Survey Underscores Impact of Technology on Case Management Practices: Pace of Integration and Automation Remains Slow

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In 2008, TCS, CMSA and ABQAURP coordinated the first in-depth survey to examine HIT trends in the field of care management. The organizations reunited to conduct the 2010 survey, allowing a longitudinal comparison of survey data. A core objective of the HIT survey is to assess the general trends related to HIT systems, especially the trends for care management software applications, and specific HIT system functionality within those applications. In addition, the research examines additional applications used by providers, payors, care managers, and others to support care management interventions and patient care. Although the practice of nursing and medicine has been transformed with the advent and adoption of HIT systems as a tool to support care management, these applications are still evolving. As a result, leveraging technology to improve medical management intervention strategies should remain a high priority in terms of both improving public health and reducing medical costs.

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Despite the slower than expected integration, the survey data indicates progress is occurring

New research indicates that Health Information Technology (HIT) systems are making an impact on a variety of medical management interventions, but less quickly than anticipated. The 2010 Health Information Technology Survey: How Technology Is Changing the Practice of Case Management report, conducted by TCS Healthcare Technologies (TCS) in conjunction with the Case Management Society of America (CMSA) and the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP), shows that more work needs to be done to integrate care management workflows into health information technology.

In 2008, TCS, CMSA and ABQAURP coordinated the first in-depth survey to examine HIT trends in the field of care management. The organizations reunited to conduct the 2010 survey, allowing a longitudinal comparison of survey data.

“These surveys represent the largest research effort assessing the opportunities and challenges associated with IT innovations in care management,” said Rob Pock, TCS CEO and Founder. “A main objective was to identify trends for care management software applications, specific capabilities within those applications, and additional applications used by providers, payors, care managers, and others to support patient care.”

The Health IT Survey:

  •     Reviews interoperability and integration interfaces;
  •     Identifies existing and future communication links;
  •     Assesses key elements associated with nurse triage solutions;
  •     Highlights data reporting and predictive modeling capabilities;
  •     Spotlights user satisfaction ratings of care management software, electronic medical record (EMR), and nurse triage systems;
  •     Explores case manager caseload Tracking consumer and provider access to health information; and
  •     Discusses respondents’ attitudes on the value of health IT systems.

“Despite the slower than expected integration, the survey data indicates progress is occurring,” notes Teri Treiger, RN-C, MA, CCM, CCP, President of CMSA. However “trends related to interoperability, functionality, and satisfaction levels indicate more work needs to done to leverage best practices for medical care.”

Other key findings in the 2010 survey 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.

Survey participants were generally positive about embracing emerging patient communication strategies within the next two years. Respondents anticipate a three-fold increase for using text messaging, ‘smart phones,’ and wireless remote monitoring, and a doubling in the use of online personal health records, patient portals, remote monitoring, and social networking.

When assessing case management caseloads, the survey found:

  •     Caseload ranges were most frequently 25-49 cases per week; and
  •     The most time spent in face-to-face contacts with patients is for those with caseloads of 100 to 124 per week.

These findings document the need to standardize clinical workflows across various case management settings.

Cheri Lattimer, RN, BSN, Executive Director of CMSA, noted, “Responses to the survey’s satisfaction questions indicate challenges remain for mobilizing care management software platforms that satisfy the desires of case managers and other users. Only one in five respondents said that care management software helped them to ‘spend more time’ with patients.”

Lattimer adds, “The majority report feeling dissatisfied with the promise to upgrade functionality. Dissatisfaction with current platforms offers an important window of opportunity to vendors who know how to and can successfully execute them."

“One bright spot is that HIT systems in care management and other healthcare settings will continue to evolve,” said Joel V. Brill, MD, AGAF, CHCQM, Member, Board of Directors, ABQAURP. “Well-designed HIT systems that integrate care management with the business and clinical IT platforms and increase efficiency in communications will have a significant impact on population health management. These features are critically important for accountable care management programs and the patients they serve.”

For copies of this survey, log on to http://www.tcshealthcare.com and click the “Health IT Survey” button, or log on to http://www.cmsa.org/HealthITSurvey. Additionally the survey is available for download at http://www.abqaurp.org.

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