By Dan Klein
By now it is pretty obvious, even to the casual observer, that there is a sea of change in our healthcare system. ACA, HITECH, HIPAA, ICD-10 and a myriad of other mandates have dramatic ramifications that are significantly transforming the system as we have known it. And, indeed, the patient care model is rapidly evolving from Illness treatment with a focus on one doctor/one hospital, to a longitudinal collaborative care management model in which multiple, often disparate, care providers are involved.
Greater responsibility is being promoted with the member/patient (the patient or member centric model). Moreover, we are seeing health plans evolve from insurance underwriters into “plans for health” by, for example, promoting targeted care management interventions for members with chronic conditions and providing wellness/prevention programs that promote behavioral changes to potentially health impacting life styles.
One result of these and other elements in this dramatic paradigm shift is that a variety of vehicles have been or are being developed to help bring all of the elements of healthcare together in a more systemic/holistic and interconnected way. Integrated, web-based care management such as the HP Atlantes Care Management Solution is one such vehicle.
Unlike EHRs today, these systems connect stakeholders in a way that facilitates communication, fosters compliance, and (securely) shares care plans and interventions, thereby delivering a member-centric collaborative care model.
The benefits of integrated, web-enabled care management systems:
- Adapts to changing needs, helping to best manage members’ clinical, social, care delivery and financial outcomes for higher-quality, more cost-effective health care
- Increases access to care, improving care coordination, better managing costs, delivering improve outcomes
- Provides the tools needed to educate members and their care providers on how to best manage their chronic conditions and improve their understanding of health options.
- Provides targeted care paths that support and promote enhanced management of patients with chronic conditions including the rapidly expanding population of seniors and those with behavioral health challenges
So how effective are these care management systems? Thanks to my involvement with HP Enterprise Services Healthcare organization, I’ve seen firsthand examples of the effectiveness of these systems such as one agency that in six months:
- Managed nearly 7,000 cases
- Considerably improved the overall efficiency of the care managers
- Reduced treatment authorization referral time by 66%, leading to faster member care
What have your experiences been? What innovative ways are you able to utilize the capabilities of automated care management systems? What are the “gotchas” and how did you address them?
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