Technology can’t replace a CM
Use it carefully and keep personal connections
Using technology increases efficiency and effectiveness and helps case managers do their jobs, but it also can be a double-edged sword if case managers are so concerned with the electronic side of care coordination that they forget about the personal side, warns Mary Beth Newman, MSN, RN-BC, CCP, CCM, case management director for CareSource, a Dayton, OH-based insurer.
"I’ve seen case managers write on blogs that their organization is so focused on getting information into the electronic health record that they can’t be attentive to their patients. There has to be a balance," she says.
Case managers shouldn’t get so carried away with technology that they forget about communicating with the patient, Newman says. "Despite the benefits of technology, case managers still have to make that human connection if they are going to be effective," she says.
Case managers at CareSource use mobile telephone applications to document their visits with Medicaid beneficiaries in the health insurer’s community-based model of care coordination. "All of our case managers have smartphones with a case management application that helps remind them of the purpose of the visit, has a place for notes, and a place for the member to sign. It’s all downloaded into our medical management system, including an image of the member’s signature," she says.
The application has check boxes that the case managers use as they assess the member and work on the treatment plan. After the visit, they can go back and fill in more information on the client, using what they entered into the mobile application as a guide.
"It helps the case manager doing the home visit focus on the person, rather than focusing on the laptop. Then they can fully document after the visit is over," she says.
Technology is just a tool, and every organization should have guidelines in place for using technology. "It’s a disservice all around if technology is used irresponsibly," says Teri Treiger, RN-BC, MA, CHCQM-CM/TOC, CCM, a case management consultant based in Holbrook, MA.
Case management software will never replace the critical thinking and knowledge needed to synthesize an achievable plan of care that helps move a patient from a high level of complexity to someone better able to manage him- or herself, she adds.
A guide, not a substitute
"Software will not do the work or write the report. Case managers need to understand technology and use it appropriately. If you put a hammer in someone’s hand and they try to saw wood with it, that’s not an effective use of a tool. It’s the same with case management software. Someone can’t just check off boxes in a software program and come up with a workable plan. It takes analysis of the individual situation and critical thinking to do that," she says.
Case management software is a guide, not a substitute, and should never be considered a replacement for a highly trained, professional case manager, Treiger says. She expresses concern that with the current emphasis on care coordination, organizations are creating numerous new positions across the continuum that purport to be case management but are not. "In some settings, unlicensed and uncertified people with no clinical background are calling themselves case managers and assuming pseudo-case management roles with the aid of software. It’s fine to use non-clinical staff to support professional case managers, but they can never truly replace case management because they don’t have the requisite education and knowledge, the critical skills to take the information from the software and develop a case management plan," she says.
"If it’s so easy to replace the clinical piece of case management, it probably wasn’t authentic case management in the first place," Treiger says.
Technology can make life easier and make people more efficient case managers if they use the technology appropriately, she adds. "If someone is not already a good case manager, technology isn’t going to make them better," she says.