When it comes to case management and discharge planning, the status quo has got to go.

The world has changed and so have the demands on these departments. Increasing regulations, mandatory adherence to more onerous compliance policies, tighter financial controls (e.g., LOS and readmissions) and a shrinking workforce necessitate the need for new approaches and strategies.

Take discharge planning for example. It generally takes at least eight healthcare professionals to complete one patient placement. This includes individuals within your facility as well as third-party organizations, all with different agendas and goals. The friction between these relationships is often compounded by the communication gap that exists within the department and outside of the department, with payers and providers.

This communication gap is like a black hole that swallows up all the valuable information required to drive quality in clinical outcomes and profitability in financial results. Therefore it is imperative to fill this gap by capturing data, the data necessary to drive best practices that in turn will lead to a better discharge process. Closing the gap requires a brand-new approach: synchronized patient management.

Synchronized patient management is a fully integrated solution that connects healthcare providers and payers with a user-centric view of patient-centric records, results and reviews. It is both a workflow tool that helps automate manual processes as well as a communication tool that connects users and departments with their external partners. This approach enables everyone involved to make informed decisions in real time based on a standardized set of data that is meaningful to each function. Only with that integrated, holistic approach will we be able to build better discharges and achieve better results.

The Need for Synchronized Patient Management

Just as utilization management (UM) evolved as an adjunct to case management to fill a new need, synchronized patient management will take root to satisfy still more distinct, yet related, needs. It will include and align every discrete discipline governing all aspects of patient care. Case management and care management. Utilization management and transition management. Payer approvals and denials. And the challenging requirements of evolving models of care.

The big difference, however, is that while UM was a reactive development designed to ensure maximum payments and minimal denials, synchronized patient management will be a deliberate, proactive effort that anticipates and satisfies a broader set of needs of all participants. By anticipating who needs what, there will be an integrated approach of connectivity and meaningful, accessible data and tools that spur utilization, which drives better outcomes.

While some may think that this approach to reconfiguring and synchronizing the people, processes and technology of patient care is revolutionary, it’s really evolutionary. It is a natural response to complex changes in healthcare, including:

Throughput pressure underscores need for synchronization. Efforts to control spiraling costs have the downstream effect of squeezing patient flow to increase capacity and optimize reimbursement. Now, to carefully choreograph the well-timed movement of patients from one level of care to another, connectivity and quick communication are required. Long gone are the days of dropping a referral packet in the mail to a SNF.

Volume of administrative work detracts from patient care. With dozens of pages of paper required in just one typical referral packet and dozens of data points required by third parties to document everything from need and eligibility to an estimated vs. actual discharge date, administrative work threatens to dwarf the clinical. There is an increasingly acute need to capture once and share detailed, updated, need-to-know information.

Evolving models need management tools. No matter how well-thought out the idea – ACO, medical home, HIE, RHIO – most concepts for improving care and lowering costs are largely just that: concepts. Making them reality means anchoring them on a technology platform that captures the data necessary to drive the creation and use of best practices and protocols for positive results.