EXECUTIVE SUMMARY

Technology helps case management programs improve efficiency and become faster at reacting to patient problems or anticipating issues before they occur.

  • Bluetooth-enabled devices can be used for patient engagement.
  • Sometimes, there can be too much information collected, so case managers need to prioritize where to place their attention.
  • Case managers easily can spot red flags through data collection of the patient’s day-to-day health actions.

Whether the nation’s healthcare industry changes in coming years, technological advances will be a constant.

Technology, including electronic health records and smart devices, will help organizations become more efficient and respond to market-based and regulatory solutions, such as Merit-based Incentive Payment System for Medicare, says Ron Sterling, CPA, MBA, of Sterling Solutions in Silver Spring, MD, a national independent consultant on EHRs and medical billing solutions.

Merit-based incentive programs aim to track specific patient outcomes and monitor health changes consistently — even outside of the clinical environment, he says.

Care coordination and case management are about increasing engagement with patients.

“What you’re trying to do is increase the number of touches we have with patients to improve their care,” Sterling says. “We do that in many different avenues.”

One of the newer avenues is through technology. Case management can monitor patients objectively through the use of Bluetooth-enabled devices and equipment that can engage with patients and monitor their health.

Even subjective information could be transmitted in real time. A patient could answer questions via smartphone about pain that is occurring at that moment. The patient could respond electronically to questions about whether they’ve walked around the block that day, Sterling says.

So much real-time information could be collected that the chief danger would be that case managers receive too much data.

“The problem is we’re talking about a constant stream of information from patients that could inundate a case manager with gobs of information, making it difficult to discern what is significant,” Sterling says.

The answer is to focus on priority health concerns.

For example, an obese patient needs to lose weight. The case manager is helping the patient monitor his or her weight, but there hasn’t been a weight reading in a couple of days. The patient’s scale automatically sends readings when the patient weighs himself or herself, Sterling says.

In this case, the case manager should make it a priority to monitor the patient’s weight and consider it a red flag if the patient hasn’t weighed himself or herself for a couple of days.

“We can use technology to help us stay in touch with patients, which doesn’t necessarily mean a phone call or home visit, but receiving information that gives us an early warning sign,” Sterling says.

Even having scales with Bluetooth technology can provide powerful incentives to patients who need to monitor their weight. “If I call a patient this morning and say, ‘What do you weigh?’ it might not be as valuable as the patient weighing himself on a scale and capturing the information electronically,” Sterling explains.

Technology can help case managers set daily or weekly priorities. If there is a patient who has a pill box that sends electronic information to the case manager’s dashboard, he or she will note that the patient did not take medications that day and call the patient, he says.

Without the technology providing an immediate alert, the case manager might not call the patient for a week or a month, and find out a little late that the patient is having trouble.

These immediate warning signs can keep patients out of the ED, he adds.

Healthcare efficiencies occur with technological monitoring. By gathering patient blood pressure, weight, and other information remotely, case manager time can be preserved for when patients have problems and need someone to call them or visit them, Sterling suggests.

“We can use case managers to provide the human touch if they’re seeing problems,” he says.

As technology improves and the costs of implementing these advances decreases, case managers will see more in use. For instance, it might even be possible to provide wound care via technology with the use of high resolution, daily video images transmitted to wound experts for monitoring, Sterling says.

“If the wound healing is not going in the right direction, we could intervene right away rather than spending more on the expensive process of having a nurse visit the patient three times a week,” he says.

As more people need care for chronic illnesses, case managers likely will find that technology is helping them do their jobs.

“The bottom line is if I only have so many resources and so much money, what is the best way to allocate those resources and allocate the money?” Sterling says.