The State-of-the-Art of Care Management Software: Disconnected

Care management software is intended to help patients make critical connections across the health care delivery system.  Today it’s used primarily by 3rd party care managers who are typically either employed directed or indirectly by payers. While not surprising, the state-of-the-art of care management software is that it continues to function as disconnected islands of information.

The  2010 Health Information Technology Survey (available at no charge) provides an insightful yet sobering snapshot of care management software. The study was sponsored by TCS Healthcare Technologies, the Case Management Society of America, and the American Board of Quality Assurance and Utilization Review Physicians.

The study consists of answers from 670 respondents who chose to fill out to a web based survey; most respondents are direct care managers. 

The results are further broken down by subcategories of care management:  case management, disease management, utilization management, nurse triage, independent review organization, pharmacy benefits management, and behavioral health.  Variability among these subcategories should be considered directional given that the respondents are self-selected. The study doesn’t portend to be methodological rigorous, yet it’s a tremendously useful glimpse into the realities of care managers and the software they use.

Here are some key conclusions (mine) based on findings shown in Table 5A.  The numbers reflect the percentage of care manager respondents who indicated that their software provided specific capabilities.

Care managers use a hodge-podge of paper and computer systems

• We use only one information technology system — 16%
• We use multiple information technology systems — 69%

Care management software has limited connectivity to other care providers

• Our information technology system(s) is/are fully integrated and interoperable with other external IT applications — 23%
• Our clinical data can be shared electronically with other providers such as specialists, facilities, etc. — 35%

Care management software has limited connectivity to patients

• Consumers or patients can access their case information through our online portal — 17%
• We provide patients access to a web-based personalized health record from a preferred vendor — 12%

When will care management software connectivity and integration improve?

In the past, care management has mostly been conceptualized as a carve-out function — something that is typically conducted by 3^rd  party care managers, as opposed to being integrated into the practices of physicians and other care providers. 

The patient centered medical home and many other initiatives are attempting to reintegrate care management into the domain of care providers; HITECH supports this direction and we expect to see Stage 2 (2013) and Stage 3 (2015) Meaningful Use measures that will incentivize this integration.

Care management software is being reconceptualized as a modular application that will connect to EHR technology platforms.

If you’re a vendor of care management software, please comment on plans you’re developing for HITECH Stages 2 & 3.