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all right welcome to today's podcast darren shank with triage now welcome darren how you doing i'm doing fantastic how are you today man oh very good thanks so for for those of you who don't know darren is located in the great state of arizona and today it snowed the apocalypse is upon us apocalypse honestly i've been in phoenix for about 35 years most of my almost my whole adult life um i think i can remember four times when it snowed but we actually had snow laying on the ground for a measurable amount of time today that may be a first as far as in town and some of the outskirts where it's a little bit higher elevation you know maybe but actually in town we had snow on the ground on the streets on the lawns it was on the news everybody's freaking out for sure i feel like it's coveted we shut everything down it snows in arizona if aliens show up tomorrow i'm not going to be surprised exactly exactly all right so darren you are you've been with triage now which is a nurse triage service and maybe a little more since its inception how many years ago was that uh right about eight years eight years ago so i know we're going to talk about triage now and all of the cool things that you guys are doing um but the great thing about the podcast is when we bring you on we kind of dig in to your social media presence and for the listeners out there uh you've got a great blog you've got your own blog page which you're sharing awesome information uh motivational inspirational some things about you and it's darrenchatter.com did i get that right uh correct that's the website and most of the the social media handles are all darren chatter one all one word um as you know as i mentioned to you it's it's it's definitely self-therapeutic for sure i love writing and getting some ideas out of my head and onto paper so to speak um and then if i think that they're worthy of it i add that to the blog that's on my the darren chatter website and then that gets posted on my darren chatter linkedin page which then rolls over to my day job darren shank triage now vp of sales linkedin page and i share some of the ones that i think are either inspirational like you said motivational or a current topic that is uh you know prompting more discussion things like that so it's had some cool side benefits i've i've connected with a few people or reconnected with somebody that i i'm you know technically connected with through linkedin but haven't spoken to directly in a while um you know a few clients have reached out and said hey i shared this with my sales team this morning things like that so i've had some surprising side benefit to it other than it being just kind of a self-serving you know mental clarity kind of exercise i i personally i i probably spent 15 minutes on there yesterday just going through it and i know it it because it says on the top please be patient some pages are slow but i was patient and the information on there was good i i wrote down a quote that i really liked that i think holds true um to especially me but it says this is a quote that you posted on darrenchatter.com your outside competition is largely irrelevant you are your competition yeah and i i love that message because i feel that in order for me to get better i in order for me to grow and get better i have to get better and i have to get out of my head and it's not somebody else's fault it's not somebody else's problem it's me yep it all starts inside right as a young company when i first started in the in this business we were always looking at what everybody else did and how could we do that the same or how could we do it better and then once we kind of hit our stride we really realized how can we be better how can we do what we do a little bit better each day each month whatever it is what other enhancements can we bring to our process and once we switch to that mindset things really started to take off we weren't trying to be somebody else we were trying to be ourselves and i think that applies on an individual level also to the corporate level uh clearly because that was that was certainly our path 100 i think it's a small-minded position to care about what your competition's doing or to set your expectations based upon your composite based upon those that you compete with if you worry about yourself yeah you're true to yourself and your path and you're better i mean internally and your processes are better you don't have competition right you're all it's all upstairs yeah and for triage now in particular we were competing against 4 billion a year companies in some case uh they're a lot bigger than we are right but in some cases that's to their disadvantage what a medium to larger size company wants as a refreshing change is to be the marquee client of a smaller company because they get more attention they feel more hands-on instead of being just a number on a file amongst thousands of other companies that that a competitor of ours may work with so we spun that to our advantage and we we also kind of took the stance that we will always operate like a small company regardless of how big we grow so we want to help everybody we want to customize and that mindset has already separated us from our competition from what i can tell well i think from what i've seen i would agree with you i know as an insurance agent myself we've sold ourselves as a boutique agency and there's just some clients that they prefer a little more hand-holding or they prefer a little more personalized feel that you don't get when you're you know an account number you call it remember they're like what's your account number we can't find you we don't know who you are what's your account number i don't know what my account number is for crying out how about you identify me by my name i have a name i'm a person let's talk about that yeah it's uh sad but true it would be great if if uh if the world operated that way on a much more you know personal one-to-one level but as we all know that's not always the case that's true so i know we're gonna talk about triage now but one of the things that you and i talked about here are a little bit of difficult prior to triage now you had a sports career i did i did it was uh not the most lucrative sport i could have gone into but it was the most personally rewarding and the best personal growth vehicle i probably could have chosen i didn't know that when i was a 15 year old kid but the my professional racquetball career and yes there is such a thing as pro racquetball i get that as a follow-up question all the time um i didn't know that was a thing and i'm not trying to knock racquetball at all i mean i did not know that was a thing until yesterday and i was just talking to somebody today in minnesota and in his office they have the state champ for racquetball in minnesota working in their office oh wow that's awesome the funny part is that guy and i are probably two degrees of separation away [Laughter] it is a it's definitely a small sport we're the ugly cousin to tennis right we we would love to play in front of tens of thousands of people for millions of dollars my standing joke is that in racquetball we played for hundreds of dollars in front of tens of people right that that was the reality of the sport in its heyday in the late 70s and early 80s it was as big as it ever was um except for one event that came to fruition about 20 years ago and that dates back to my career um well uh 30 years ago sorry um no i'm sorry 20 20 with the end that's correct um so we uh one of the more prominent people in the sport of racquetball began putting together the us open championships of racquetball so that was by far the largest event a year we were on the tennis channel for a little while espn some of them not the main espn but some of the minor like espn3 kind of a programming and so that was great exposure for the sport and brought a lot of uh awareness to the fact that there is a professional racquetball tour um but flashback to the 80s when it was at its largest companies like you know beer companies and nike and people like that were involved in the sport and that's when it was at its absolute peak the hard part was televising it very effectively and that really became the downfall of the sport in general if you can't put it on tv effectively then the non-industry sponsors aren't terribly interested and that's really how you make the the leap to the next level there's kids riding skateboards at 12 years old that are making a hundred thousand dollars there's very few racquetball players out there making that kind of money where would where would they hold the was there like a national championship so the u.s open in its the first several years was actually held at the racquet club of memphis which also hosted the saint jude tennis the pro men's tennis event as well so they would uh build a grandstand stadium with a portable court that was uh lucite on two sides and therefore the crowd could sit behind the court and on the side and there was also windows cut in the front wall uh with the same lucite where a camera could be used to film from the front at times and then in post-production with the three or four different camera angles you can make all of that look very presentable watching it live was almost always done by racquetball fans so that was fine but you had to make it look very cohesive on television and that takes a lot of production work post-production work and that's expensive so for us a niche sport like racquetball that was also a determining factor if we could have had somebody like let's say nike or gatorade or somebody like that say we're going to be the official sponsor of this event or of the of this pro tour and part of that is the budget to be on espn because they would get more exposure out of that that would have certainly taken us to the next level but unfortunately that never materialized i've learned more today about racquetball uh yeah i've it's been again for me starting at age 15 i probably could not have picked too many other sports that i could have started that late and still was able to turn pro and do a lot of the things that i did if you're not a marquee standout world recognized junior by age 15 in tennis you've missed your window racquetball's a small enough sport that i was able to start late and even though a lot of the people that i competed against when i was on the tour uh started 10 years before i did i just did enough work in a crunched window of time to get to that level and be somewhat competitive with the top 20 players in the world there was definitely a noticeable gap between me and the guy at number 10 and there was twice that gap from me to number five i competed against some of the best players in the history of the game and managed to sneak one out of a one game out of a best three out of five match off of them at times that was as close as i got wow i'm actually i'm gonna have to go back in and dig in and just kind of look at that a little more now now that i've gotten the education well the the the best thing for me was i did a lot of things the hard way so when i segued into coaching i've been the coach of the arizona state racquetball team for the last 14 years i would never let my kids follow in my footsteps right i did a lot of things the hard way and i learned a lot of tough lessons because of it and so as a coach that gives me a great base to draw from even if it's what not to do right that that can be very very helpful in somebody's personal and athletic development i think personally the only way to learn is the hard way i don't i don't know any other way but if they're in the wrong way and a hard way that's going to be the first attempt and that's the only way that i'm going to gain any education or insight yeah to fail as long as we can get back up and recover but yeah it's always going to be the hard way yeah and as much as i'd like to think i'm smart enough to learn from others and and avoid some of the aches and pains i you're right i i have learned an awful lot of lessons the hard way and had somebody go well told you so but hey welcome to the club right so you know it is what it is you're a business owner out there listening to us don't do it the hard way listen we've been there we've done that we know right yeah it's you know it anytime you pour your heart and soul into something your judgment gets clouded right it's just it's so it's impossible to keep like you said as a business owner or as an athlete and whatever your pursuit or endeavor is it is so hard to be objective when your heart and soul is tied into what you're doing and that just leads to bad decisions right in some cases right you think that you can you know i mean i've i've flown to or driven to a tournament where i knew i didn't have gas money to drive back right like i'll figure it out when i get there right that's crazy sometimes it's necessary and in that one particular example that jumps to mind i drove to a tournament in vegas knowing that i wouldn't have enough money to drive home if i didn't win the tournament and i'm not at the pro level i played in the amateur division but uh i i literally bounced my entry fee check and so i had to win the division to cover my entry fee and put gas in the car to get back home i finished second which was enough money to get me out of trouble and i borrowed a little bit of money to put you know gas in the car and stop by del taco on the way out of town that was my weekend in vegas right um but i learned to not do that again because the pressure of that affected me in that final match and that was part of the reason that i lost had i planned more effectively and could have just gone on the court and played without the worry of i need the money i think the results would have been different i feel like that's a that's a bigger message right there yeah yeah yeah and that's you know the the entrepreneurial ventures that i've gone into that was always the downfall was okay we need to we need to have this much money in the bank before we start okay well we've got almost that much we've got an opportunity we might want to explore here so let's get things rolling now we're going in underfunded underarmed and sure enough you know at some point we fall short because of the lack of planning and the emotional side taking over not wanting to miss out on something but we weren't really ready to truly execute well that's not the case with triage now because you guys are doing some pretty cool things well thanks it's you know i mean we've we've had our growing pains you know since day one of course i mean the first couple of years going into a market where we were competing with you know literally billion dollar companies uh that was that was tough and as i like to you know reminisce it keeps me humble to remember that the first year that we went to the annual uh workers compensation and disability expo in las vegas we got the smallest table slash booth that we could have and we were right next to the men's restroom i was practically handing out towels to people as they were walking out of the restroom that's how close we were right and but we we were there we learned we had a couple of competitors walk by and go oh cute you guys are going to do triage huh good luck hopefully you'll be here next year right and then we were we kept going we figured things out we came back next year a little bit bigger booth better spot on the floor oh hey look you guys are you know good for you you made it to year two right and then when we're you know three or four years deep and we're starting to take clients away from those competitors now their attitude has changed a little bit so that was that was when the fun started the first couple years were certainly a struggle as with any startup company you know that is that's probably the case but we hit a tipping point where things got to be a lot more fun for sure so let's let's uh let's talk a little bit about um about what triage is a couple episodes ago we actually had uh mike mcdonough on uh mike mcdonough as a work comp renegade in california uh he's the king of triage as far as i'm concerned because the guy has been doing triage i've been doing it well and has been implementing it successfully with his cl ents in california and the surrounding states for a number of years and that was that was kind of the agent side of it it blows my mind but there are still insurance companies out there today i had a phone call you're not even going to believe this erin i had a phone call from a marketing rep from an insurance company today young company we're looking to appoint agents uh we want to partner with you and i said to him i said well how is your claims process handled and he says to me well you log into the website report it and i said are you using nurse triage and he goes i don't know what that is this is a representative working for a workers compensation insurance company that does not know what nurse triage is yep and i mean luckily we weren't on a zoom thing but mike my my head wanted to come off my body because i don't understand how it's 20 21 and nurse triage is not utilized at every single claim at every single every claim no matter the size of the account or the size of the claim let's transfer that liability to a professional nurse and so i don't want to i don't want to steal your thunder here and you're going to do better than i am but for those businesses that may not know what triage now is or what nurse triage is can you just help educate us sure so i'm not surprised to hear your experience because i still have that experience frequently i it's baffling to me as well why what we do is still somewhat of a well-kept secret so about 20 years ago this con concept came to fruition we did not invent the process by any means we had the luxury of standing on the shoulders of the people who did and who came before us and at least meeting those minimum requirements and then looking to add to the process and make things a little different and a little better so in general the objective of a nurse triage company is to provide time of injury solutions so that means assuming it's not a life or limb threatening injury those should still be 9-1-1 phone calls right anything short of that you call your nurse triage company you speak to a registered nurse the supervisor can initiate the process or the employees can call directly depends on the client they speak to a registered nurse the nurse follows a medical algorithm to determine the appropriate level of care for that injury so not the ehs officer not the manager not the employee themselves but a medical professional is making the determination for care within moments of that injury occurring in most cases so for us lat 2020 and most the companies that i consider our competition all do a good job right there isn't anybody that i can kick dirt out and say uh they they're just not doing a very good job of this service right there's five companies we're one of them that provide this service nationwide at a very high level all of us do a good job i know there's no governing body to the triage industry so there i don't i every stat that i'm going to share is anecdotal for us in 2020 42 of the calls that we took ended up as a self-care referral so that means that that injured employee had an injury minor enough that it did not need clinical intervention based on the medical algorithm and the nurse's professional opinion so that of course directly equates to a 42 reduction in the number of injuries that became claims so that for the company is the major benefit not only are you outsourcing the liability of the decision making but you're having a medical professional record the phone calls document everything that happens and if somebody needs clinical care help facilitate that and if somebody can be sufficiently cared for with self-care or even first aid on site guide them through the process and get that person back in action as quickly as possible so today let's uh let's say i slip and fall at work what floor sign whatever it is slip fall hurt my elbow my elbow hurts i go to my employer they don't have nurse triage i tell them my elbow hurts and i want it looked at and there's a good chance they're going to say well maybe you should self-care and i i can probably push back and say no it hurts i think i want it looked at emergency room is probably where i'm going to end up if i'm in a rural area maybe it's urgent care if i'm in a larger metropolitan area it's a thousand dollar bill minimum easily yeah add x-rays add whatever else to that maybe it's not broken you're right thousand dollars whereas if i'm an insured that partners with triage now or maybe my insurance company partners with chia's now we call our 800 number and we've transferred a hundred percent of that liability off onto your team of registered nurses therefore may be saving that business a thousand dollar er bill well to some degree right i mean to a large degree what you said is correct this is america anybody can sue anybody and i and i i never want to give a prospective client the impression that they're going to be 100 shielded behind triage now our medical director's license is on the line first and then the nurse and then us as a company but at some point if an if an employee goes to get legal representation at some point the employer is going to end up on the list of people that are being sued as well now we're we're absorbing the brunt of a lot of that and there are very few opportunities if any for an injured employee to really get a fraudulent claim through the system or enhance or exaggerate on something because if they end up at the clinic the doctor knows the extent of the extent of the injury or the damage that occurred so if you fall and like you said you slip and fall you land on your elbow we take that call we talk about your elbow we ask questions about anything else being injured and the answer is no several times and then we make a clinical referral if you go to the clinic and say my left ankle hurts and my elbow hurts well the left ankle was not related to the injury we know that i discussed the discussion with the nurse the mechanism of injury you know were there any witnesses to the to the incident that occurred things like that so we're putting handcuffs to some degree on that person's ability to get representation and sue their employer or sue us as the triage service i hate to say it but if somebody does not disclose to us something important like they're diabetic and they have a laceration or an abrasion and we ask that question several times and they don't disclose something if they get a less than ideal outcome and come back to try to sue us all we have to do is pull the call recording and say you were asked this question we made a medical determination based on what you shared with us and that's very defensible in a court of law of course so we're in the position of for ourselves easily defending what we do and as you had said for the employer shifting as much of that responsibility to us and away from them as possible well i think that even your team or a nurse triage team is better equipped to make a decision than the floor supervisor the floor manager when it comes to non-urgent non-emergency claims right i mean life-threatening call 9-1-1 nobody yeah what are you saying don't call 9-1-1 and don't get an ambulance out there but i think from from a position of if i'm an employer and i want maybe some of the best care that i can get for my employees and maybe our closest facility is 20 or 30 miles away this is a great resource and it's going to do it's going to do a couple of things one it's going to allow a recorded statement it's going to allow the employee to get instant care i'm guessing you guys pick up the phone in what 10 seconds 15 seconds process yeah exactly there there's an auto attendant that has that familiar language of if this is a life or limb threatening scenario please hang up and call 9-1-1 and then we inform the caller that it's being recorded and then it rolls over to the call center to be answered live got it and one of the cool things that your company does is everybody gets a dedicated number so that when abc construction calls in you already know it's abc construction yes i don't i don't believe that's unique to us i think the other triage companies do that as well for the most part but for us we tie that client's info to that that call-in number so when that phone number hits the call center that is the information that pops up on the screen in front of the nurse so we pre-determine who gets what documentation what clinics are in the vicinity of this particular location things like that so as much of the process as possible is automated so that we can focus on the high touch part of what we do which is our nurses talking to your injured employees that's where the focus of the call should be so everything that we can automate in the background to happen during or at the end of the call we do that so we can focus on the human to human part got it so there's a oh my gosh there's so much stuff i want to talk about here because i love i love nurse triage okay so let's say i'm a construction firm and we a lot of construction firms out there right now uh in order to get a job they need to have a mod a worker's compensation mod factor of one or below and as an insurance agency we have to send that to general contractors because a general contractor certainly does not want to hire a sub that has experience with multiple workers compensation claims on a job it's going to invite osha it's going to invite delays all sorts of problems so going back to that slip and fall claim if it ends up being self-care for the person that injured their elbow there is no cost that gets reported to the insurance company or rolls on some loss experience report if that claim ends up being self-care 80 yes there are some of our partners that we work with um have as at the carrier level have a program where they want everything reported to them even if it's for first aid only and then they don't they don't necessarily assign a claim number and open a claim they just sit on it in case that happens in the future by and large what the the methodology that we use is that if a clinical referral is made that's the trigger to send information not only to the clinic but also to the carrier to set up a claim to pay for that clinic visit and the other expenses got it so slip and fall claim results in self-care ends up being probably a zero dollar claim becomes a claim if there's a referral the next day tomorrow and at that point the claim cost has been reduced because instead of an urgent care or emergency room claim or doing a doctor's follow-up or doctor's visit and getting some eyes on it then usually probably within 24-36 hours still a lower cost for the employer and that employee got instant moment of care yes and the other thing is especially unfortunately in these these times with the kovic concerns we were trying to make the best employee experience possible out of the unfortunate scenario of a workplace injury so if you go to an er because you think that's the best level of care or in some cases the time of day dictates that that's the only thing that's open or as you mentioned earlier you know rural areas where the nearest uh medical resource at all is the er or the hospital that's the next town over and is 60 miles away all of those things are factored in right if we can have somebody meet the criteria for self-care then they don't need to go to the clinic at all if somebody has a minor injury and it's four o'clock in the morning because they work a third shift at a warehouse or they're just showing up at the job site for construction they jump out of the truck they twist their ankle but they're on the premises so that makes it work related the only thing open is the er well that's going to be a long wait time because it's not a life or length limb threatening injury the care playbook at that point is all very very similar so what the nurse at the er would say is the basically the same thing that the nurse at the urgent care or occupational medicine facility would say as well as what our nurses would say and right now unfortunately there's concern about who's sitting next to you in the waiting room at the er right if somebody's walking in because they think they need a covid test or they lost their sense of taste and smell and they're coughing like crazy and they're not sure what's wrong you don't want to be sitting next to that guy for three to four hours in the er waiting for a nurse to come talk to you so all of those things can be filtered out with a triage process let's take it even one step further i think the cool thing about triage is if i'm abc construction and i've got crews working in multiple job sites multiple states one call to you and we now know where to go that employ that injured worker gets instant care no matter where they're at and then you can manage that claim process for our on behalf of the employer as opposed to that employer or that you know like you said if it's six o'clock in the morning somebody slips and falls on a job site hr's not until eight they don't know what to do where do they go do i have to file a claim should i go to the er should i not go to the if the employer has this nurse triage from triage now in place they call that 800 number you guys can make a determination set up the right appointment put them in the network and advise where they go and make sure that process is simple from the instant phone call yep we we're the tip of the spear in that process and like you said with having you know injuries that happen 24 7 a company resource isn't always available so even more reason to have a triage service in place but even if it's during the day the the registered nurses can ask questions that managers and supervisors should not are you on blood thinners are you diabetic you know what medications do you take things like that that are very relevant in dealing with the injury but are hipaa protected so now you're in that gray area of okay well i shouldn't ask this question but i'm gonna so that i know what to do that's bad or i'm not gonna ask the questions and i'm gonna tell somebody who is diabetic but i'm i is the manager i'm not aware i'm gonna tell them uh put a band-aid you know put go go to the first aid kit put a couple bandages on that you know hopefully it should be fine go ahead and get back to work well a week later that that person now has an infection on that abrasion and now they're going to go to the hospital to get it de-breeded maybe stitched up they're going to miss some time etc etc right so by being the time of injury solution that we are we're taking better care of the employees we're alleviating some of the duties of the company and even the ehs officers right i mean that's kind of their role but they don't have the medical expertise to the degree that the registered nurses do so again you're outsourcing those decisions to us or another triage service and when a clinical intervention is necessary we facilitate that we send all the documentation out to anybody who's involved in the process and that is typically where the triage service ends if somebody walks through the doors of a clinic they're now under the care jurisdiction of that clinic if we make a first aid or self-care recommendation they're still technically under our care jurisdiction but because it's very minor we would expect to not hear back from that person or rarely hear back from somebody that gets a self-care disposition because the instructions that we share are minor and that should be sufficient to have market improvement overnight or in the next day or two if i have an employer and i don't have triage now and that's something i want to put in on my own what uh do you have an estimated cost i mean without holding it any numbers like how inexpensive is it for a business to put this in maybe a one a one shop location or something yeah so it's a million dollars to set it up and then just kidding um if that was the case i wouldn't be sitting here talking to you right [Laughter] so um we have a small setup fee there's an annual fee that covers recurring expenses like replacing posters and wallet cards doing more training updating the phone app things like that um and the setup fee includes all of our the niceties that we bring to the table such as our client portal where you can run all of your o n reporting if you choose to the phone app all of the training that we do which comes in a variety of forms we have some pre-recorded videos i do custom voice over powerpoints i do live web-based trainings and we can even do a train the trainer scenario all of those kind of expenses are rolled into that one-time setup fee from that point forward it is a pay as you use it service for most of our clients if it's a large enough client that has maybe 100 injuries a month for example they can benefit by prepaying and have a little bit of a discount instead of just a regular fee on on their invoice at the end of the month but for a smaller client the pay as you use it is the ideal setup because there's no monthly minimums there's no pre-purchase and use it or lose it type of a methodology when the phone rings however many times they they call us in january on february 1 they get an invoice for those phone calls if there was no calls in january they don't get an invoice from us in february it's just as simple as that so i think what i want to share with business owners out there is that the cost to put this in is is very reasonable i would almost say inexpensive really for what you get and the other thing we should probably touch on is if i'm a business or a small business and my workers compensation company does not have triage now or nurse triage i can partner with triage now and put that in on my own yes so in an ideal world you as the client should have full autonomy to make those decisions there are from what i hear a few insurance carriers out there that discourage the use of this type of service and the reason for that is is simply selfish right they charge you for every claim they set up a triage service is going to reduce the number of claims therefore they don't want you using the service well here's the reality a you're the client so you do get to make those decisions b they're gonna save money working with you versus you leaving them to go to another carrier who does offer that service so in the end it is the best thing for everybody to for all of us to play nice in the same sandbox and have our service funnel into the rest of the services that the carrier would provide and make that a cohesive approach i like it so i would advocate i'm 100 on board with you if if you're a business owner and you're purchasing workers compensation insurance step one at a bare minimum at least find a carrier that offers some type of triage your employees will thank you and you're going to have a better claim experience and from a paperwork and an administrative compliance issue once they call the 800 number on all of that documentation is taken verbally it's a recorded statement there is a much higher level of protection there for you the business owner than there is for somebody who sent somebody to the er and seven days later is filing a first report of injury with the carrier yep yeah go ahead i'm sorry go ahead no go ahead what do you want to say oh the yeah a couple of thoughts jumped to mind there when you were going through that so when you have a time of injury solution that also does all the documentation one of the major complaints that the carriers have which you were alluding to there is the lag time of reporting excuse me so not only does that impact in some cases the care for the employee because if they show up at the clinic and there's no documentation that we all think that the clinics will do the care and then worry about who to chase for the bill that's not the case that that person will sit there until the company can get a hold of somebody that says oh yeah yeah this you know we work with liberty mutual or our account excuse me our policy is with travelers and here's the number you can build a uh that policy number for the claim things like that um so when you automate those processes through a triage program you're you're streamlining it for everybody the employee will get the care they need as soon as they walk in the door everybody else who's involved in the process including the carrier gets the information they need to set up a claim and we're in the triage business we're not in the investigative business right so there still needs to be an adjuster that reaches out gets more detail and stuff but when we can get a statement from the supervisor and from the employee themselves and get that into the hands of the right people that greatly expedites the process overall and i'm just guessing for those people that say i don't want to call in it takes too long i'm too busy those are probably common excuses right sometimes and i'm i'm amazed that people call us and they're mad that we're trying to help right it's like you haven't you're talking to a nurse within moments of getting hurt and you're you just wanted to go and sit at the er that's not that's not solving the problem right you're going to sit at the er for a couple of hours before the nurse there talks to you if you talk to our nurse she's going to tell you she or he is going to tell you you know how serious this is what the next course of action should be if you can do things immediately to help alleviate pain or if we need to get you to a clinic we're streamlining the process when you get there all of that is to the employee's benefit but on occasion people call and are a little grumpy with the nurses because they're like ah this is a hassle i don't want to be on the phone for 15 minutes i just want to go to the er well that's not the fastest resolution by any means no and sitting in the er and some of those larger metropolitan like yeah we're fortunate where we live that uh we're pretty rural and we get in and out but i've heard you know horror stories about you know the large cities and you can spend seven eight ten twelve hours just waiting yep it is not uncommon we actually work with a large university uh can't say exactly who they are but they're on the left coast i'll leave it at that and they have a facility on site and sometimes their wait times are six to seven hours routinely and so when we can funnel people to the urgent care that's better for everybody it's a way better experience for the employee it's not clogging up the hospital that's in the in their vicinity it's getting people to the urgent care which is a faster resolution it's less expensive care without sacrificing the care the hospitals just charge more for the same type of care when it's a minor injury so it's a win for everybody for sure so let's talk about uh there's a push in the industry right now i mean instead of instead of calling to do like what we're doing right now zoom video app where do you where do you see the future heading for for uh the ability for businesses to be able to report claims and actually i don't want to say facetime but like facetime video conference whatever the term is the the registered nurse with the injured worker so we kind of took us a halfway step towards that a while ago we brought the first phone app to the industry that allowed you to take a still photo or two of an injury and send it to the nurse in real time now there's limitations to that right if you pull a back muscle there's nothing to look at but if somebody gets bitten or stung by an insect or an animal has an abrasion a laceration a chemical burn something like that um it can be very helpful because you know we've all had injuries and the nurses all joke about how you know the women are so much tougher than the men are a guy will call you and tell you oh it's a 10 out of 10 on a pain scale well if you're speaking in a normal voice and not fading in and out of consciousness it's not a 10 out of 10. you haven't experienced childbirth you don't know what 10 out of 10 is right so um we that's a the the phone app was helpful in determining more accurate information in some cases and we get both ends of the spectrum we get somebody that has a splinter and thinks they need to go to er and we may get the occasional construction worker that shoots himself with a nail gun in the thigh but wants to finish the job first before they worry about the injury right so sometimes we're talking people off the ledge sometimes we're talking sense into them but the phone app with the pictures helped facilitate that the extension obviously would be to upgrade to video and bring a video interaction into that process how far do you think the industry is from that well it's already happening um we don't do that ourselves we partner with a couple of companies that do telemedicine our primary partner has been concentra they have a great system they have their own brick and mortar locations around the country they have dedicated doctors to doing telemedicine somebody some other companies are still trying to build their doctor network and things like that so it's a little clunkier concentra has really they're they're i think they're much farther down the road than most so since you're the tip of the spear is it you take the cream you take the report um and then if further care is needed you just transfer that claim off then to to concentra when it's applicable that's that's the best way to do it in in our opinion is to filter the injuries through the telephonic triage process and when it meets the criteria and the injured employee agrees that telemedicine is an additional approach they'd like to take then we facilitate that that's the best way to do it for sure because the one downside currently well there's two but the one major downside to telemedicine is that if you see a doctor via video it creates a claim so that negates at least for us at triage now the 42 self-care rate that we had for our client base last year that's why we want to filter it if the if we're going to make a clinical referral let's use a burn for example i'm not a medical professional so you know i'm i try to do my best to stay in my lane here right but if somebody has a burn on their arm and we do our telephonic triage process and they're describing it effectively there we have a good idea of what's going on the ideal treatment for that would be a prescription ointment for example so now instead of sending that person to the clinic having that person go to the clinic sit there repeat the process we just did on the phone then get a referral to the pharmacy write a script go to the pharmacy sit there wait for this to get filled the win with telemedicine would be this we make sure that this injury is meeting the criteria the injured employee agrees yep i'd like to do telemedicine we send it to our telemedicine partner they take over from there the doctor sees that person via video writes a prescription sends it directly to the pharmacy in their vicinity and the injured employee gets to skip the clinic visit and go right to the pharmacy get the ointment that they need and the pain relief and the healing process starts that much faster than the previous example that i gave that's the win that we're all looking for with telemedicine it just isn't as much of a blanket approach as we would all like because of it negating the you know the self-care instances everything becomes a claim if you if you only run it through telemedicine yeah well i think i mean there's no one-size-fits-all approach when it comes to workers compensation claims the one side that the one-size-fits-all approach for workers compensation claims when you don't have nurse triage is the emergency room we don't know go the register as an alternative we can pass that claim along to nurse triage that nurse triage service if needed can pass it along video conference to a provider it's a seamless experience it's faster it's a lower cost and you gave a great example earlier of somebody working in a rural area right like maybe a highway crew that's doing asphalt they may be a hundred miles from the nearest location we work with a couple companies on the indian reservation that we're building a hospital well until they're done there's no hospital on the reservation right their nearest facility is 180 miles away in flagstaff arizona so telemedicine's a great solution there because what you want to know is how do we treat this injury do we drop what we're doing and get this guy in the truck and drive him 180 miles because that needs to be done can we wait till the end of the shift and have him do that on his own time do we eravac this guy out of here because it's worse than we thought he's got a pacemaker he got shocked from a downed power line etc etc right all of those things can play in and in some cases telemedicine is the exact solution that alleviates a lot of those problems agreed darren we're running out of time here what else all right these hours i try and keep it about an hour but sometimes these hours go by so fast what else do you want people to know about nurse triage or triage now well in the grand scheme of things i think almost every single company benefits from a triage process right we even have clients that are call centers and i didn't i wasn't sure we'd have a ton of impact for them but people slip in the break room people fall in the parking lot right that's all com those are workplace injuries so anybody who's doing anything remotely physical should be looking at a triage process even if it's only for better employee care and they can get a couple of wins by having injuries not end up as claims if you're a company that has multiple claims a week or multiple injuries a month if you're not utilizing a triage service you're absolutely missing out there's tons of benefit the big five all we all do a great job for us at triage now we use a slightly different approach on the front end we have a military triage approach to our algorithms what we're looking at is can we help you where you are and get you back in action or do we need to get you to a clinical environment again this is anecdotal but what i have learned from the clients that i have taken from competitors and brought them over to triage now a lot of our competitors utilize a system that's more clinical based which means of course you're going to get more clinical referrals out of that but if you have no triage program anybody that's in the top five of providers is going to be a huge benefit to you if you're working with a provider for that service that you think you could do better with then you know shop around a little bit there's only a couple of other companies to look at of course i'm biased i'm going to tell you that i believe we do a better job we i think our biggest attributes are the military triage algorithms and the fact that we are able to customize to a very high degree for each individual client what we do we wrote our own software we have our own coders so that gives us some flexibilities that some of the other big five do not have got it so businesses if you don't have nurse triage now or if you're if your workers compensation carrier doesn't provide nurse triage number one go find an insurance company that at least has nurse triage i mean like that's step one right it's gonna make a better experience and help a better claim process and then what i heard you say that i thought was really interesting was if you're a business that's having multiple workers compensation claims a month and maybe you're concerned about having every one of those go directly to the insurance company maybe layer in a nurse triage service such as yourself which is stand-alone that way claim is filed but not i guess formally filed so that uh that dollars are being accrued yeah it's documented if things escalate to where it does become a claim the process has already started again we've got the call recording if we ever need it so that's that there's plenty of benefits right there for sure and just just to make let's go back here and revisit the beauty of nurse triage the insurance company knows about the claim right we are not advocating that i'm not advocating you're not advocating we're not we're not telling business owners don't submit the claim to the insurance company but the beauty of nurse triage is if the insurance company knows about the claim and it results in self-clear and it gets closed out with zero dollars that's a win for the business and what they're going to pay on workers compensation it's a lower cost for the system and it's a win becaus it instantly takes care of the injured worker fair enough right yes and in some cases if the insurance carrier is okay with us notifying them only when something gets a clinical referral they're not even going to be adding up the injuries that were first aid or self-care onto your claims history report for that year so that means a reduction in the osho reportables obviously everything's recordable but the osha reportables your emr score or your emod score if we're taking a bunch of the minor 42 of the minor injuries off of the books so to speak not hiding claims not squashing information but handling it appropriately and because it's first aid or self-care not having it enter the clinical system there are tremendous financial benefits to that as well it's above my pay grade to calculate those things um but when you're talking about lost time emo emr score all of those kind of things a professional in the industry such as yourself could easily shed some light on the additional monetary benefit to the client on those types of things i can i can tell you the clinical spent expenditure that would be impacted by a triage service by looking at a claims history report the other pieces you know in partnership with a broker or a carrier you know we can we can also shed light on the rest of it as well absolutely i'm just an advocate for i think we just need a better experience and i think companies like this like what triage now is doing creates a better experience i mean without a doubt and unfortunately you know without a without a plan in place employees feel like they're left to their own devices to solve this problem even though it happened at work that's never a good place to start from if you have an employee who's had a couple of injuries and have bad experiences you know that's somebody that's a candidate to get lawyered up or just from a you know a personnel perspective starts talking very badly about the process in general oh the company doesn't care they're just trying to save money you know they're not worried about if my if my knee gets better or not you don't even want that toxic environment occurring if you can have a better employee experience and again i i firmly believe as you that that the triage process does really help that it's it's employee focused and the tr the byproduct of that happens to be all of the employer benefits that come out of it agreed any other messages for businesses or listeners out there today if not i have a couple questions for you um i think we kind of touched on it you know like i said everybody that's in any kind of business that has employees that's looking to even if you only have five injuries a year not every one of the triage companies will will work with you but there are us and some others that would um it's worth exploring especially if it's a pay as you use it service you're really you're not risking anything you're not buying something that you're not going to use at that point so kind of uh as user friendly as it could possibly get for sure so triage now is www.triagenow.com.net.net my apologies www.triagenow.net your contact information is front and center on the website yep how else can people get a hold of you um linkedin's always a good way i'm always watching that for sure um day job me of course my my linkedin profile for triage now um and uh email of course like you said the information is on the website um the phone number that is on the website if i'm not at my office desk it rings to my cell phone so you'll get me either way you are full service i tell you what i do what i can all right before we wrap up here um i ask everybody what they're reading right now ah um i'm actually in a book club i started as nerdy as that sounds i started a book club um with some friends of mine uh three years ago and we pick one book a month that we read and uh then we all discuss it on conference call because some of my friends are actually out of state um we don't sit around drinking tea together you know at my house it's you know it's done by a conference call or zoom but um uh what is this involved though what's that are beverages involved um not for me but i'm sure some of some of the people are for um for sure um so i'm actually reading a couple of books so i'm blanking on which one was worth the the assigned one for the um uh for the book club um actually you know what i hate to do this i'm gonna look it up looking up the last the last guy i asked this too he was a private investigator he says i don't read books i read these and he held up a private investigator magazine of like wow and i thought i told him i said i didn't even know that that magazine existed oh that's why i didn't remember it's a repeat for me um we're reading outliers by malcolm gladwell oh i love him um really liked that book a lot um if if you've read it before you kind of know that's where the 10 000 hours towards mastery theory really kind of crystallized i know there's been a lot of dispute to that um you know i i think there's some validity to it i mean having been a professional athlete accruing time on the court mastering certain skills i would say that his his numbers are pretty accurate you know does that translate directly over to to bill gates and other people that he uses as examples maybe maybe not but for me i actually thought that fit my timeline pretty effectively i thought that was probably spot on in in that assessment so i'm curious to see my book club has quite a wide variety of age ranges so i'm always curious as the different inputs and the different takeaways everybody has so having read this once before and it's still being you know kind of fresh in my mind i'll be real curious to see what everybody else has to say i'd be curious to hear that too i've read uh he's actually got i think four books out now and i i'm just in the middle of uh what the dog saw yeah uh i like his writing style a lot um you know i'm i there there's just a conversational tone to it with a good balance of a lot of technical information but not too technical where it's boring or over my head or i'm stopping and looking stuff up so that i can understand what he's talking about he's a great writer for sure yeah and so for people who haven't heard of the outliers as and i'm trying to go from memory because it's been a while since i've read this but he talks about how the the where your birth is like if you're a baseball player chances are you're born between january and what march uh hockey was the one that he used that sticks in my head because of the traveling teams and the the coaching the level of coaching you'd have access to and things like that so yeah if you were born earlier in the year and as a 14 year old you had 11 months as a 14 year old versus having a birthday in november where you were a 14 year old for one month of the year that was a tremendous advantage in terms of your physical development um and a bunch of other things that went along with that yep and he yeah he currently sat back to bill gates and the program he used to do with the library at night and the ten thousand yeah fantastic all right next thing is what's uh what are you spending more money on than you should that's a great question so um i'll go back to last year to to answer that question um food um my wife my wife and i are kind of foodies we went to some really nice restaurants um it's in sedona arizona we went to a new restaurant that we had never been to before it was quite a pricey experience it's not something we do very often but we decided to treat ourselves as of january of this year we've put ourselves on a budget we have some finance personal financial goals that we're close to achieving so we're we're kind of on self-imposed lockdown financially for some of the niceties that we experienced last year um but as for something that you possess for 30 minutes or less food is a terrible investment right but the experience of going to sedona spending the weekend going to a really nice restaurant you know my wife looks up the menu ahead of time so that she you know she studies through it knows exactly what she wants right i show up i look at the menu i'm like oh steak there we go you know but it's an experience for us and that has a lot of value but you know sometimes that value is not uh the monetary value of that versus the experiential value are quite disparate so that was something we've decided we we spent too much money on last year and we're clamping down on this year i totally understand i'm a foodie as well and i think the reason i'm successfully still married and i say still married because i might be hard to get along with at some points and [Laughter] uh is the date days or the date nights where we do the nice dinner we go out to eat we enjoy each other and it's just her and myself so totally get it i think i wrote a blog post about that not too long ago about you know just being the the best partner that you can be and date night is certainly part of that right i mean you don't ever want to lose the romance just because you got married and continuing to date your wife or your spouse is certainly a big part of that absolutely and last thing is what what piece of it you get the floor here on the way out what uh what piece of advice do you want to leave for the listeners today uh good question um you know for one of the things that i talk about a lot in relation to my racquetball career is to not make a job out of your passion i happen to love what i do at triage now i'm really excited still eight years into it to you know land new clients and share the opportunity of what benefits we bring with a company large or small i love the company culture that we have i absolutely love what i do but i never got you know the work comp business isn't the sexiest business out there right and i didn't have any experience in this business previously the hard lesson that i learned as a professional racquetball player was i made a job out of something i was very passionate about and that ended up becoming a job and led to burnout and that's why i retired from the sport so i think the ideal world is that you have a job that you at least like i'm fortunate that i love what i do but at least a job that you like that on sunday night you're not dreading going to work tomorrow and then have a passion on the side that you throw all your spare time and effort and maybe money into whether that's building homes for habitat or for humanity digging wells in the congo for the pygmies being a big brother big sister whatever it is that you're passionate about that fills your soul don't expect your day job to to check that box too i think if you keep those things separate it gives you a different perspective when you're at the office and when you're away from the office and that's the best of both worlds that is great advice that is great advice i i wish i would have known that sooner right who knows maybe i'd still be complaining i would still be paying excuse me playing competitive racquetball uh not at the pro level of course but um i i did i totally burned out on it because you know winning matches to to pay rent or to put gas in the car is a lot of pressure and eventually that just becomes too much if i would have been a fireman at that age of my life who played pro racquetball might have been a completely different story you never know well yeah i i i'm in agreement with you do something that you love and i think life's getting too short to put up with things we don't love definitely and uh there needs to be some type of balance and you need to find that balance internally i don't know that there's such a thing as a work-life balance but i think there's just balance in general and you'll know where it's at in your life yeah i i i don't think it was warren buffett but somebody his age range you know very knowledgeable um was doing an interview and and he said he doesn't believe in work-life balance it's whatever you choose it to be if you want to be an entrepreneur and work 18 hours a day because you love it and that's what your passion is awesome go do that if you want to work part-time and travel the world great do that do what makes you happy but having a blanket definition of work-life balance just doesn't work everybody's too different so you have to find what your definition is of that and and go from there agreed and with that we'll end this this great informative podcast thank you very much it was a pleasure to be here darren thank you so much pleasure was all mine thanks