In the future, data will help manage patient resources
Technology will help get a better handle on costs
Geoff Deutsch has a vision for the future of case management. In his vision, case managers will have information at their fingertips about how good a job each individual physician does with a particular diagnosis or severity level, and what each physician’s costs are for each diagnosis and each episode of care.
"The case managers might know that Dr. A does a good job with patients with this degree of severity in a certain diagnosis and won’t intervene to manage those patients’ care. But they know that Dr. B may need some management with a particular patient. They will be able to intervene aggressively and earlier on with some patients and save resources by not doing an early intervention on patients whose doctors have better outcomes," says Deutsch, senior vice president of HealthShare Technology, a Waltham, MA-based health care technology company.
Case managers will have specific information and benchmarks for individual physicians and their handling of specific types of cases, he says. "Instead of calling a doctor to review the care, the case manager can start the process by knowing where the issues are likely to be," he says. For example, when questioned about cost of care, many physicians will say that their patients are different. "With the type of data they’ll have available, case managers will be able to say that the data indicate that this doctor’s average length of stay tends to be 25% longer than any other physician in the hospital with the same outcomes," he says.
Case managers will be able to look at mortality, postoperative infection rate, and whatever other quality indicators are appropriate. Deutsch envisions a case manager being able to say, "I know cost issues tend to be in blood products, but your blood products are 40% higher, and the use of the lab is 26% higher. Data can give depth and meat and productivity to a discussion. Case managers are now coming in blind, knowing that quality and high cost are a problem. This will enable a more constructive fact-based discussion, a healthier and more productive approach," he says.
Data tools offer a tremendously exciting vision of how case management can be data-driven, Deutsch says. "The game has become how to manage and utilize resources to make the most impact where we can," he says.
Every hospital releases data on Medicare patients, such as charges, outcomes, and cost data down to the department level. This allows comparative benchmarking. Hospital case managers can access more detailed hospital information, but the challenge is to find it buried within a series of complex data management systems.
Deutsch’s company has developed two Internet-based tools, HealthShare One and HealthShare Two, that generate information from a variety of public and private sources, including clients’ existing information systems, provider and payer systems, and state and federal government health care provider filing information.
For more information, contact Deutsch at [email protected].
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