Technology: A Driver of Case Management?

I’ll start off by saying that I am not afraid of technology.

Historically, I have been an early adopter. I definitely see the greater benefit of being plugged in rather than perpetuating the paper trail of life. With that statement out-of-the-way, I have to admit that I am very afraid of a trend that I am watching emerge in case managers across the U.S. It is the growing belief that software is the “process” of case management.  Well folks, I am drawing a line in the sand right here and now.  The resources we access as case managers are a tremendous value-add in how we conduct our work… but the software is NOT THE PROCESS!!!!!  It is simply a tool for how we document the process.

Let me explain…

To my way of thinking, the process of case management was clearly defined and documented by Powell and Tahan (2008) as the following six steps:

  1. Client identification and selection
  2. Assessment and problem/opportunity Identification
  3. Development of the case management plan
  4. Implementation and coordination of care activities
  5. Evaluation of the case management plan and follow-up
  6. Termination of the case management process

The process of case management is NOT about checking off boxes in an electronic assessment in order to produce an automated care plan and canned activities list which is then considered the roadmap for completion of the case management intervention. No… no… no!  That is not what case management is about and it is extremely troubling to me when I repeatedly meet individuals who consider themselves case managers and think that they have cornered the market on case management practice simply because they have figured out how to use their organization’s software program.

What do I believe case management is?  Well, here are a few thoughts to that point…

  • The process of case management is an intellectual exercise in which the professional case manager utilizes his/her gained knowledge and experience to make sound clinical judgements as to what will benefit their client the most.
  • The process of case management is a symphony of skills and knowledge in which the professional case manager examines the unique circumstances of their client’s past and current experience in order to make educated estimations as to their future risks, then proposes desired outcomes and goals, as well as interventions and activities as the means to reach those goals.
  • The process of case management works when the professional case manager collaborates with the client, caregiver, provider, and other members of the healthcare team in order to identify barriers that must be addressed in order to optimize personal health and facilitate reaching maximum potential.

Now, I understand the flip side of systematizing case management tools.  I developed software for case managers. I know having this support is a tremendous timesaver. I know it makes reporting case management interventions and outcomes more straightforward and consistent. It is clearly a value-add in the toolbox of case management… but that is where the distinction must be made.  Case management software is a tool… it is a means to an end, not the end in and of itself.

I have often said that I worry about some case managers losing sight of their soul and forgetting why they got into case management to begin with.  An overwhelming percentage of case managers I know want to help the people with whom they work. The myth that case managers got into the field simply to not have to work evenings and weekends is just plain old garbage and I do not subscribe to that point of view.  However, the frustration created by working under a system where the priority of throughput trumps that of quality is clearly evidenced through the thin smile of an over-burdened case manager. Unfortunately, there are those working under the title of case manager who are simply not really performing the core roles and functions of a professional case manager, as defined by the Case Management Society of America’s Standards of Practice for Case Management (2010).

So keep this in the forefront of your mind… while it may be easy to latch on to a tool in the name of progress and efficiency, that tool will never be a replacement for a kind word or gentle squeeze of the shoulder for those individuals we are privileged to work with.  As a professional case manager, I refuse to allow my years of gained knowledge and experience to be subjugated to the perception of being a computerized caricature driven by a call queue or turnaround timeline.  I challenge each and every one of my colleagues to always find the balance of efficiency to intellect… and to resist the temptation of simply following the trend to productize the professional practice of case management.  We are not bots, our clients are people… and the value of our work can not be captured by a tick in a box.

Now get out there and creatively collaborate!

References

Powell, S.K. & Tahan, H.A. (2008). Case Management Society of America (CMSA)  Core Curriculum for Case Management, (Ed. 2). Philadelphia: Lippincott Williams & Wilkins.

Case Management Society of America, (2010). Standards of Practice for Case Management. Little Rock, Arkansas.

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