31 Jul Amplifying DSRIP Care Manager Productivity and Effectiveness
Samir D’Sa, Principal, NY DSRIP Services, Earl Steinberg, MD, MPP, CEO, Chuck Baumgart, MD, Senior Medical Director, Melodi Brown, RN, MSN, CCM, Vice President, Care Management, xG Health Solutions, July 31, 2015
Care management is a key to success in Delivery System Reform Incentive Payment (DSRIP) because it directly influences patient health outcomes and use (for example, inpatient admissions, readmissions, and ED visits). Most PPSs envision use of diverse care teams composed of nurse care managers, pharmacists, social workers, care associates, and community health workers. Empowering a well-trained care team with workflow/documentation tools and robust analytics amplifies their impact and, by extension, delivers better patient and DSRIP outcomes.
Challenges: Off-the-shelf care management workflow tools are not the right answer. They are generally payer-centric and don’t readily support provider-directed care management or team-based care. For example, they are not always compatible with the documentation and care management process needs of an embedded care manager in a PCP office setting. Other care management tools are tightly coupled with a particular EHR and so do not readily support the needs of a regional PPS whose providers use several EHRs. Still others have no prebuilt clinical assessments or care plans with logical workflows—or worse, they contain lengthy, generic questionnaires that are siloed, rather than dynamic.
What to look for: Here are some important care management capabilities for DSRIP:
- Workflow: To be efficient and effective, care managers need clinically informed disease-specific assessments, care plans produced automatically based on the assessment results, clinical decision support, and algorithms that help the care manager prioritize his or her workload. The xG Care™ care management software platform provides all of these. xG Care™ uses branching logic so a care manager can ask the most efficient sequence of questions to get the job done. xG Care™ also uses a question library so a care manager is only prompted to ask a patient a particular question once, even if the question applies to more than one disease. The software inserts the nurse’s response wherever it is relevant automatically.
- Interventions: Reducing unjustified variation in clinical practice is essential—care managers should be prompted with the right set of interventions and care plan templates to create effective patient interventions. With xG Care™, we integrate a correspondence module with a library of auto-generated email/letter templates and educational materials, carefully worded and designed to influence patient behavior.
- Performance Management: Measuring the productivity and impact of each member of the care team helps supervisors get the most out of their team. xG Care™ has a preloaded set of case load, load balancing, productivity, and outcome metrics that support day-to-day management of the care team, promote team work, and provide a care management team scorecard for PPS executives as well as care management supervisors.
- Reporting: DSRIP wants an audit trail for the Dept. of Health. A care management platform that contains discrete data elements, workflows, queues, and documentation and that captures patient-specific care plans and management will meet this need and obviate the need for manual recordkeeping and retrospective searches for data to corroborate care management screening, outreach, and enrollment.
We look forward to engaging with you in a dialogue around your care management workflow and documentation needs.