Welcome
Lounge
Registration to the conference takes place at the information desk. Upon arrival at the hotel, go directly up the stairs to the next floor.
Program
18:00 - 18:30
18:30 - 20:30
Dinner buffet
Athena 1 and 2
After registering at the information desk, the dinner buffet will start at 6:30 pm.
20:30 - 20:35
Opening congress evening
Atlanta 1 and 2
Opening of the evening by the chairman of the DICIM committee Harrie Veneman.
20:35 - 22:30
If you can't measure what's important, you make your measurements important.
Atlanta 1 and 2
And so then things get pretty out of hand. An audio-visual tour of where craftsmanship takes us, and science gets us lost. And vice versa. Craftsmanship and science, a special marriage: "I live in a fairy tale," says the craftsman, "as I sit next to a witch on the couch every night, called 'evidence based'".
08:30 - 09:00
Welcome
Lounge
Registration to the conference takes place at the information desk. Upon arrival at the hotel, go directly up the stairs to the next floor.
09:00 - 09:15
Opening congress day
Atlanta 1 and 2
Participants are welcomed by the presidents of the organizing associations. Afterwards, Angelique Reitsma, the chairman of the day, will start the day.
09:15 - 10:15
Why is it so hard for patients to return to work once persistent pain starts?
Atlanta 1 and 2
In most developed countries, pain-related conditions such as cervical and lumbar spinal pain, shoulder pain and migraines are among the leading reasons why people leave the workforce. There is no major economy that deals well with these issues. The reasons are complex and include perceived injustice and so-called ‘yellow flag’ factors on behalf of the patient. Less well recognized are employer and insurance system contributors, and still less understood are evolving individual relationships with employment and the role of work in society. This plenary talk will discuss these ideas in detail and seek to offer insights as to the directions that may provide better outcomes in the future.
10:15 - 11:15
Which persons with musculoskeletal disorders can benefit of tele-rehabilitation?
Atlanta 1 and 2
11:15 - 11:45
Coffee break
Lounge
11:45 - 12:45
A systematic review on the prevalence of symptom exaggeration among patients attending for independent medical assessments
Atlanta 1 and 2
Independent medical evaluations (IMEs) are often used to determine whether patients receive compensation for an injury or illness; however, assessment findings may be affected by medical and non-medical factors. This presentation will summarize a systematic review of the prevalence of symptom exaggeration among individuals attending for an IME.
12:45 - 13:45
Lunch
Athena 1 and 2
13:45 - 14:45
Disabled but Not Deserving?
Atlanta 1 and 2
The perceived deservingness of disability welfare benefit claimants
14:45 - 14:55
Switch rooms
Time to walk to the session of your choice in the first parallel session
Parallellsessions 1
First round Parallelsessions
Value based care for pain patients
Barcelona
Every craft group within health care has their own opinions on treating persistent pain, but how can pain physicians, non-specialist pain doctors, allied health professionals and community members agree on what insurers should provide? Is scientific evidence enough to decide? This workshop will explore what optimal pain management care should look like in the 21st century, and how value based care may be the best approach yet for deciding what to fund.
Workshop Jorge Lains
Almere
The workshop will elaborate on the lecture
A systematic review of the prevalence and predictors of long-COVID
Atlanta 1 and 2
The COVID-19 pandemic has resulted in enormous loss of life, and some individuals who recover report ongoing symptoms and functional limitations. This presentation will summarize the evidence regarding the prevalence of long-COVID and our current understanding of predictors for persistent complaints associated with COVID.
Disabled but Not Deserving?
Calgary
The perceived deservingness of disability welfare benefit claimants
The Evidence-To-Decision–Framework for Insurers
Athena 4
Insurance physicians provide recommendations to specific medical questions to enable the administration of the insurer to take a decision and solve a claim. While recommendations should be evidence-based, other considerations - preferences, values, cost - come into play and influence the final decision. To come up with comprehensible decisions, insurer need to have a transparent process in place, for individual claimants and for general decisions about coverage of a specific service. The DECIDE Working Group (A research group of GRADE funded by the European Commission under the Seventh Framework Programme) developed an Evidence-To-Decision-Framework (EtD) for decision making by insurers. In this workshop, I will present the EtD-Framework and provide an illustrative case for discussion.
15:35 - 15:45
Switch rooms
Time to walk to the session of your choice in the second parallel session
Parallelsessions 2
Second round Parallelsessions
The cutting edge of pain science
Barcelona
This workshop will take delegates on a tour of the current state of the science in pain neurobiology and relate it to emerging and proposed therapies. It will explain why pain professionals are looking at non medical practices such as yoga, meditation and social prescribing as well as an array of new treatments drawing inspiration from nature such as animal and marine venoms, evolutionary biology and the microbiome.
Workshop Jorge Lains
Almere
The workshop will elaborate on the lecture
A systematic review of the prevalence and predictors of long-COVID
Atlanta 1 and 2
The COVID-19 pandemic has resulted in enormous loss of life, and some individuals who recover report ongoing symptoms and functional limitations. This presentation will summarize the evidence regarding the prevalence of long-COVID and our current understanding of predictors for persistent complaints associated with COVID.
Disabled but Not Deserving?
Calgary
The perceived deservingness of disability welfare benefit claimants
The Evidence-To-Decision–Framework for Insurers
Athena 4
Insurance physicians provide recommendations to specific medical questions to enable the administration of the insurer to take a decision and solve a claim. While recommendations should be evidence-based, other considerations - preferences, values, cost - come into play and influence the final decision. To come up with comprehensible decisions, insurer need to have a transparent process in place, for individual claimants and for general decisions about coverage of a specific service. The DECIDE Working Group (A research group of GRADE funded by the European Commission under the Seventh Framework Programme) developed an Evidence-To-Decision-Framework (EtD) for decision making by insurers. In this workshop, I will present the EtD-Framework and provide an illustrative case for discussion.
16:25 - 16:35
Switch rooms
Time to go to the plenary hall
16:35 - 17:35
Knowledge translation from IA in clinical oncology to risk evaluation in insurance
Atlanta 1 and 2
Artificial intelligence (AI) in medicine combines computer science and robust/large datasets to enable solving issues that cannot be otherwise answer by physicians. The holistic approach that was prevalent at the end of the last century in most area of medicine, including prevention, diagnosis, and therapy, has been progressively challenged by the need of providing data to justify unbiased decisions in most areas of medicine. The development of large medical data set was initially limited by the reduced capability of computers to handle large set of variables for statistical calculation. As hardware and computational sciences have developed, it is now common medical practice to use real time software algorithms that estimate the most appropriate therapy for cancer patients. This approach is often based on machine learning processes using large library of data that physicians can use in their practice to compute individual medical and molecular information for their patients.
Similar requirements aiming justifying rating decisions based on reliable statistics rather than expert decision may be required in insurance medicine. As such, we initiated a program for data analysis using the SEER database for patients with cancer. The goal was to provide for everyone with history of cancer an accurate appraisal of the risk of death over 10 years based on the available medical parameters, then to derive from this evaluation a personalized rating supported by strong statistical analyses. Interestingly, individual risk estimation using this approach was often shown to be more inclusive, offering more insurance options for people with history of cancer.
Taking advantaged of working both at the hospital and in a reinsurance company, I will organize this presentation using breast cancer as an example to show how both areas can nowadays use AI to define individual patient risk and use this information to optimize therapy at the time of diagnosis and to select the most appropriate rating few years later at the time when patient survivors may want to resume normal life and get access to insurance protection for business or real estate projects.
17:35 - 17:45
Closure
Atlanta 1 and 2
Chair Angelique Reitsma wraps up the day
17:45 - 18:30
Drinks
Lounge
Drinks before dinner
18:30 - 20:00
Dinner
Athena 1, 2 and 3
20:00 - 21:00
Walking dessert
Lounge
During dessert, the party room is decorated
21:00 - 00:00
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Party
Athena 1, 2 and 3
08:30 - 09:00
Welcome
Lounge
Registration to the conference takes place at the information desk. Upon arrival at the hotel, go directly up the stairs to the next floor.
09:00 - 09:10
Opening
Atlanta 1 and 2
Opening of the conference day by chair Waheeda Joemai
09:10 - 09:55
How to deal with sick employees with persistent physical complaints?
Atlanta 1 and 2
Persistent physical complaints can lead to limitations in functioning and long-term absence from work. After prolonged absence from work, insurance doctors assess the workload at the time of the assessment and in the long term of workers who have reported sick with persistent physical complaints. To be able to do this assessment, insurance doctors need to know which factors are important for the chance of recovery and work resumption. In practice it turns out that this assessment is not always easy for someone with persistent health complaints. This can cause uncertainty and a difference of opinion about the possibilities of functioning, both for people who have reported sick as well as for doctors. Insight into these important factors may give insurance physicians more guidance on how to better approach the assessment of sick employees with persistent physical symptoms.
09:55 - 10:40
Understanding the impact of a visual impairment on life and work
Atlanta 1 and 2
In the Netherlands, over 60,000 adults of working age have a severe visual impairment. The impact of such a profound sensory impairment on daily life is not always evident. However, many have complaints of somberness, anxiety and fatigue. This makes full participation in society sometimes difficult. This also applies to work. Factors such as a person's residual visual abilities and their impact mean that some people manage better than others. The attitude of employers and accessibility of workplaces also play a role. In this lecture attention is paid to which factors predict labour participation and which barriers are experienced from the perspective of professionals and the target group itself. In addition, the guidance available to increase participation will be discussed.
10:40 - 11:10
Coffee break
Lounge
Coffee break
11:10 - 11:55
How to increase our understanding of burn-out via stress
Atlanta 1 and 2
Our daily lives are more hectic than ever. No wonder burnout complaints are so recognizable: one in six Dutch people suffer from it, there are many thousands of burnout coaches and the phenomenon is regularly discussed in the media. So although we seem to be under the spell of burnout, strangely enough we don't really know what it is. Its scientific basis is shaky: it is poorly measurable, not reliably diagnosed and, moreover, there are few proven effective treatments. But if we understand so little about burnout, how should we proceed? As a psychiatrist and stress researcher, Christiaan Vinkers believes we need a fundamentally different view. We should focus less on burnout as the final stage and more on the stressful road leading up to it: how does someone become overburdened, with whom does this happen, and when? In this way we can get a better grip on burnout: who suffers from it and how can we prevent it?
11:55 - 12:40
New insights into autism
Atlanta 1 and 2
What about autism and taxability, what is 'autistic burnout' and how do we look at autism according to the latest insights? This lecture will address these topics and discuss the latest insights into autism.
12:40 - 13:40
Lunch
Athena 1 and 2
13:40 - 14:25
Traumatic Stress - perspective and developments
Atlanta 1 and 2
An entire generation was raised with the concept of PTSD. The prevalence is known, and there is also consensus in the field of diagnostics. The neuroscience behind PTSD is well mapped. The body keeps track of the score unleashes a lot of tongues! The treatment is under development, in part due to innovations in technology, new drugs and possibly greater effectiveness and less dropout in ambulantory and clinical programs. In the field of uniformed professionals (defence, police) much has been done to build up knowledge. This presentation provides an overview of new therapies: Golden hours, 3MDR, treatment with psychedelics and other developments. The fear-desensitization model seems to be giving way to "third lines" cognitive therapies, based on disclosure, acceptance and behavioral change. Covid and morale injury are key drivers.
14:25 - 14:35
Switch rooms
Short time to walk to the room with the abstracts of your choice.
Abstracts
A round of parallellsessions. Per session two abstracts are presented
Barcelona
Implementation of a training for company and insurance physicians aimed at involving cognitions and perceptions in the guidance and assessment of working people
Mariska de WitCognitions and perceptions such as motivation, catastrophic thoughts or expectations about recovery, influence the work participation of chronically ill working people. Insurance physicians must therefore take these factors into account when providing social medical guidance and assessing functional capacity. In 2020, an effective training course was developed for occupational and insurance physicians in which they learn about important cognitions and perceptions for work participation, how to obtain information about them, and what recommendations they can make to change impeding cognitions and perceptions. This presentation will provide more information about this training and its implementation in practice.
Evaluation of an implementation strategy for Individual Placement and Support in the Netherlands: a 30-month observational study
Miljana VukadinThis study shows that almost half of the people who participate in IPS+MIS obtain a competitive job within 30 months. The results further suggest that both the level of experience of mental health agencies with providing IPS+MIS, and funding may play a role in employment outcomes.
Athena 4
Influence of work-related factors on disability after arthroscopic partial meniscectomy
Jef van DoninckWe investigated whether work-related factors co-determine the duration of disability after orthopedic surgery: arthroscopic partial meniscectomy. A retrospective study in a population of 63 patients confirmed our hypothesis. Physical job intensity, ability to telecommute, and work status (independent, salaried) were examined. Our study showed that telework allows faster return to work postoperatively. Self-employed workers and those with lighter physical work were also incapacitated for a shorter period. In addition to medical condition, work-related factors play an important role in the duration of disability. The prescription of disability should always be tailored to the individual patient.
PROGNOSABLE, an intervention for the insurance medical prognosis assessment
Sylvia Snoeck-KrygsmanThe insurance medical prognosis assessment is about functioning. Will a client with gonarthrosis be able to kneel and squat normally again after a knee replacement? This prognosis has to meet high standards. A lot depends on this for the client and other stakeholders. They deserve a clear and customized prognosis. At the same time, this is very difficult: evidence on work functioning is hard to find, evidence on prognosis is often of low quality, the claim context can distort information, and the production pressure is also high. In this lecture the intervention Prognosable is presented, a methodology with software tool and training to help the insurance doctor with this.
Athena 3
Recognizing the work resumption mode of safety-netters with psychological complaints
Yvonne SuijkerbuijkThe work resumption mode plays an important role in the reintegration process. There are three types of work resumption modes for safety-netters with psychological symptoms: the passive, the ambivalent-uncertain and the active work resumption mode. It is important for sickness benefit professionals to recognize the work resumption mode, so that adequate (reintegration) interventions can be used. A tool is under development that can support the recognition of the work resumption mode. Qualitative research shows that the tool is easy to use and fits the practice. However, some adjustments to a number of items and the scoring system are needed. Quantitative research will follow in 2022 to assess the reliability and validity.
The role of symptoms that transcend disease in absenteeism guidance, reintegration and claims assessment
Alice LagangaResearch has shown that symptoms that transcend disease have a major impact on absenteeism, reintegration and disability. However, these are not yet structurally mapped and monitored. The aim of this study is to better embed transversal symptoms in company and insurance medicine by developing a structural, validated and uniform way to measure these symptoms. By developing and implementing a standardized set of instruments in the client portal of Arbo Unie, the possibility arises to follow sick employees in the process of absenteeism, reintegration and incapacity for work, and to promote the transfer of information between company and insurance doctors.
Atlanta 1 and 2
Outcomes of the study on the assessment of endurance capacity by the Insurance Doctor
Henk-Jan BoersemaWorkers with a chronic illness often struggle with severe energetic limitations that prevent them from working full time. The assessment of endurance capacity is an important part of the disability assessment. Through conceptualization and operationalization of the concept and exploration of registry data from a year cohort of first WIA assessments, this PhD research aims to contribute to the available knowledge on this concept. The study shows that limited endurance workload is a complex concept and is fairly frequent and has varying degrees of association with socio-demographic and health-related factors.
Further development and substantiation of Description of Workload and Reintegration Opportunities
Donny KreugerIn 2020-2021, the BAR instrument, based on the International Classification of Functioning Disability and Health (ICF) (WHO, 2022), and the accompanying guidance were developed as an unambiguous reference and conceptual framework to describe workload and reintegration opportunities of employees. The aim was to improve the coordination between professionals, employees and employers in the context of reintegration. In April-July 2022 interviews were held with employees and employers to collect their experiences with the reintegration process, looking at the perception of the contact moments they have with professionals within the reintegration. Also, in May-June 2022, focus groups were held with professionals, in which we used elements of the Design thinking methodology to design prototype BAR instrument 2.0 and associated guidance together.
Calgary
Evaluation of the IWMD Questionnaire causation in accident results of a survey and options for revision
Angelique ReitsmaThe IWMD Questionnaire (January 2010 version) has now been in use for over 12 years. In late 2019, an enquiry about it was conducted among personal injury professionals. This presentation will discuss the results, published in the Journal of Personal Injury Compensation (March 2022). Important conclusions: the IWMD question is frequently used, both in and out of court. However, criticism was also expressed and suggestions for modification were given. Lawyers appear to be more satisfied with the question format than medical advisors and independent experts. Ergo, sufficient reason for improvement of the IWRM questionnaire; options for this will be presented in this parallel session. Attendees can join the discussion on these possible adjustments.
Facilitators and barriers for the implementation of eHealth technologies from a healthcare professional's perspective: preliminary results of a systematic review of reviews
Elza MullerEHealth interventions are regularly used to improve healthcare, but sustainable implementation has many challenges. Through a literature review (a systematic review of reviews) we investigated what facilitating and hindering factors health care providers believe influence successful implementation of eHealth interventions. Sixteen reviews met the inclusion criteria. The eHealth interventions were divided into 4 groups: decision aids and diagnostics, remote contact, self-management, and information and administrative applications. Barriers and facilitators were found at different levels (individual, organization, technology, and policy). The preliminary results provide guidance for future implementation strategies of eHealth within insurance medicine.
Almere
International inventory of client ownership in disability assessment
Djoeke PetterWith the desire stated in the Parliamentary Letter of April 9, 2021 for more client ownership in the implementation of social security medical assessments, this research focuses on forms of client ownership prior to the disability assessment in different countries. It is expected that a higher degree of targeted client ownership facilitates the AO assessment process. The aim of this research is to gain insight into different social security systems and to investigate which aspects of client autonomy are of interest for the Dutch system.
Own direction in reintegration: the development of the website www.mijn-reintegratie.nl
Trees JuurlinkResearch shows that work resumption is promoted by allowing sick employees to think and decide early in the reintegration process. Yet in practice this is often difficult. In this project Amsterdam UMC (with funding from ZonMw) is developing the website www.mijn-reintegratie.nl together with employees, employers, patient representatives, professional associations and (occupational health and safety) professionals. This website provides unambiguous information, tools and modules for sick employees to promote reintegration and mutual cooperation between all stakeholders. As part of this project, we will test the effectiveness of this website compared to current mainstream information on reintegration in 2023.
Collaborate efficiently. Communicate with employment experts about functional capabilities.
Montreal
In this workshop, we first look at what problems employment experts within UWV experience in working with the FML and how we can help them as insurance doctors. Then we will take off the blinders from the FML and, leading up to the discussion with the audience, take a broad look at communication for insurance doctors. Particular attention will be paid to efficient reporting, interdisciplinary cooperation and professional confidentiality.
15:15 - 15:45
Tea break
Atlanta 1 and 2
Refreshments are served in the lounge.
15:45 - 16:30
Lecture Jacob Jolij
Atlanta 1 and 2
16:30 - 16:45
Closure
Atlanta 1 and 2
Chair of the day Waheeda Joemai wraps up the day. The congress ends with closure by the presidents of the organizing associations.
16:45 - 18:00
Drinks
Lounge
Drinks and chat before going home.
