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SPONSORED: CARISK PARTNERS



ADDRESSING PHYSICAL & EMOTIONAL INJURY: A CASE STUDY SUPPORTING THE
EVIDENCE-BASED APPROACH TO WOUND MANAGEMENT

This injured worker recovery story sheds light on the benefits of having a
specialized wound care program designed by a dedicated and knowledgeable team.
By: Carisk Partners | March 2, 2022

Meeting the needs of a patient with chronic or acute wounds requires care beyond
convention, including a multidisciplinary approach, specialized treatment, and
comprehensive surgical and non-surgical interventions.  Wound management can be
complicated by psychosocial risk factors such as anxiety, depression, and/or
post-traumatic stress disorder, where each emotional injury (often in
combination) requires as much care and attention as the physical wound.

Proper wound management calls for a program that combines specialized medical
and mental health disciplines, expertise in managing the toughest clinical cases
and often with the most challenging patients to reach and activate; this
requires responsive, quality care that focuses on addressing the depth of any
mental health damage, along with the depth of the patient’s tissue damage.

A specialized program developed by Carisk® Partners incorporates an
understanding of evidence-based medical and behavioral health practices in wound
management and addresses the full spectrum of challenges often seen in wound
care cases.  Carisk recognizes the complexity of all of the biopsychosocial
variables involved with individual injuries requiring wound management.  As
illustrated in the following case study, the Carisk Wound Management Program
meets individual patients and their unique needs right where they are in their
journey.  The program, which is embedded into Carisk’s existing Pathways™ 2
Recovery program, delivers on all of the hallmarks of Carisk’s distinctive
approach that their clients have come to appreciate and expect:  science-based
medical expertise, strengths-based patient engagement, empathy-based care
navigation, and outcomes-based Care Coordination Plans.

“When a patient is recovering from physical wounds, it’s important to remember
that they are often attempting to heal from emotional injury as well. Attention
to one, without the other, dramatically increases the medical and the mental
health risks for that individual.”

– David Vittoria, Senior Vice President, Clinical Business & Product Development
at Carisk Partners


THE CASE OF COREY

David Vittoria, Senior Vice President, Clinical Business & Product Development
at Carisk Partners

Corey is a young man who sustained an L1 spinal cord injury while at work in
2017, resulting in paraplegia.  Corey was referred to Carisk two years following
his initial injury, after experiencing significant delays in recovery due to the
nature of the physical and emotional challenges he was experiencing.  At the
time of referral, Corey presented with multiple stage 4 pressure injuries with
diverting colostomy, three failed flap procedures and osteomyelitis
(inflammation or swelling that occurs in the bone as a result of an infection). 
His wound recurrence was secondary to non-compliance and presented a significant
risk, as infection is the leading cause of hospitalization and mortality in this
patient group.

Especially notable in Corey’s case was the difficult emotional journey he was
experiencing. Initially, Corey was extremely reluctant to open up and engage
with the assembled care team.  He was disengaged, hopeless, sad, suicidal,
angry, resistant, anxious, and using substances. Through weeks of building trust
and engagement with the Clinical team, Carisk would come to learn that there was
a history of domestic disputes and arrests which led to Corey, his wife and
their small child being kicked out of family members’ homes, hotels, and motels
where they were staying.  Corey was non-compliant with his physical therapy and
other rehab treatment, with access to reliable transportation being one of the
many barriers.  He had been abusive to hospital staff, eventually being asked to
leave a rehabilitation center of excellence due to his behavior.  Much of this
was a replay of aspects of his traumatic, abusive childhood and became a
significant factor contributing to delays in his recovery.


COREY’S PATHWAY 2 RECOVERY

Alana Letourneau, MD, MBA, Chief Clinical Strategy Officer at Carisk Partners

“Through development of the Carisk Wound Management Program, we have further
expanded the Pathways 2 Recovery program, including adding to our medical and
mental health team expertise, focusing our patient clinical interview, and
augmenting our systems and technology by way of data capture, analysis and
documentation. The result is a program that recognizes the unique needs of
patients with wounds, powered by key data mining, expert guidance and patient
partnership.”

 – Alana Letourneau, MD, MBA, Chief Clinical Strategy Officer at Carisk Partners

The Carisk Pathways™ 2 Recovery Program was created for cases like Corey’s.
Through the bond Corey and his multidisciplinary team forged, Carisk helped him
to enact positive changes and reframe his perceived threats as opportunities. He
stopped using substances, benefited from anger management coaching, reduced his
anxiety and depressive symptoms, processed his trauma related to the accident,
improved his marriage, and became a better father to his young daughter.

The psychosocial interventions in this case were key to enabling effective
medical interventions. Carisk assisted in smoking cessation prior to Corey’s
fourth flap procedure; the procedure was followed by antibiotics, wound care and
infectious disease oversight.  Corey was provided a wearable device- a remote
watch- to assist in offloading reminders.  Referrals to Urology and GI were
facilitated for neurogenic bladder and bowel oversight.  The Carisk clinical
team paired Corey with a nutritionist, connected him to housing assistance and
coordinated transportation to all appointments.

Over time, Corey was matched with behavioral health support, including a
psychiatrist, mental health counselor and a pain management specialist to help
transition him from opioids to suboxone.  With proper psychosocial support in
place, Carisk was able to get Corey to a place where he was motivated to
complete outpatient physical therapy and rehabilitation through a home program,
followed by a gym membership coordinated by Carisk.


WHERE IS COREY NOW?

Corey’s experience was coordinated by a team whose activities centered around
information gathering, understanding his personal viewpoint and forming a
relationship built on empathy-based care navigation, sensitivity and trust.

Corey’s clinical outcomes included resolution of osteomyelitis without infection
recurrence during the period of Carisk’s management over two years.  Corey’s
fourth flap procedure was successful, without need for further revision. He
completed his rehabilitation course and was offered a job at the gym he
attended.  Functionally, Corey achieved independence in self-care and modified
independence in mobility.  Corey stated that his goal was to walk into the
hospital where he was treated following his acute injury. At present, this goal
is a reality, as Corey is able to stand and ambulate with the assistance of
durable medical equipment.

Previously too ashamed to smile, Corey today finds himself smiling frequently –
both due to his current fulfillment in life and also secondary to the dental
work that restored his fractured smile following the accident.

Carisk recognizes how important it is to invest equal attention to the whole
patient and their lived experience, being attuned to patient and family
perceptions and expectations of care, all of which drive engagement, activation,
trust, and timely wound healing.  Ultimately, it’s not just the physical aspects
of the healing process that patients must face but also the deeper psychological
problems that can surface. Delivering on a patient-centered, specialized wound
care program is key to patient recovery and improved outcomes.

To learn more about the Carisk Wound Management Program, please reach out to
Thomas Downey, EVP Sales, thomas.downey@cariskpartners.com or visit
www.cariskpartners.com. 





This article was produced by the R&I Brand Studio, a unit of the advertising
department of Risk & Insurance, in collaboration with Carisk Partners. The
editorial staff of Risk & Insurance had no role in its preparation.







Carisk Partners- A Risk-Transfer, Care Coordination Company





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WATER DAMAGE CLAIMS CONTINUE TO DRIVE NON-CAT PROPERTY LOSSES. HOW WATER DAMAGE
PREVENTION PROGRAMS CAN HELP

Water damage prevention programs that utilize Internet of Things technology can
help mitigate losses from non-catastrophic water damage.
By: The Hartford | April 1, 2022

When a building suffers water damage, many would think a heavy rain or hurricane
was the primary cause.

But not all water damage is due to major storms. In fact, about 75% of all real
estate water damage losses are caused by the accidental discharge of plumbing,
HVAC systems and appliances, the Hartford reports.

These losses aren’t just limited to claims for structural damage. Loss of
income, the expense to rebuild and the cost of relocating residents during any
building repairs can all add up. Certain industries and types of buildings face
higher risks than others. Health care and hospitality structures are just two
examples.

These costs can be reduced, however, if a commercial property owner employs a
water mitigation plan, especially one that uses Internet of Things (IoT)
technology. Water sensors, shut-off valves and other tools can detect when a
leak occurs, enabling someone to step in and assess — or maybe even prevent —
the damage.

“It’s important to take proactive measures to avoid water damage through a water
damage prevention program,” said Caleb Woodby, large property underwriting
officer at The Hartford. “It really helps to mitigate the loss.”


COMMON CAUSES OF NON-CAT WATER DAMAGE

Caleb Woodby, Large Property Underwriting Officer, The Hartford

A number of factors can cause buildings to suffer from water damage. Compromised
building envelopes, bursting pipes and other factors can cause water to
infiltrate a building and lead to mold and other forms of damage. Poor
workmanship, improper installation and defective or substandard materials can
also be part of the root cause of water damage.

An internal review of the five years of loss activity from 2015-2020 by The
Hartford found three leading causes of water damage: Accidental water discharge,
freezing pipes and sprinkler leakage. Accidental water discharge accounted for
54% of claims, freezing pipes 23%, and sprinkler leakage 16%.

“One of the biggest causes of water loss is accidental discharge,” Woodby said.

These losses can be high. Woodby gave the example of a pipe failure on a
discharge pipe from a pool that caused thousands of gallons of water to flow
down multiple floors of a building before the issue was discovered the next
morning. “The water ran overnight and there was nothing to stop the flow,” he
explained, resulting in costly losses.


WHAT INDUSTRIES AND BUILDINGS ARE MOST AT-RISK?

Though non-CAT water damage can affect any commercial property, some industries
and types of buildings are at higher risk.

The Hartford’s internal data reveals that the habitational, health care and
hospitality industries have the highest frequency of loss activity from water
damage claims. The sheer number of appliances, laboratories, heating & cooling
systems and related piping systems in residential, condominiums, hotels, public
entity and commercial high-rise buildings, mean that these items alone produce
many of the highest costing water damage claims.

“We’re seeing increases in water damage activity for hotels, senior living care
condominiums, and other residential occupancies,” Woodby said.

“We are also seeing water damage in hospitals. Loss activity is more severity
driven because even a little bit of water could damage sensitive equipment.”

Certain types of buildings are also at increased risk. High rises and older
buildings are two structures in particular that face a higher-level of non-CAT
water damage risk.

High rises frequently see non-CAT water damage claims with increased severity
due to their vertical risk. If there’s a leak in a utility room on the 12th
floor of a building, for example, water flows downward, damaging multiple floors
in the process. If it gets into the walls, the building could then suffer mold
damage as well. Water intrusion into elevator shafts, electrical bus ducts and
other vertical spaces helps accelerate and increase property damage.

“We’re seeing more severity in high-rise buildings,” Woodby said. “We did a loss
analysis and we found a direct correlation in the increase of the average losses
over time, over a five year period as you go up in building height. You can
start seeing more water damage severity in buildings with 10 floors or more.”

Older buildings are also at an increased risk. As a property ages, roofs, piping
systems and other parts of the building envelope deteriorate, making them more
prone to failure. Sources of losses include roof drainage systems, HVAC drain
pans, refrigeration appliances, hot water heaters and plumbing systems, all of
which need to be properly maintained.

“A lot of times there’s a lack of general maintenance for the building and
equipment,” Woodby said. “It is important not to lose sight of the fact that
these systems age and need to be maintained.”


HOW A WATER DAMAGE PREVENTION PROGRAM CAN REDUCE CLAIM SEVERITY

Camryn Santos, Director of Strategy for the IoT Innovation Team, The Hartford

To address concerns related to water damage claims, Hartford’s Risk Engineering
Organization developed a comprehensive Water Damage Prevention Program which
includes the use of Internet of Things products. The program uses water sensors,
flow monitoring systems, automatic shut-off switches and temperature and
humidity monitoring tools among other technologies to detect water leakages
before they can cause large amounts of damage.

“We’re looking to proactively use this water sensor technology to mitigate those
risks,” said Camryn Santos, director of strategy for the IoT Innovation Team at
The Hartford.

In most cases, the devices are used to detect water, allowing risk managers to
step in and contact the people needed to stop the leakage before it causes too
much damage. But in some cases, tools like temperature monitors, could detect
freezing conditions that may cause pipes to burst, before a loss occurs.

The Hartford is also committed to learning from past losses in order to
constantly improve their technology.

Santos gave the example of rooftop chiller equipment failing due to freezing
temperatures as an example of a way the enterprise has learned to improve their
technology over time.

After a rooftop chiller failed due to freezing conditions that were uncommon in
the area, The Hartford’s IoT Innovation team realized that both temperature
monitoring devices and strategically placed water sensors can help detect a
burst pipe early on. If the temperature monitoring devices fail for whatever
reason, the water sensors can help prevent egregious amounts of damage from
occurring.

“There’s a second layer of protection where we’d get an immediate alert if the
pipe actually did burst,” Santos said.

As these tools develop, The Hartford will continue to find new ways to use them
and help insureds prevent and mitigate risk.

“Our primary objective as an IoT team is focused around leveraging technology to
prevent or mitigate risk,” Santos said.

To learn more about The Hartford and its water damage prevention program, visit:
https://www.thehartford.com/insights/home-workplace-safety/real-estate-water-damage.

The information provided in these materials is intended to be general and
advisory in nature. It shall not be considered legal advice. The Hartford does
not warrant that the implementation of any view or recommendation contained
herein will: (i) result in the elimination of any unsafe conditions at your
business locations or with respect to your business operations; or (ii) be an
appropriate legal or business practice. The Hartford assumes no responsibility
for the control or correction of hazards or legal compliance with respect to
your business practices, and the views and recommendations contained herein
shall not constitute our undertaking, on your behalf or for the benefit of
others, to determine or warrant that your business premises, locations or
operations are safe or healthful, or are in compliance with any law, rule or
regulation. Readers seeking to resolve specific safety, legal or business issues
or concerns related to the information provided in these materials should
consult their safety consultant, attorney or business advisors. All information
and representations contained herein are as of March 2022.

The Hartford Financial Services Group, Inc., (NYSE: HIG) operates through its
subsidiaries, including the underwriting company Hartford Fire insurance
Company, under the brand name, The Hartford®, and is headquartered in Hartford,
CT. For additional details, please read The Hartford’s legal notice at
www.thehartford.com.





This article was produced by the R&I Brand Studio, a unit of the advertising
department of Risk & Insurance, in collaboration with The Hartford. The
editorial staff of Risk & Insurance had no role in its preparation.

The Hartford is a leader in property and casualty insurance, group benefits and
mutual funds. With more than 200 years of expertise, The Hartford is widely
recognized for its service excellence, sustainability practices, trust and
integrity.







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