5 Attributes of a Robust Care Management System

This article is Part 2 in a series of articles on Care Management Systems. In Part 1 – What is a Care Management System? – I made the case that Care Management Systems are the next major healthcare product. A new generation of Care Management Systems is evolving driven by the patient-centric and value-based healthcare models. These new generation Care Management Systems include patients in the management of care, enable the entire care team to track patient health and collaborate, and engage patients outside the healthcare facility, not just inside. This article presents my point-of-view on the 5 attributes of a robust Care Management System.

  1. Personalization: With the increasing “consumerism” of healthcare, Patients – the consumers of healthcare – are expecting a personalized experience when they engage with their Healthcare Providers. These consumers have been trained by companies like Netflix and Amazon to expect that their Healthcare Provider knows about their preferences. Patients engage and respond much more positively to these personalized experiences, which encourages loyalty and better adherence to care plans. A robust care management solution will need to communicate with the Patients in the mode (e.g., email, text, phone) they prefer, in the language they prefer, and at the time they prefer. A smart care management solution will even learn and adapt based on the past patient behavior.
  2. Behavior Change: Changing individual behavior is increasingly at the heart of healthcare. In a McKinsey analysis of US healthcare costs (which are now nearing $3 trillion annually), 31 percent of those costs could be directly attributed to behaviorally-influenced chronic conditions. Fully 69 percent of total costs were heavily influenced by consumer behaviors. The burden consumer choices place on low- and middle-income patients is relatively more staggering. A robust care management system will need to incorporate behavioral science strategies (e.g., rewards, gamification, social competition) to engage the patients and increase probability of changing behavior and sustaining behavior change.
  3. Ease of Use for Providers: Providers are looking for care management solutions that are easy to deploy, use, and maintain, and that integrate seamlessly with their existing systems (EHR, PMS, Patient Portals). A robust care management solution will be a cloud-based solution requiring no hardware or software installation on premise. It will enable the Provider to quickly create and administer customized care management programs, from anywhere, anytime, and using any internet-enabled device. It will allow the users to view real-time outcomes on a dashboard and allow ad-hoc reporting for program assessment and audit. It will integrate seamlessly with the Providers’ EHR system to obtain patient data for the care management programs, and to feed relevant patient-generated data back into the EHR system to facilitate clinical workflow integration.
  4. HIPAA Compliant: Not much needs to be said here. A robust care management solution needs to be HIPAA compliant not just for compliance reasons, but also for the solution to be effective. To reap the promise of digital health information to achieve better health outcomes and lower costs, Providers and Patients alike must trust that an individual’s health information is private and secure. If Patients lack trust in the Care Management solution, feeling that the confidentiality and accuracy of their responses is at risk, they may not want to respond to the care management solution.
  5. Scalability: A robust solution will be scalable & able to grow as the client needs grow – from chronic disease management programs to wellness programs; from small to large facilities; and across systems and networks.

My firm, Patientriciti (www.patientriciti.com), has a multi-modal, multi-lingual, patient engagement and care management solution which helps Providers and Health Systems reach and engage with different segments of the population in a personalized way to affect sustained behavior change. Email info@patientriciti.com if you are interested in more information.