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Don't rush into a technology purchase
Evaluate all options
Technology can make a huge difference in the practice of case management, but you should choose carefully and deliberately to avoid pitfalls in the future, cautions Marcia Diane Ward, RN, CCM, PMP, a case management consultant based in Columbus, Ohio.
"No matter what kind of technology case managers are looking at, they have to make sure that it will do what they want it to do and work with their organization's computer software, hardware, and operating system. Whether case managers are looking for practice management software or telemonitoring technology, it has to fit into their organization's information technology framework," she adds.
Ward recommends assembling a team of people from all areas of the organization to evaluate and choose technology. The team should include clinicians/case managers who will be using the product, representatives from the information technology department, a product marketing representative who understands the service level agreement with customers, and a representative from the legal/security department to ensure compliance with industry and government mandates and regulations.
According to Ward, an organization's information technology department's architect/administrator should be a key part of the selection team as he or she is responsible for monitoring the technology needs of the entire organization.
"Whether the end user will be a nurse case manager or nurse utilization manager in the provider or payer setting, or, in the case of monitoring equipment, the person who is in charge of monitoring, the direct user of the equipment must be part of the selection team. The application must fit into the framework of the organization's legacy information management system while supporting the clinical judgment and advocacy role of the nurse case manager who uses it," she says.
"Before you begin, outline the goals and objectives for the equipment. Look at what you need to be able to provide for public reporting, payer audits, outcomes tracking, and service level agreements your organization has with its direct customers. Review your contract with your customers to ensure that the product will be able to provide the information that is requested and required," Ward advises.
"Develop the business case for purchasing the new technology. Include how the product will support the need to serve your customers or patients, how it will improve outcomes, and soft savings, such as improved patient or customer satisfaction, as well as potential dollar savings. Present the information to the executive team and the chief financial officer," she continues.
"With any project, the sponsor is the one who pays the bills. The executive team that approves the budget for the new technology is a major stakeholder in the process. You have to have buy-in from the beginning," she says.
Ward suggests mapping out the technology will be used, how it should interface with existing technology, and what information will be input and analyzed. "For instance, do you want to manage every aspect of the patient's care or just the telephonic reporting of symptoms for compliance monitoring?"
"Case managers need to choose technology that is appropriate to their case mix/caseload and that is appropriate for the case management methodology and processes of their organization. The team should also decide what specialty modules need to be added to the basic product, such as disease management or life care planning," she says.
"When you begin to evaluate individual products, keep in mind that most case managers may not have strong technical skills and look for technology that is easy to understand and navigate," adds Thomas R. Ferry, president and chief executive officer at Curaspan Health Group, with headquarters in Newton, MA.
"Historically, applications have been complicated and confusing. I advise people to look for case management technology that is intuitive and easy-to-use," he adds. Determine what kind of customization may be necessary for the system to fit your needs and how easy will it be to perform. Look at the hardware requirements for the technology, and determine if it will integrate into your system. Select a provider that has a strong service component of client support, Ferry says.
"If organizations are left to their own devices, the implementation may not fail, but they won't be able to achieve all the results they hoped for. When new technology is being implemented, organizations need support from an experienced vendor who is with them every step of the way," Ferry says.
"Consider the training needs of your staff and the training and support offered by the vendors you are considering. Get detailed information about the kind of training and support the technology vendor offers," Ward says.
Look at the features and capabilities of the technology you are considering. Ask for product demonstrations and instructional tutorials, as well as testimonials from users of the product. "On-site demos of the past have transitioned to remote demonstrations and web-based reviews," she adds.
Ask the vendor for a list of customers in similar organizations, and talk to people who are using the product. Ask how easy it was to work with the vendor and if the product meets their needs.
Ward advises that when you choose a vendor, review the contract carefully to make sure it contains details on how the company will install the technology, train your staff, and provide support. If possible, negotiate an incremental payment plan with the product vendor to ensure that it provides what is promised in a timely manner.