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Mentor moment: What the EHR means to case managers

Case Management Weekly, June 30, 2010

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The Office of the National Coordinator for Health Information Technology (ONC) has released a final rule establishing a certification program for health information technology. The rule released June 18 describes the temporary certification program for electronic health records (EHR) and what organizations must do to be authorized to test and certify EHR technology, according to an HCPro.com article.

As a busy case manager you might think “well, that’s nice, but what is the big deal about the EHR?”

Most case managers have more work than they can handle and no time to think about their facilities’ adoption of EHR. Some case managers probably doubt that EHR will make their lives any easier.

Actually, case managers are invested in use of EHR. I want to share information compiled in a 2006 study by Eclipsys Systems entitled Eclipsys EHR Success Case Studies: Improved Operational Efficiency with an EHR. I don’t endorse a particular product, but I think this information demonstrates how EHR affects case managers.

The study found that EHRs helped:

• Reduce the need for full-time case managers while also increasing the number of reviews completed.
• Improve the process for managing concurrent denials because they allow clinicians to review medical records in their office or other locations within the hospital.
• Decrease the number of denials due to better management of avoidable days
• Improve staff effectiveness. Staff can access the entire chart and prioritize their workload.
• Enhance the ability to perform trend analysis by avoiding the need to manually enter data into an Excel® spreadsheet.

Users also commented that EHRs save time, reduce missed orders, provide better and safer care, and improve communication with physicians with legible notes.

While I wonder whether EHRs will reduce the need for full-time case managers, it would be wonderful if case managers had more time to focus on Medicare admissions, especially with increased scrutiny from government auditors. It also makes sense that legible records will reduce confusion and time spent verifying orders and outcomes. Also, EHRs with built-in utilization criteria may help providers reduce concurrent denials.

The ability to perform concurrent trend analysis with an EHR will allow case managers to actively prioritize their reviews and work more efficiently. Case managers could focus their time and energy on cases that need intervention most, which could reduce denials, improve quality of care, and increase cost effectiveness.

Case managers should be active participants in their organization’s process of reviewing and rating prospective EHR systems. EHR technology should facilitate communication between case management and computer-assisted coding software.

Case managers should be involved in all process improvement initiatives as payers move toward pay-for-performance reimbursement models. There are exciting opportunities for the practice of case management in the digital era. 

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