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Technology is changing the practice of case management
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Suzanne Tambasco, RN, BSN, Med, CCM, CBMS, CRRN, COHNS/CM, LNCC, NCLCP was on vacation in Italy but didn't want to miss accompanying her workers' compensation client to a doctor's visit in Atlanta, so she had her assistant take a web-enabled computer to the doctor's office and "attended" the appointment via the Internet.
"This was a new patient who had a severe hand injury and was seeing a microsurgeon for an evaluation. By using the latest technology, I could see the extent of the patient's injury, talk to the doctor, and get a picture of the hand to send to the insurance adjuster," says Tambasco, chief executive officer and a practicing case manager for Medical Management International, an Atlanta-based company that contracts with insurance companies to manage workers compensation claims, legal liability, short-term and long-term disability, and legal nurse consulting.
Although she was thousands of miles away, by using technology, Tambasco was able to coordinate follow-up appointments, tests, and procedures for the patient as if she was in the doctor's office.
"Technology is truly changing the practice of case management," points out Marcia Diane Ward, RN, CCM, PMP, a case management consultant based in Columbus, Ohio.
At one time, case managers used a pencil and paper and a notebook when they evaluated their patients or developed a treatment plan and entered the information into a paper chart. Then, laptop computers allowed the case managers to make notes when they talked to patients, and then print them to go into the record. The next level of technology enabled case managers to download information from their computers into the electronic medical record. Now case managers are using smart phones and tablet computers which instantaneously connect with their organization's information technology system, and everything is linked.
"As healthcare continues to evolve, technology is going to be essential for case managers to do their jobs. The assumption of greater financial risk in capitated environments, publicly reported data, individual and aggregate outcomes, the need to manage patients with chronic conditions, and the emphasis on preventing readmission all make it necessary for robust information management systems that can yield measurable data across populations," Ward says.
Today, case managers have a tremendous amount of options for using technology applications to work more efficiently and effectively, Tambasco adds. "No matter what kind of case management someone does, technology can make their job easier. It allows them to work in real time as much as possible and includes reminders so they can do everything in a timely manner," she says.
"Clinicians may feel overwhelmed by the new hardware and software products on the market, but today's healthcare environment makes it imperative for them to keep up with cutting edge technology," Tambasco says.
"Case managers have to be willing to use new technology in order to be competitive. We have to communicate with patients, providers, insurers, and others and to do it faster than ever and as accurately as possible," Tambasco says.
"Technology increases case managers' efficiency, giving them more time to spend with their patients rather than filling out forms, filing papers, and sending faxes. The data gathered by technology tools is very valuable in helping case management departments develop metrics to improve the quality of care," says Thomas R. Ferry, president and chief executive officer at Curaspan Health Group, with headquarters in Newton, MA.
"For instance, case management directors can use technology to measure the performance of employees within the department and to determine if they are performing in the most optimal way or if there are issues and challenges that need to be addressed," Ferry says. "In the absence of technology, a case management director may intuitively think that some workers aren't performing the way they should, but they don't have time to gather the data by hand to support their feeling. Technology gives them the capacity to know what is going on in the department in real time," he says.
Case management directors can analyze data to look for patterns in readmissions and long lengths-of-stay and drill down to find the cause. "They can analyze data from post-acute providers to make sure they are taking appropriate patients and giving them the care they need to avoid rehospitalization," Ferry says.
"Technology helps case managers who are working with chronically ill patients identify gaps in care and monitor patient compliance," Ward says. "It's invaluable in creating reports and tracking patient outcomes. When case managers have technology at their finger tips, they no longer have to analyze everything manually," she adds.
Ward goes on to say, "Case management is a process which promotes a balance between quality care and cost-effective outcomes. Case managers are becoming major players in today's healthcare environment, and they need real time access to information at every point of the care cycle. That's where technology comes in."
Today, the care of patients is often being coordinated by case managers at acute care hospitals, at post-acute facilities, in the home care setting, the primary care physician's office, and the payer setting. All of these need real-time information about the care patients receive in each setting to ensure that gaps in care do not occur, that patients don't receive redundant care, and to ensure optimal treatment outcomes in the most cost-effective way, Ward says.
"Technology is the only way to create a synchronized patient management system which integrates data from payers, providers, and physicians and allows clinicians from the entire continuum of care to look at the same information and the same data and provide a coordinated approach to patient care. In the future, technology will synchronize case management, utilization management, and discharge planning and integrate information from all providers in all patient settings with payer data, enabling better transitions in care and better outcomes," Ferry says.
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