2018-07-15

Disconnected and disjointed data: A care management survival guide

One of the biggest challenges hospitals will face in 2018 is interoperability, according to Healthcare IT News.

As a care manager, you know how dangerous it can be when you see conflicting data about the same patient, from various systems. But you’ve got to figure out how to let data empower your workflow, not prevent you from doing the best possible job for your patients. Here are a few tips on how to do just that.

Dig deeper: Don’t take data at a surface level

You can’t take one look at a patient’s data points and automatically assume you know their whole health story. It’s true that your EHR will give you their vitals: family history, weight, blood pressure, medications and past surgeries, but a patient’s health doesn’t live within an EHR. It’s their everyday actions that decide their wellness. When you spend an extra five minutes talking with a patient, you have the chance to not only understand their perspective, but gently re-direct them to more healthful choices.

For example, let’s say there’s a patient in the hospital with diabetes. Sure, the data says the diabetes is the problem, but maybe it’s because the patient couldn’t afford a bus ticket to refill their Metformin? Find out by asking a simple question: “Why are you in the hospital today?” Then, be open to seeing where the answer leads—don’t automatically type it into the EMR like a robot—and hear what the patient is telling you.

Meet patients where they are—literally

If you want patients to open up to you, you’ve got to be open to building a relationship with them. You want your relationship to be built on trust and understanding. After each visit, you want patients to walk away feeling, “I can tell this person something personal about my health and they aren’t going to judge me.”

When meeting with a patient, don’t start by asking all the tough questions. Ask them about their family, pets or hobbies. Focus on building a rapport first and then, get into the nitty-gritty of why they made an appointment.

Also, keep in mind that not every patient is comfortable in a hospital or an office setting. If possible, see if you can meet patients where they are. Maybe it’s as simple as meeting them at their church, home or favorite restaurant.

Be a community resource

Your patients aren’t just patients. They are people. They’ve got a life beyond your healthcare system—with their family, friends, career and so much more. If you only treat your patients for their diseases, you’re missing out on helping them reach their full potential in other areas of their life. Don’t just focus on the medical end of things—treat each patient as a whole person.

Here’s how you can be most helpful: Consider keeping a binder of resources that help patients when they need it. Include information for mental health, food pantries, legal, employment, education and childcare. Make sure the referrals are solid because you don’t want to send patients anywhere where they could have a bad experience.

Find a tech partner

Care managers like you are struggling with patient data and cumbersome reporting/quality programs, while trying to figure out who their patient population actually is. Readily available technology helps healthcare leaders insulate themselves from risk by identifying patients through data aggregation, risk stratifying them, and building patient-centric care plans to position all relevant parties for successful outcomes. In addition, you can’t rely on their EHRs to do everything. There are technology platforms out on the market that can help improve patient engagement, which is necessary for you and your peers.