Although EMRs have the ability to track patient data, features that manage the ability to care for populations is missing. A Care Management solution will provide Care Managers with the ability to target high-risk patients for whom care is needed. Once a patient is identified as one who is high-risk for continued medical care, or high-risk diagnoses, they can be assigned to a particular care management program where their needs can be customized for their illness. For example, Care management can:
- Tools to collaborate on personalized plans of care
- Evidenced based care pathways that identify gaps in care in near-real time and recommend mitigations
- Information to enable timely and appropriate interventions to reduce unnecessary utilization
Examples might include patients with Diabetes whose A1c is not well managed. Gaps in care could also be characterized as missing annual immunizations, colonoscopies, or mammography physician orders.
By increasing access to patient and population data from across care settings and providing better facilitation of communication among members of the care team – including the patient – Caradigm's Care Management solution will:
- Enable informed decision-making with comprehensive, cross-community views of patient data
- Allow clinicians to provide proactive intervention
- Improve coordination of care Increase patient engagement
- Enhance outcomes Help organizations more predictably manage cost and risk
Healthcare is changing rapidly with bundled payments, and movement from Fee-for-Service volume to Quality and value of care based on outcomes. A system that provides the ability to integrate and aggregate data from just about anywhere is essential to have a complete picture of patient needs, interventions and outcomes.
See the above link for more information on Care Management.