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Navigating the Internet is a skill most elementary school students master by the second grade these days. Consumers are logging on daily to gather medical information. Yet case managers who are charged with the responsibility of guiding those same consumers to make informed decisions about treatment options lag far behind the average American consumer when it comes to surfing the Web, according to the results of the 2000 Case Management Caseload Survey from American Health Consultants in Atlanta and the Case Management Society of America (CMSA) in Little Rock, AR.
Of 522 case managers responding to the survey, only 22.4% reported that they currently use the Internet in their daily practice. Even more alarming, 78% reported that they recommend the use of the Internet as a resource to their patients, indicating that there is a huge technology gap between case managers and their patients, say experts.
"Navigating the Web is quickly becoming a fundamental skill for case managers, not only for operational efficiency but for credibility with consumers," says Sandra L. Lowery, RN, BSN, CRRN, CCM, president of CCMI Associates (formerly Consultants in Case Management Intervention) in Francestown, NH, and president of CMSA. "Case managers not only need to know how to access information on the Internet but how to evaluate and use it, as well."
Unfortunately, notes Catherine Mullahy, RN, CRRN, CCM, president-elect of the CMSA and president of Options Unlimited, a case management firm in Huntington, NY, case management is often "one of the last areas to receive the latest technology." She explains, "When case management receives Internet access and other information resources will depend on how case management is positioned within an organization. Case management is most often part of the nonprofit side of an organization; the nice offices and latest technology often first go to the profit areas, such as marketing and sales."
Lesia C. Stuart, RN, BSN, CCM, a director of health care operations in Chattanooga, TN, and a member of the national board of CMSA who helped develop the caseload survey tool, notes that all of the case managers in her department have Internet access at their desks. "As part of their training, our case managers learn how to navigate the Web and receive a list of recommended Web sites that provide information relevant to their jobs. In addition, most conference and seminar presenters now include a list of Internet resources on their subject matter for those in attendance to take away with them. Helping patients find credible and appropriate Web sites for their particular disease or disorder is now part of the case manager’s job, which has always included patient counseling and education."
Many case management organizations, including Options Unlimited, are adding Internet knowledge and related computer skills to the list of qualifications they look for in a case management job applicant. "I’ve started advertising job openings on Monster.com, an Internet job posting site. If a job applicant responds to me from the Monster.com listing, I know they know how to get the job done in this technological age. It’s now one of the things I look for when hiring new case managers," says Mullahy. "Another is keyboard skills. We enter our notes electronically. A case manager without strong keyboard skills will not be productive in this environment."
Some case management supervisors worry that case managers will spend too much time on-line, but Stuart and Mullahy note it’s fairly simple to monitor Internet use and make sure that it’s not impacting case management productivity.
"It’s important to set strict Internet policies and procedures that define appropriate use of the Internet," says Stuart. "It’s also important that violation of the policy leads to disciplinary measures."
Organizations also may add options to their information systems that track the amount of time case managers spend on-line and even which sites they visit, notes Stuart. "I think as managers we were fearful when we provided our case managers with Internet access at their desks about two years ago, but those fears have been unfounded. We set guidelines, and they’ve been followed. The Internet is simply a necessary tool for case managers to do their jobs in 2001."
"I simply tell case managers that I can’t bill clients for the time they spend surfing the Internet," says Mullahy. "It makes them much more conscientious about getting in and getting out with the information they need. If they don’t get their work done, they can’t bill their hours, and it becomes apparent fairly quickly that there’s a problem. There are definitely management issues surrounding Internet access for case managers, but need far outweighs any concerns about possible abuse."
"Consider the value of a case manager who can click and access information about a clinical trial and explain it to a client within a few minutes," Lowery points out, ". . . or the value of a case manager who can quickly locate a service provider for a client who is moving out of state."