Is Technology Changing the Practice of Case Management?

As time goes on care managers are relying more heavily on technology to ensure that proper care is delivered to patients and targeted populations. It has become clear that easy access to past and real-time data is essential to optimizing the coordination of care.

The ideal method of optimizing care through technology necessitates a single, interoperable health information technology (IT) system. The most effective would consist of a seamless platform linking utilization management (UM), case management (CM), disease management (DM), nurse triage, and prevention/wellness services and programs.

Through this approach case managers are able to store, index and sort all manner of data and information from a single health IT system, placing the requisite information at the case manager’s fingertips.

Health IT Survey

To better understand how health IT applications are supporting or hindering the care management process, TCS Healthcare Technologies (TCS) conducted an in-depth survey to examine health IT trends in the care management field. The American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) and the Case Management Society of America (CMSA) helped coordinate the survey.

The respondents represented a comprehensive cross-section of healthcare professionals: one-third are practicing clinicians, one-third are administrators, and roughly half work for a care management organization (CMO). The survey presented some important finds, which include:

• Information technology platforms supporting the care management process are not standardized in the industry, and in fact have many different orientations and attributes.

• Organizations are deploying a myriad of in-house and vendor-based solutions as they explore ways to increase health- care efficiency.

• The adoption of electronic applications may take longer than originally anticipated.

Integration and Interoperability

Most organizations reported using multiple IT systems to support their information management practices. For example, 64 percent of the respondents report using multiple systems — in contrast to 17 percent who rely on one system. Not surprisingly, just 20 percent indicated that their system is fully integrated and interoperable with other external IT applications. When asked what their “clinical practice or medical management data is electronically linked to,” survey participants reported the following:

• Claims payment data 53%

• Pharmacy claims 31%

• Laboratory or LOINC data 29%

• Radiology data 24%

• Data warehouse 28%

• A predictive modeling application 18%

• None of the above 15%

• Not applicable/not sure 24%

The reported levels of linking and interoperability with the data sources listed above are fairly low. These information resources also could improve the management and support of patients.