National Study Assesses How Health IT Is Impacting Case Management

A new research report by TCS Healthcare Technologies (TCS), in conjunction with the Case Management Society of America (CMSA) and the American Board of Quality Assurance Utilization Review Physicians (ABQAURP), finds that health information technology (HIT) systems are having an impact on a variety of medical management interventions, but less quickly than anticipated. The first HIT study was conducted in 2008 to examine HIT trends in the field of care management. ABQAURP and CMSA rejoined with TCS in 2010 to conduct the second survey, resulting in two years of comparison data.

A core objective of both HIT surveys was to assess general trends related to HIT systems, especially the trends for care management software applications, as well as the specific capabilities within those applications. The research further examines additional electronic applications used by providers, payors, care managers, and others to support patient care.

While progress is slow, it is occurring. More specifically, trends related to interoperability, functionality, and satisfaction levels indicate more work needs to done in leveraging best practices for medical care.

In the 2010 survey findings, respondent trends include:

• 69% use multiple health IT systems, while 16% use only one health IT system;
• 23% of information technology system(s) is/are fully integrated and interoperable with other external IT applications;
• 23% have moved to a completely paperless environment regarding patient or care management records;
• 54% scan medical records, documents, or communications into their medical management information system;
• 35% can share clinical data electronically with other providers; and
• 26% allow providers to access report cards that show physician- and patient-specific compliance with reporting initiatives.

Regarding patient communication strategies, respondents sound a strong positive note about embracing emerging communication options within the next two years. They anticipate a three-fold increase for using text messaging, smart-phones and wireless remote monitoring. A doubling in the use of online personal health records, patient portals, remote monitoring and social networking is also projected.

The survey results also offer interesting insights about the average number of caseloads handled per week:

• the most frequently selected caseload range is 25-49 cases per week; and
• the most time spent in face-to-face contacts with patients is 100 to 124 cases per week.

This last response conflicts with general wisdom about how case managers spend their time. For example, one would assume that the more face-to-face contacts a case manager has with patients, the smaller the caseload – but as it turns out, this does not appear to be the pattern. This result should be studied in more detail through additional analysis of the current survey and in future surveys. Are the nurses in each of these categories working in the same field, e.g., telephonic versus on-site with patients at clinics? If so, the latter group would probably report more “face-to-face contacts”.

Responses to several satisfaction questions indicate challenges remain for mobilizing HIT software platforms that satisfy the desires of case managers and other users. Dissatisfaction with current platforms offers an important window of opportunity for vendors to develop and sell software applications that are based upon designs that will increase user efficiency and satisfaction.

The study concludes that many opportunities exist to leverage technology to enhance the care management process through the following principles:

• Implementing sound platform designs – that support the natural workflow processes of the care management professional.
• Moving toward integrated and interoperable HIT systems – that minimize the need to identify and collate data manually across systems and platforms.
• Promoting automation – that reduces the number of actions care management professionals need to perform while conducting the basic actions affiliated with their work.
• Leveraging emerging communication portals – that include text messaging and social media as long as protected health information is properly safeguarded.
• Using the right information at the right time – that enables patients, their providers, and other stakeholders to access the patient’s health information, care plans, evidence-based protocols, and other information to make meaningful decisions.
• Increasing workflow efficiencies – that should allow care managers and other professionals to spend more quality-based time interacting with and supporting their patients.
• Increasing transparency and accountability – that in turn enhance feedback loops in ways that can further improve care management interventions.

For copies of this survey, log on to http://www.tcshealthcare.com and click the “Health IT Survey” button.