Female doctor take a note on clipboard , Medical concept

In 1996, HIPPA was passed to help standardize how privacy and security of health information work in the US. It’s an essential part of keeping patients safe and also recognizing what care is needed for patients as they have new health requirements.

Medical practice management is essential to stay aligned with HIPPA guidelines and earn the trust of patients. Case management software can make this practice much easier.

But, what is case management software? Why do medical professionals need to use it to keep track of patient data?

Keep reading as we explain what this software is, why it is a necessity in the medical field, and more.

What Is Case Management?

Case management is the act of processing data and information relevant to resolving a case. More simply, it’s managing, tracking, and storing client data so that all of the information pertinent to a “case” is in one spot.

With all the healthcare services provided to individuals, case management will coordinate care. Everyone involved in the case will know what is going on with that specific client or patient.

Role of a Case Manager in Medical Case Management

The person in charge of processing, tracking, and managing all of the information within a case is called a case manager.

You can find these professionals in many types of working environments. But, in the medical field, they generally work in hospitals, outpatient care centers, or insurance companies.

They will be in charge of specific patients’ cases, and they will have a caseload that they must keep up with. Their main job is to keep all data and patient health information (PHI) secure within that patient’s case file.

Some physicians do practice case management on the job, but they might not necessarily be the case manager for a patient. This means that multiple healthcare professionals might have access to a patient’s data to update or change things, but it lies on the shoulders of the case manager to keep everything processed and organized within the file for ease of access.

Case managers that work in the nursing field will usually follow up with patients to ensure that they are receiving care and rehab as needed for their treatment. Case managers that work in social work are likely to assist a client, as well as their family members, with accessing services and resources.

There are many “hats” that a case manager wears, but the main goal is to get the patient or client the services they need for a happy and healthy life.

Does a Case Manager Need Certification?

There are case management certifications, so it is a good idea for professional case managers to keep this in mind if they want to work in the medical field specifically.

The qualifications needed to take the exam include having at least 30% of qualified work time as a case manager. The person must also have a current and active license in a health or human services field.

A person that wants to take the CCM exam needs to have a bachelor’s or graduate degree in social work, human services, nursing, or other health fields.

This is specifically for individuals that are wanting a case manager certification for medical work, as other case managers, such as those for non-profits or government agencies, will have different requirements.

What Is Case Management Software?

Case management software makes it easy to compile information and keep it all in one place. Instead of having to create physical copies of documents, paperwork, and medical history, a case manager can work with all of it digitally.

This is more eco-friendly, clearly, but it also makes it a lot easier to track and change the case information as needed.

In addition to this, it’s more secure in that it’s easier to encrypt or lock documentation on a computer system than with any in-person storage mechanisms.

Adaptive Case Management vs. Dynamic Case Management

The two main types of case management, adaptive and dynamic, are similar. Both of these describe a case management system that lets the user (case manager) be in charge but allows the system to help determine what the best workflow is.

Adaptive case management looks at how cases were handled previously by the same case manager and bases the workflow off of this. Dynamic case management looks at events as they occur to see if those events need to change the workflow.

A case manager still has the authority to change the workflow as needed, but these two systems help make the process a little bit easier altogether.

What to Look for in Case Management Software

It’s essential to find case management software that meets the needs of your agency. This is in terms of tracking, communication, and reporting.

Many case management software options have other special features, which may be helpful for many of the case managers, but the basis of the software should be the main focus. Some key things to look for include:

  • Is there ongoing support from the provider?
  • Can the software grow with the organization?
  • Does it offer alerts for deadlines or due dates?
  • Can the system be customized to fit your case managers’ needs?
  • Are minor changes possible without having to speak with the provider?
  • Does it make the intake process easy?

You also need to consider specific populations you may work with in healthcare, such as the elderly. Software for case management in aged care, for instance, will have its own requirements that need features to help facilitate the care.

This is why looking at the needs of your agency when choosing software is extremely important, and it’s not a decision to take lightly.

Choose the Right Case Management Software for Healthcare Work

Your answers to “what is case management software?” and “why is case management important?” should now be answered, so the next step is finding case management software to take your patient care up a notch.

If you’re planning to open a healthcare agency or need to revamp your practices, investing in case management software is an important step to take for PHI security and patient care.

Did you enjoy learning about case management in this blog? If so, be sure to take a look at other posts in our healthcare section for more like this.