Technology is essential today, but there are pitfalls
Don’t let it replace personal interactions
Technology, which was supposed to make case managers’ jobs easier, save time, and reduce stress, can also create problems, limit communication, and increase the silos that healthcare professionals are trying to eliminate, says Karen Zander, RN, MS, CMAC, FAAN, president and co-owner of the Center for Case Management.
Technology is making clinicians more isolated and limiting communication, Zander adds.
“People in some organizations have told us that communication that used to happen verbally is now happening through email and text messages. It’s not the same,” she adds.
Technology can be a wonderful tool, but it also brings challenges, says Patrice Sminkey, RN, chief executive officer for the Commission for Case Management Certification.
“Over-reliance on technology leads to case managers coming to the bedside and not actually talking with the patient,” she adds.
Case managers have to step back and take the time to find out about the patients, their living situations, support systems, and post-acute needs, she adds. “We should never forget that one-on-one conversations ensure that an individual’s needs are met. Technology is new and exciting, but it should never replace a patient-centered approach,” she adds.
Because of the way the electronic medical records are designed, patient assessment has become a task-oriented function that often involves just checking off boxes, adds BK Kizziar, RN-BC, CCM, owner of BK & Associates, a Southlake, TX, case management consulting firm.
“When case managers complete an assessment using drop-down boxes, they are limited to a few options. Patients don’t fit into boxes. That’s not the way we are. The check-off boxes in the electronic medical record are supposed to make things easier, but case managers need to write down how each patient is different,” Kizziar says.
When hospitals are financially at risk for what happens to the patients for 90 days after discharge, case managers need to spend a lot of time developing an effective discharge plan, Kizziar says.
“Case managers have to be able to understand their patients’ support systems, and to assess their understanding of the disease process and their ability to follow their treatment plan. All of these can be tied to readmissions and it takes more than a three-minute visit, more than a checklist,” she says.
“Instead of becoming more check-box oriented to get everything done, hospitals need to focus on patient-centered care and care coordination, and to be able to do that with the constraints of reimbursement changes. It’s going to be a real challenge,” Kizziar says.
Hospitals’ information technology systems aren’t always integrated, which produces more challenges, Zander points out.
“The electronic medical record doesn’t always work with case management-specific software and case managers have to move from one software program to another in order to do their jobs. This is time consuming and burdensome,” Zander adds.
Case management software producers have added functionality to their products, but case managers aren’t usually at the top of the hospital information technology department’s list in making changes to software, Zander says.
Technology, which was supposed to make case managers’ jobs easier, save time, and reduce stress, can also create problems, limit communication, and increase the silos that healthcare professionals are trying to eliminate.
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