An essential part of successful case management is identifying patient risk, especially those with high risk, and then to engage them in a suitable management program. To achieve this, however, health systems need to stop relying solely on claims-data as that provides a partial and incomplete picture of patients.
Instead, other sources of data such as clinical data, pharmaceutical data, and social determinants of health such as homelessness, abuse, lack of insurance, and lack of access to routine care are important factors to consider. The industry is adopting this approach and working to create and support each individual user appropriately.
This fundamental shift from simple descriptive analysis to real-time and predictive understanding and perception is a fundamental driver to keeping costs low and to ensure that resources are spent in the best and most efficient way possible.
Companies who have not made the switch to intelligent and technology-driven management and execution models may think that the cost is too high, or the operating solutions are too complicated for their team members. This is because it is important to create a very precision-based model that can track and manage all of the resources, services, and data points of each individual patient in order to efficiently deliver timely and effective care at the best cost.
To top that there is a colossal amount of data to be stored, used, delivered, considered, and shared from and to many different sources – some are part of medical records while others require the engagement of team members, administration, other companies, and patient caregivers. All this action and information needs to be HIPAA compliant, shared, and stored in a confidential and safe manner.
As the trend of using technology to manage all business processes inside case management agencies increases, more firms are now implementing the software and interfaces to help create a sound and reliable means to operate efficiently with financial effectiveness. With HealtheFirst, processes are customized and data is used to allow for seamless integration and application of the requirements for positive service and financial outcomes. HealtheFirst reduces the cost of using a bunch of separate services as well as manual workload by providing an interface that allows the entire company to operate smoothly and generate positive results for all stakeholders.