Every healthcare service provider's primary objective is patient care, yet the reality of day-to-day operations involves a myriad of routine tasks - scheduling, paperwork, billing, and more. The efficiency and quality of care hinge on how well these processes are managed.
This is where case management steps in. By implementing a robust case management system, healthcare providers can streamline these routine tasks, creating a more efficient workflow. Case management helps coordinate these processes, from scheduling appointments to billing, ensuring tasks are completed efficiently and accurately.
But more than just managing mundane tasks, case management in healthcare also involves coordinating patient care. It encompasses gathering information from various sources, making informed decisions on the best course of action, and ensuring the patient's journey from admission to discharge is smooth and well-coordinated.
Benefits of Case Management in Healthcare
- What is Case Management in Healthcare
- Role of a Case Manager
- Benefits of Case Management in the Healthcare Industry
What is Case Management in Healthcare?
Over time, healthcare providers have been leveraging technology to simplify these processes and make them more efficient. Technology has drastically improved certain functions such as registering and maintaining patient information, managing prescriptions, tracking diagnoses, and monitoring the overall patient lifecycle process of interacting with patients in clinical settings.
While some case management systems focus on general healthcare and patient lifecycle management, others are designed specifically for the handling of complex cases in healthcare settings. These automated case management tools assist caseworkers in tackling complex patient-related queries, incidents, and claims at healthcare environments such as hospitals, care homes, and health insurance centers.
What is the role of a Case Manager in a Healthcare Organization?
The exact role of a case manager in the healthcare industry depends mainly on the functional area they serve. For instance, a healthcare caseworker in a hospital is responsible for ensuring that patients get the necessary medical treatment they need while they are in the hospital and continual therapy after they leave. They may deal with scheduling hospital visits, escalating cases for appropriate treatment or further tests, and ensuring patients’ records, diagnoses, and prescriptions are appropriately managed.
This is different from the role of a health insurance case worker, whose job is to ensure that the best quality medical care is made available to patients in the most economical way possible. The health insurance case manager would be responsible for liaising with healthcare providers, physicians, and the patients themselves to ensure parity and manage their coverage claims as efficiently as possible.
In either case, both case managers are responsible for assessing the needs of the patients and ensuring they get access to the services and resources they need. However, the cases they are likely to encounter, and the processes for solving them will be different. Both situations may involve potentially complex cases that must be organized and properly handled for optimal results.
Benefits of Case Management In The Healthcare Industry
Modern automated case management solutions are designed to handle the numerous needs of the healthcare case management process and ease the burden of case managers. Employing software that automates case management is a step in the right direction in a bid to improve healthcare service delivery for any medical practice.
Here are some of the benefits of automating case management in the healthcare industry:
Keeping patients informed
Most automated case management tools are designed to allow knowledge workers to seamlessly interact with patients through various channels. Case management software also makes it easier to access patient profiles, which contain relevant information such as histories, test results, and diagnoses that may be needed to create a holistic patient experience.
Some patient requests are simple and straightforward. Others are more complicated and will require several approvals before they can be carried out. A major surgical operation, for instance, may require multiple levels of approvals and authorizations not just within the hospital but also with external parties such as health insurance providers. Without using an automated system, such approvals might take a lot of time. This may delay patient care and hinder case resolution. Automated case management software will make it possible to pass these approval requests along faster to avoid delays and bottlenecks in the healthcare delivery process.
An automated case management solution promotes faster and more efficient case escalations. When patients have complaints or are dissatisfied with the way the appointed case manager is handling their issues, they can request to have the case handled by another service professional or higher-up. The centralized database that an automated case manager provides makes it possible to simply pass along patient data to the managers or higher-ups to take charge of the incident and attempt service recovery.
Seamless collaboration between departments
Inter-departmental collaboration is an absolute necessity in the healthcare sector. Case management software makes it possible to refer and transfer patients from one department to another seamlessly. An efficient platform may also make it easier to grant healthcare providers access to information such as their medical history or billing information.
Streamlined operation for quicker resolution
An automated case management software greatly streamlines administrative tasks involved in healthcare service delivery. On the one hand, this will make it easier to resolve cases quickly and more efficiently. On the other hand, it also eases the burden on medical staff by streamlining administrative duties while allowing them to focus better on delivering the best care to patients. Simplifying the process this way also improves accuracy and ensures caseworkers make fewer errors. This can make a world of difference in a healthcare case management setting.
Security of sensitive patient data
Automated case management tools provide a centralized location for sensitive patient-related data. This may include their contact information, notes about the case, appointment history, scheduling, billing, claims, etc.
With an automated case management solution, caseworkers and other stakeholders can store, access, track, and amend this information in a safe and secure manner. Caseworkers can also seamlessly transmit required pieces of information digitally for doctors and other healthcare providers to access remotely and across devices. A dynamic case management solution also ensures role-based access—only authorized personnel are allowed to access and operate data.
How Vibrant Emotional Health streamlined its daily operations with Kissflow
Vibrant Emotional Health, previously known as the Mental Health Association of New York City (MHA-NYC), has been a leader in promoting emotional well-being for all people for over 50 years. They are the driving force behind the National Suicide Prevention Lifeline and administer the NYC Well program.
However, Vibrant faced challenges with manual processes, lack of reporting capabilities, and increased costs related to their previous system, DocuSign. The need for a more efficient and cost-effective solution led them to Kissflow.
Kissflow helped automate approvals and streamline the process of making payments and submitting requests. CIO David Koosis chose Kissflow due to its ease of use and affordability. The implementation of Kissflow reduced manual errors, cut down form filling time by half, and decreased overall process cycle time.
Internet Application Specialist at Vibrant, Zenzele Tanya, praised Kissflow for its user-friendly interface and responsive customer support. Vibrant plans to migrate all its forms to Kissflow, hoping to increase efficiency further. Kissflow is proud to support Vibrant in its mission to provide emotional support and care.
In recent years, automated healthcare case management software has been helping caseworkers set new standards of excellence in the healthcare industry. A versatile tool has a range of helpful features that facilitate better service delivery and increase the efficiency of processes and overall operational effectiveness of case management in a healthcare or insurance setting.
Kissflow is a low-code platform that specializes in case management. It can be easily customized and configured to suit the needs of your practice without having to employ product experts or the need to learn how to code. Learn more about how you can improve case management in your organization today. Try Kissflow for free.