaried workers.  In the early stages of the coronavirus pandemic, we recognized the need to formally expand our business continuity plans, and determine how we would continue servicing our clients in the event of a complete shutdown of our entire operation.  Investments were made in new technology, updated policy and procedure, and training, resulting in a seamless transition to a work from home solution for the entire company, with no impact to our clients. 

Many companies have interdependencies to consider when planning for business continuity, and ours is no different.  While upstream supply chain or downstream distribution issues are concerns for some organizations, we manage a network of medical providers and the question quickly became how would patients be seen in a timely and safe manner, despite quarantine and shelter-in-place orders?  Would urgent care centers and physical therapy clinics have enough staff to open, and would they be overwhelmed with patients ill from the virus?

Most medical facilities are considered essential, but without healthy staff to operate them and safe procedures with which to work, all of our efforts at continuing our business could be for naught.

The business continuity efforts across our medical and ancillary networks have been amazing.  Nurses, doctors, physician assistants, clinic directors, PT techs, and others have stepped up to the plate in more ways than one.  Whether it be shifting hours of operation, staff assignments, or moving patients to more convenient locations, our providers have proven flexible and resilient in these trying times.  The entire intake process for most clinics has changed to ensure patient and staff safety from the virus.  We have been fortunate that despite some changes to operational procedures, our clients have had the peace of mind that their employees would be taken care of.  Many of our clients are in the retail and hospitality sectors, and have been deemed essential business to keep the country supplied and fed during the pandemic.  The evolution of medical support for these workers who put themselves at risk to continue essential services has been incredible.  We have been able to facilitate medical appointments for all injured workers who have needed care the last several weeks.

One alternative many general and group health providers quickly turned to, is telemedicine.  A relatively new option for care, telemedicine has grown in popularity on personal health plans as a way to quickly diagnose and treat minor illnesses.  This process has not been widely adopted for occupational injuries, as it is extremely important for the provider to see the patient in person to appropriately document a thorough examination of injured body parts and address issues like causation and work status.  In some telemedicine programs, a patient in Dallas might be seen over the phone by a doctor in Houston, who may or may not be well-versed on occupational medicine or the client’s culture and protocols. 

With the reality of Covid-19 forcing providers to consider all options, Corporate Remedies saw the opportunity to work closely with doctors and medical directors in our network to ensure that where telemedicine would be deployed, our client’s return-to-work protocols would be followed.  Equally as important, whenever possible, we worked to ensure our injured workers who received care using alternative technology were still being seen by the same medical professionals they would be seeing if they were at the clinic in person.  All telemedicine visits for occupational injuries would continue to be seen by a credentialed provider in our network.

With the pandemic literally impacting all sectors of our economy, this alternative is becoming more prevalent whether we are ready or not.  We feel that in most cases, initial face-to-face care is still the best pathway to positive outcomes, but we recognize that in some cases, telemedicine will be the only option.  For these situations we have reviewed our protocols with the clinics so we can be assured that the quality of care is not impacted and clients have a clear understanding of the process.  Corporate Remedies has been working closely with providers in our network to ensure that all viable options for care are on the table, and that evidence-based medicine protocols are adhered to even via telemedicine.  One leading provider has ramped up development of their telemedicine offerings with pilots in Nashville and DFW and continues to work closely with us to ensure return-to-work outcomes are a priority.  One solution we have found effective is an initial in-person visit subsequent to a work-related injury, with follow up visits and physical therapy conducted via HIPAA compliant video technology.

When disaster strikes, we are often forced to consider the old cliché, “think outside the box”.  What we may be surprised to find however, is that some elements of our business continuity plan will become the new normal.  Consider all of the restaurants who are now successfully executing take-out and delivery.  Prior to the pandemic, many restaurants were already building or operating such models, but is there a restaurant in business today that is not doing take-out or delivery?  And when the pandemic ends, will they stop offering delivery? 

Whether your business is selling hamburgers or treating injured workers, traditional models likely won’t and shouldn’t go away, but it may just be that changes we are making as a result of Covid-19 will help us to think differently and improve our service models in the long-term.