Contact us

Trigo

For many insurers, musculoskeletal claims follow a familiar pattern. A claimant reports a condition. Treatment is authorised. The claimant selects a provider. The treatment pathway proceeds largely outside the insurer’s visibility and control. The insurer knows how many appointments are funded, but often has less visibility into whether those appointments were the minimum necessary to achieve the desired outcome. The challenge is not authorisation. The challenge is optimisation.

A different approach

Trigo was designed around a simple principle. Before treatment begins, every claimant should have rapid access to a physiotherapist who can help determine the most appropriate pathway. Rather than immediately entering a treatment programme, claimants receive an early professional assessment through a rapid-access digital consultation. Some claimants may be suitable for a digitally supported pathway. Others may require hands-on treatment. Some may benefit from a hybrid approach. The important point is that the decision is made using professional assessment rather than assumptions.

Faster access, stronger engagement

One of the most significant findings from a recent insurer pilot was the level of claimant engagement achieved through rapid access. Almost four out of five referred claimants successfully registered and engaged with the service. More than eight out of ten registered users progressed to a professional assessment. Attendance at initial assessments exceeded expectations, with no recorded failures to attend. These findings suggest that rapid access to a physiotherapist creates a strong sense of responsiveness and support, encouraging engagement at the earliest stage of the claim journey.

Better routing into the right pathway

Not every claimant requires the same type of intervention. Following assessment, users were directed into the most appropriate pathway based on professional judgement and patient preference. Where digital treatment was suitable and accepted, users entered a Trigo-managed supported self-care programme. Where digital treatment was not suitable, or where users preferred hands-on care, recommendations were provided regarding likely treatment requirements before referral into the wider physiotherapy network. This created an additional layer of utilisation management that does not typically exist within traditional open-authorisation models.

Creating the potential for lower utilisation

Within digitally managed cases, average treatment intensity was 2.46 clinical contacts per case. This demonstrates the potential for a supported self-care model to deliver care efficiently while maintaining professional oversight. The pilot demonstrated that a professionally managed digital pathway can operate with substantially fewer clinician contacts than many traditional treatment models, creating opportunities for improved efficiency and cost control.

The future of insurer-led musculoskeletal care

The opportunity for insurers is not simply digitising treatment. It is creating greater visibility, earlier intervention and more intelligent utilisation management. A rapid-access front-door model gives insurers the ability to improve claimant experience through faster access, increase engagement and attendance, route claimants into more appropriate pathways, improve visibility of treatment utilisation, support more efficient allocation of clinical resources and create the foundations for better cost control. For insurers seeking new approaches to musculoskeletal care, the future may not lie in authorising more treatment. It may lie in optimising treatment before it begins.

Pilot data available on request. Results derived from a musculoskeletal pilot conducted with a leading Norwegian insurer.

We Have Built Healthcare Around Access to Professionals. But Is That Enough?

Musculoskeletal conditions are among the most common health challenges facing individuals, employers and healthcare systems.

Back pain, neck pain, shoulder problems, joint conditions and movement-related disorders affect millions of people every year. They contribute significantly to healthcare utilisation, workplace absence, reduced productivity and diminished quality of life.

The scale of the challenge is substantial.

Yet despite decades of clinical advancement, many healthcare systems continue to struggle with a familiar problem.

For many organisations, this creates an uncomfortable reality.

The traditional response to increasing demand has often been to increase clinical capacity.

But what if the future of musculoskeletal care is not primarily about increasing the number of appointments?

What if it is about delivering the right support at the right time through the right channel?

This question has become increasingly important as healthcare systems explore digital models of care delivery.

The emerging evidence suggests that telehealth and digital-first pathways may have an important role to play.

These findings have significantly influenced the way we think about support within the Trigo platform.

The Access Problem

One of the greatest barriers to effective musculoskeletal care is often access.

The challenge is not necessarily the availability of clinical expertise.

The challenge is connecting people to that expertise efficiently.

Traditional healthcare pathways frequently involve:

For individuals experiencing pain, these barriers can create frustration and delay.

For employers and insurers, delayed access can prolong absence and increase costs.

For healthcare providers, growing demand places pressure on already stretched resources.

Importantly, many musculoskeletal conditions do not require complex medical intervention as a first response.

Many individuals benefit from:

The question therefore becomes:

How can these forms of support be delivered more effectively?

This is where telehealth enters the conversation.

What the Research Says About Telehealth

For many years, telehealth was viewed primarily as a convenience.

The assumption was that digital consultations represented a compromise compared with traditional face-to-face care.

The evidence increasingly challenges this assumption.

Marks and colleagues (2023) reviewed the health economic impact of musculoskeletal physiotherapy delivered through telehealth.

The review found evidence that telehealth can achieve outcomes comparable to face-to-face delivery across many musculoskeletal presentations while improving accessibility and reducing delivery costs.

These findings are important because they shift the conversation.

The question is no longer:

“Can telehealth work?”

The question increasingly becomes:

“When is telehealth the most appropriate option?”

This distinction reflects the growing maturity of the evidence base.

Telehealth is no longer being evaluated as an experimental concept.

It is increasingly being evaluated as a practical component of healthcare delivery.

A Stronger Evidence Base Emerges

Further support for this perspective comes from Bargeri and colleagues (2024).

Their umbrella review examined evidence relating to telemedicine for musculoskeletal disorders across multiple systematic reviews.

The findings were remarkably consistent.

Telemedicine demonstrated:

Perhaps most importantly, the review highlighted that many individuals can receive meaningful support without requiring an initial face-to-face consultation.

This finding challenges one of the longstanding assumptions within healthcare delivery.

Historically, physical presence has often been viewed as essential.

The evidence increasingly suggests that effective support depends less on location and more on the quality of the pathway itself.

This observation has significant implications for healthcare design.

The Future Is Not Digital Versus Human

One of the most common misconceptions surrounding telehealth is that technology seeks to replace clinicians.

The research does not support this conclusion.

Neither Marks et al. (2023) nor Bargeri et al. (2024) suggest that professional expertise becomes less important.

In fact, the opposite may be true.

Effective telehealth depends upon:

The clinician remains central.

What changes is the method of delivery.

This distinction matters.

The future of musculoskeletal care is unlikely to be a choice between digital support and professional expertise.

It is far more likely to be a combination of both.

Together they create pathways that are more responsive, more scalable and more accessible.

This principle has become increasingly important in the design of modern healthcare systems.

What Happens Between Appointments Matters Most

One of the recurring themes throughout this article series has been participation.

The previous article explored supported self-care and the growing recognition that health outcomes are often influenced by what happens outside formal healthcare settings.

This principle applies particularly strongly within musculoskeletal care.

Most improvement occurs between appointments.

Individuals spend the overwhelming majority of their time:

The appointment itself is only one component of the journey.

This observation helps explain why telehealth can be effective.

The objective is not simply to conduct appointments remotely.

The objective is to support people more effectively during the periods between appointments.

Digital pathways create opportunities to provide:

These capabilities help extend the influence of professional support beyond the consultation itself.

Why Speed Matters

Another important lesson emerging from musculoskeletal research is the value of early intervention.

Many conditions become more difficult to manage when support is delayed.

Waiting weeks for an assessment may not always be clinically necessary.

In many situations, individuals benefit from quickly receiving:

Digital-first pathways can improve responsiveness.

They reduce geographical barriers.

They reduce scheduling constraints.

They create opportunities for earlier engagement.

Importantly, earlier support does not necessarily mean more support.

Often it simply means the right support delivered sooner.

This distinction is particularly relevant for employers and insurers seeking to improve access while managing resources responsibly.

The Implications for Employers and Insurers

Musculoskeletal conditions remain one of the leading causes of workplace absence and reduced work ability.

Research reviewed by Odeen et al. (2013) and Tarro et al. (2020) suggests that workplace interventions can positively influence outcomes that matter to organisations.

While these studies do not specifically examine telehealth, they reinforce an important principle.

Digital pathways create opportunities to address all three.

For individuals, it means receiving help when it is needed rather than when capacity becomes available.

The significance of this shift should not be underestimated.

How This Influenced Trigo

When we examined the emerging evidence around telehealth, one conclusion became increasingly clear.

The future of musculoskeletal care is not about replacing clinicians.

It is about improving access to clinicians.

This insight influenced several aspects of the Trigo platform.

Our objective was not to create a self-service system where individuals are left to manage complex health challenges alone.

Nor was it to recreate traditional healthcare pathways in digital form.

Instead, we sought to combine:

The platform is designed to help individuals access appropriate support while maintaining active participation in their own health.

Telehealth becomes one component of a broader support ecosystem rather than a standalone service.

This distinction is important because it reflects what the evidence suggests.

The strongest outcomes emerge when professional support and active participation work together.

Building Smarter Pathways

One of the most valuable lessons emerging from the literature is that healthcare systems should be judged not only by the quality of individual interventions but also by the quality of the pathways connecting them.

Digital technologies create opportunities to redesign those pathways.

Most importantly, they help ensure that professional expertise is available where it adds the greatest value.

This is particularly important at a time when healthcare systems face growing demand and limited resources.

Looking Forward

The future of musculoskeletal care will require innovation.

Not innovation for its own sake.

Innovation that helps more people access effective support more quickly and more efficiently.

The evidence reviewed by Marks et al. (2023) and Bargeri et al. (2024) suggests that telehealth can play an important role in achieving this objective.

The research does not suggest that technology replaces healthcare professionals.

Nor does it suggest that every condition can be managed remotely.

What it does suggest is that digital delivery can become an effective component of modern musculoskeletal pathways.

At Trigo, these findings have helped shape our thinking.

The future is not more appointments.

The future is better pathways.

Pathways that combine professional expertise, supported self-care, digital accessibility and active participation.

Because ultimately, the goal is not simply to increase healthcare activity.

The goal is to improve outcomes.

References

  1. Marks, D., et al. (2023). The Health Economic Impact of Musculoskeletal Physiotherapy Delivered by Telehealth: A Systematic Review.
  2. Bargeri, S., et al. (2024). Effectiveness of Telemedicine for Musculoskeletal Disorders: Umbrella Review. Journal of Medical Internet Research.
  3. Odeen, M., Magnussen, L. H., Maeland, S., Larun, L., Eriksen, H. R., & Tveito, T. H. (2013). Systematic Review of Active Workplace Interventions to Reduce Sickness Absence. Occupational Medicine.
  4. Tarro, L., Llauradó, E., Ulldemolins, G., Hermoso,P., Solà, R., & Moriña, D. (2020). Effectiveness of Workplace Interventions for Improving Absenteeism, Productivity and Work Ability of Employees: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. International Journal of Environmental Research and Public Health, 17(6), 1901.