What should you put on your software wish list?
Before you spend $25,000 or more on case management software, determine that the product you purchase meets both your current and future needs. When you send out your request for proposal to software vendors, make sure you include questions on the following specific features, applications, and technical considerations recommended by Marcia Diane Ward, RN, CCM, market segment manager for IBM Healthcare Solutions in Atlanta.
"What you need is a product with good architectural characteristics that will go over the long term. Selecting case management software simply requires good common-sense shopping principles that you would apply to any major purchase, whether it’s a house, a car, or software," Ward says. "You look for basic performance, and then you can add custom features to the package according to your case management needs."
Before you purchase case management software from a vendor, Ward suggests you use the checklist below to question vendors about their product. A good product should include the following features:
• rule-based targeting or flagging of members or patients to be case managed;
• concurrent review/real-time review capability;
• protocols authoring tool/flexibility;
• interface capability;
• EDI (electronic data interface) support;
• ad hoc query/analysis capability;
• security/authentication and encryption capabilities;
• client server base/remote support capability;
• open systems design/interaction with standard mail systems;
• compliance with existing industry standards.
Software applications requirements.
• eligibility determination;
• health needs assessment and functional status evaluation;
• diagnostic procedure codes/medical appropriateness;
• domain specific criteria sets/protocols and guidelines;
• create and administer care treatment plan;
• manage compliance/variance from care plan;
• schedule member resources;
• clinical and cost outcomes reporting;
• provider profiling with flags;
• billing and invoicing capability;
• tracking and billing of professional time;
• integrated case-centered calendar;
• case management/nursing notes-narrative.
• technology platform;
• minimal hardware needs;
• service contracts;
• specialty modules;
• average sale/number of workstations/ seats.
Narrowing your search
These vendors have software that makes the cut
Case management software is hot property. A market of no more than 10 good products just a few years back is now being flooded with a constant influx of new products. If you don’t have the time to research the more than 70 case management software vendors on the market, use this "A" list of vendors developed by Marcia Diane Ward, RN, CCM, market segment manager for IBM Healthcare Solutions in Atlanta. Ward has spent the past two years carefully researching the case management software market; she also speaks frequently on issues relating to case management information systems.
"Several promising new products are under development, but the software wasn’t available for a thorough review," she says. "I wanted to put together a list of case management software vendors whose products comply with a certain standard of architectural integrity."
Ward interviewed each vendor listed here, using the recommended features on p. 99, and each passed her minimum standards test:
• The SSI Group’s "CareWare" managed care software, Mobile, AL. Telephone: (800) 880-3032 or (800) 766-1736.
• Erisco’s "Facets," New York, NY. Telephone: (800) 537-4726.
• Health Cost Consultants’ "MedAdvice," Reston, VA. Telephone: (703) 262-7800.
• IMA Technologies’ "Case Trakker," Sacramento, CA. (800) 458-1114.
• MEDecision’s "Utilization Control System," Berwyn, PA. Telephone: (610) 648-0202.
• Trinity Computer Services’ "Wisdom," Foresthill, CA. Telephone: (916) 367-4208.
• Liaisons in Negotiating Care’s (LINC) "Case Manager Assistant," Pasadena, CA. Telephone: (800) 424-5462.
• Optimed Medical Systems, Lexington, MA. Telephone: (617) 863-2000.
• Advanced Research Systems, Seattle. Telephone: (206) 622-1995.
• Automated Case Management Systems’ "Case Watch," Los Angeles. Telephone: (213) 876-2273.
• Nomis’ "Case Man," Brecksville, OH. Telephone: (800) 266-4300.
• PhyCom’s "Care Partner," Bellevue, WA. Telephone: (206) 644-1441.
• Mids’ "Midas +," Tucson, AZ. Telephone: (800) 737-8835.
Several software companies offer products designed to support special case management functions, such as life care planning and vocational rehabilitation, Ward says. They include:
• TechSolutions’ "LPC Stat," Ridgeland, MS: life care planning product. Telephone: (800) 733-9101.
• JobQuest, Spokane, WA: vocational rehabilitation software. Telephone: (800) 541-5006.
• Decision Arts, Paoli, PA: accounting system for field case management. Telephone: (610) 296-7009.
• Health Management Technologies’ "Return," Moraga, CA: workers’ compensation system. Telephone: (800) 647-7007.
• Rothenberg Health Services’ "EZ-CAP," Woodland Hills, CA: physician network and capitated model software. Telephone: (818) 598-3200.
Many case management organizations integrate automated clinical protocols into their case management software to provide decision support and benchmarking. Some of the better-known vendors of these protocols include:
• Institute for Healthcare Quality, Minneapolis. Telephone: (612) 829-3500.
• InterQual, Westborough, MA. Telephone: (508) 481-1181.
• Milliman & Robertson, San Diego. Telephone: (619) 558-8400.
• Value Health Sciences, Santa Monica, CA. Telephone: (310) 315-7400.
• The Oak Group, Wellesley, MA. Telephone: (800) 841-3966.
• GMIS, Boston, MA. Telephone: (617) 731-4560.
(Editor’s note: The next Case Management Advisor will include profiles of two new entries in the specialized case management software market: "CyberCAM," developed by Connecticut Community Care in Bristol, CT, to support long-term care management of the frail elderly; and "ProviderCompare" and "CompCompare," designed by Risk Data in Irvine, CA, to help reduce workers’ compensation claims costs.)