What to Know When Becoming a Nurse Practitioner

Friendly and attractive of a woman practitioner standing in a glass hall office of the clinic and examining documentsWritten by Victoria Maxwell

Becoming a nurse practitioner (NP) is a rewarding and challenging journey. NPs are advanced practice nurses who provide a wide range of healthcare services, including diagnosing and treating medical conditions. If you’re considering a career as a nurse practitioner, it’s essential to be well-informed about the path you’ll need to follow. This guide will provide valuable insights and information on what to know when becoming a nurse practitioner.

1. Educational Requirements

Becoming a nurse practitioner requires extensive and challenging schooling. It usually begins with a Bachelor of Science in Nursing (BSN) or comparable degree, which teaches nursing fundamentals. After getting an RN license, you can pursue higher study, such as an MSN or DNP. Aspiring nurse practitioners get specific clinical training from these postgraduate degrees. The program emphasizes advanced clinical practice, specialization, and preparing students for larger patient care and healthcare leadership positions. Becoming a nurse practitioner requires effort, knowledge, and a desire to improve patient care.

2. Specialization and Certification

Nurse practitioners often specialize in family practice, pediatrics, adult gerontology, women’s health, and more. After completing their school, they must get specialist certification. Reputable organizations like the American Academy of Nurse Practitioners (AANP) and the American Nurses Credentialing Center provide certification. These organizations set and enforce nurse practitioner standards, ensuring they have the skills and knowledge to succeed in their industry. Specialization certification boosts a nurse practitioner’s reputation and validates their expertise in their field. It also shows their dedication to providing high-quality care to patients.

3. Licensing and State Regulations

Nurse practitioner licensing standards vary by state or nation. Understanding local legislation and licensing requirements is crucial. Some states allow nurse practitioners to work independently and offer patient care. Other states require nurse practitioners to collaborate with doctors under collaborative practice agreements. Understanding and meeting license requirements is crucial for legal compliance, practice scope, independence, and patient care as a nurse practitioner.

4. Clinical Training and Residency

Clinical training gives nurse practitioners excellent hands-on experience to develop their specialization-specific abilities. Nurse practitioners gain practical knowledge and skills throughout their studies to succeed in their careers. Some nurse practitioners choose postgraduate residencies or fellowships to improve their clinical skills. These extra training possibilities help nurse practitioners flourish in their healthcare professions by deepening their knowledge and skills in their field. They can become leaders and specialists in their disciplines by improving their clinical abilities via postgraduate residencies and fellowships.

5. Prescriptive Authority

Nurse practitioners can prescribe drugs in most states, although their authority varies. Nurse practitioners must comprehend the laws and regulations that allow them to prescribe pharmaceuticals, including prohibited substances, in their practice region. It is important to know your state’s prescriptive authority legislation since it determines its reach. Nurse practitioners can offer patients the right drugs and restricted substances within their licensure and meet the highest standards of patient care and safety by being aware of these legal limits.

6. Continuing Education and Recertification

Lifelong learning is essential for nurse practitioners. Healthcare is always changing. Therefore, continual education and recertification are essential. Nurse practitioners must commit to continued professional development to stay current on healthcare trends and best practices, according to most certification organizations. Learning is a professional commitment and a way to provide high-quality patient care. Nurse practitioners can maintain their accreditation and function as critical healthcare professionals in the changing healthcare environment by maintaining their education and recertification.

7. Collaborative Practice or Independent Practice

One significant decision to make when considering a career as a Nurse Practitioner is whether to pursue a collaborative practice or an independent practice. This choice can impact the nature of your role and the type of healthcare facility where you’ll work. Nurse practitioners often have a range of opportunities, with nurse practitioner jobs available in collaborative settings within hospitals, clinics, and medical practices, as well as the option to operate independently in certain states. Each path has its advantages, and the decision should align with your career goals and the level of autonomy you desire. Whether you opt for a collaborative practice or an independent one, the demand for nurse practitioners is on the rise, offering a promising and rewarding career in the healthcare field.

Conclusion

Becoming a nurse practitioner is a significant commitment involving education, specialization, certification, licensing, and ongoing professional development. As advanced practice nurses, NPs play a crucial role in healthcare delivery, providing primary and specialized care to diverse patient populations. Understanding the educational, regulatory, and professional aspects of the nurse practitioner role is essential for a successful and fulfilling career in healthcare.

 

Author Bio:

Victoria Maxwell is an aspiring author residing in New Hampshire. When not writing, she loves hiking in the White Mountains and learning about all things backpacking.

 

 

Please also review AIHCP’s Case Management Certificate program and see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification.

How to decide if a care home is right for your loved one

Smiling multiracial female physiotherapist assisting senior man in walking with walker at home. Unaltered, physical therapy, healthcare, patient, retirement, recovery, support, disability concept.

Written by Laura-Jane Evans

Taking the decision to move your loved one into a care home can be really tricky. They might object to the idea, or you might feel that you’re failing in your responsibilities to them. The truth is that the right care home can improve the quality of life for your loved one, and make it easier for you, allowing you to enjoy the time you spend with them rather than filling it with caring tasks. With over 1.3 million residents in care homes in the US, it’s clear that this is a decision many people will have to make at some point.

But choosing the right care home is a crucial part of the process. Every place will offer something slightly different, so it’s important to take your time and consider the options carefully so that everyone is happy. Let’s explore some of the factors you should consider.

Take time to understand what care they need

Sometimes, taking the decision to look at care homes is just the result of deteriorating health, but in many cases, it’s triggered by a feeling of overwhelm following a fall or something similar. This can make it hard to think carefully about what care your loved one needs, and if the home you’re looking at can offer that. If you feel that you need to move your family member urgently, you’ll feel under pressure to choose a place quickly.

However, taking the time to understand the care that they need is really important. Do you need to look for a specialist care home for a certain medical condition? Will they need ad-hoc support or around-the-clock care? Are they likely to need care at night? Will they have the chance to be independent if they want to, or does every resident get treated the same?

You can write down your own answers to these questions, but also make sure to ask your loved one if possible, or any carers you already have visiting on a daily basis. You can then use this list as a criteria for narrowing down your choices.

Consider the future

As well as understanding the care your loved one needs now, you’ll also need to consider what things might look like in the future. Unfortunately, things can deteriorate rapidly, and it might be wise to choose a care home that offers different levels of care as and when needed.

For example, if your relative only needs once-per-day check-ins now, but might need them more regularly in the future, make sure that is an option. It’s highly disruptive to move someone once they’re settled at a care home – and on the other end of the scale, you don’t want to force them to have full-time care and lose their independence if they don’t need it. Independent living is particularly vital for seniors, as it gives them a sense of control and purpose, as well as supporting their memory skills.

Look at the location of any potential care homes

The location of a care home is important for two reasons: proximity to family and friends, and proximity to local services if your loved one is able to use them. Firstly, you’ll want to make sure that your relative can have plenty of visitors if they’d like them, which means choosing a place that’s either close to as many people as possible, or has good transport links to enable them to get there easily. Part of the resistance to moving into a care home sometimes stems from the fear of being isolated and lonely, so do your best to combat this from the start, so it isn’t a barrier.

Secondly, not everyone who moves into a care home needs to remain in their room or in the home 24/7. Depending on their health, they may be able to go on planned excursions to the local town or the surrounding area. Care homes that are close to towns or other attractions are more likely to offer these sorts of trips, so consider this when making your choice. This may make moving into a care home more attractive to your loved one, especially if they can’t currently manage these sorts of trips themselves.

Meet the staff team

If you’re looking at care homes, it’s understandable that you’d want to ensure that the people who are looking after your loved one are kind, well-trained and compassionate. After all, they would be taking your place when you’re not there. So, when trying to decide if a care home is right for your family member, make sure you take the time to speak with the manager of the homes you’re considering, and visit in person if possible.

Care workers need to be dependable, good communicators and trustworthy, so look out for these traits in the staff when you make your visit. If they seem unorganized, unable to answer your questions, or like they’re rushing through their tasks, the home might not be the right fit.

Speak to your loved one

If your loved one is well enough to give input into this decision, then make sure to include them. This is a big change that will impact every part of their life, so whilst you might be taking the lead in making enquiries, they need to feel like they have a chance to contribute to the discussion. No one likes to feel blindsided, so before you make any commitments, make sure that you have their input about what they would like from their new home. By doing so, you are showing them that you see them as an individual, and give them the respect they deserve.

 

Author bio: Laura-Jane Evans

Having trained as a care worker initially, Laura-Jane now works in the community to provide social events and talks for seniors from surrounding nursing homes. She believes that everyone has the right to good care.

 

 

Please also review AIHCP’s Case Management Certificate program and see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification.

10 Basics of Medical Billing: How Does the Process Work?

a stethoscope is on the keyboard of a computer. allocation and organization of doctors.Written by Veronica Turner

 

Medical billing is a vital cog in the healthcare machine, a process that exists at the intersection of healthcare services and financial practices. If you’re a case manager looking to master medical billing and coding, it’s crucial to acquaint yourself with its many facets and core steps.

From patient registration to debt collection, medical billing offers a unique blend of challenges and rewards. This guide will provide an overview of basic principles that drive medical billing, equipping case managers with essential knowledge to navigate this complex landscape.

 

10 Basics of Medical Billing for Case Managers

Navigating the world of medical billing can be daunting. To make things simpler, we’ve broken down the medical billing process steps into 10 easy-to-understand basics for case managers.

  1. Patient Registration

Patient registration is one of the primary steps in the medical billing process. This phase involves obtaining key details about patients, including their personal information, insurance details, and medical history. Simple missteps here can lead to delayed payments or denied claims.

It’s crucial that you get an accurate and complete data set during registration, as this impacts subsequent stages of billing and claims processing. To avoid errors and confusion later on, confirm all details with the patient or their caregiver right at the beginning.

 

  1. Insurance Verification

Insurance verification is another important step in the medical billing process as a case manager. It consists of confirming that the patient’s insurance is valid, determining the level of coverage, and understanding exactly what treatments or procedures the policy includes.

This task can be time-consuming and often requires contacting insurance companies directly, but it’s crucial to prevent misunderstandings about payment responsibilities. Ultimately, successful insurance verification ensures that healthcare providers are compensated.

 

  1. Medical Coding

Medical coding plays a significant part in the medical billing process for case managers. Essentially, it involves translating patient records into standardized codes used throughout the healthcare industry. These codes, including ICD and CPT, represent diagnoses and services.

Accuracy is paramount in this step, as incorrect or incomplete coding can lead to claim denials or delays by insurance providers. Therefore, being fluent in medical coding not only streamlines billing procedures but also ensures appropriate and timely reimbursements.

 

  1. Charge Entry

Charge entry involves assigning appropriate costs to the medical services that a patient has received. It’s critical to note for this stage that charges should match the services and procedures as per their specific codes from both treatment records and insurance policies.

Any mismatch could lead to claim denials, making it crucial to be meticulous during charge entry. After all, accurate charge entries form a crucial basis for creating spotless invoices, ensuring smooth cash flow, and maintaining a healthy financial state for healthcare providers.

 

  1. Claim Submission

Once the charges are entered accurately against the appropriate medical codes, it’s time to submit these claims to insurance providers. This procedure needs to be done promptly and without errors, using designated software that most healthcare providers have in place.

It’s important that you follow the specific guidelines of each insurance company when submitting claims. Otherwise, there could be delays or rejections. Well-organized claim submissions minimize disputes and ensure faster payments, two key factors of effective case management.

 

  1. Payment Posting

As a case manager, once a claim has been approved and paid by the insurance company, it’s your job to post these payments accurately against each patient’s account. This involves matching received amounts with claims submissions, marking each settled claim as ‘paid.’

It also includes identifying and recording any adjustments or discrepancies like underpayments or overpayments. Getting this step right is integral to maintaining accurate financial records for both healthcare providers and patients, ensuring smooth closures to individual patient episodes.

 

  1. Rejection Management

Rejection management is an area where case managers need to show their problem-solving skills. Sometimes, despite your best efforts, insurance companies might reject a claim due to various reasons, such as errors in coding or documentation or even timeline issues.

The key here is not to panic but to meticulously assess the rejection reason and take corrective actions accordingly. Replacement or corrected claims should be submitted promptly following the insurance company’s guidelines. Proper management of rejections ensures low denial rates.

 

  1. Patient Statement Generation

Patient statement generation is technically the final step in the medical billing process. As a case manager, once insurance payments have been posted, you’ll need to generate statements for patients detailing any outstanding (or possibly late) balances for which they are responsible.

These statements typically include services provided, amounts paid by their insurance, and any remaining balance due. Patients should clearly understand what they are being charged for. Providing comprehensive, easy-to-understand bill statements helps in timely collections.

 

  1. Debt Collection

Debt collection is an inevitable aspect of the medical billing process when patients fail to clear their dues. It’s important to handle this delicate task with empathy while maintaining professionalism. You may have to escalate outstanding patient balances to collections agencies.

This step often requires understanding intricate regulations around debt collection practices, especially those stipulated by the Fair Debt Collection Practices Act (FDCPA). Balancing prompt recoveries with compassionate communication can avoid creating strain in your relationships.

 

  1. Report Generation and Analysis

In the world of medical billing, case managers are often tasked with report generation and analysis. This involves creating comprehensive summaries of the billing activities, including sent claims, payments received, current receivables, and rejected claims, among other data points.

These reports give valuable insights into the financial health of a healthcare provider and can identify patterns or areas for improvement. They help drive strategic decision-making for better financial management and provide proof to the IRS in case of an audit or legal dispute.

 

In Conclusion…

As you navigate this field, remember that every challenge is an opportunity to refine your skills as a case manager. By embracing these principles, you’re contributing to streamlining operations, mitigating disputes, and helping patients better understand their financial responsibilities.

Keep exploring these facets of medical billing and enhancing your skills. Stay informed about updates in healthcare finance, as proficiency in medical billing requires constant adaptation!

 

Author Bio:

Veronica Turner is a health and lifestyle writer with over 10 years of experience. She creates compelling content on nutrition, fitness, mental health, and overall wellness.

 

 

Please also review AIHCP’s Case Management Certificate program and see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification.

Revamping the Patient Journey: Top Tips for Medical Professionals

Patient in hospital bed holding Black doctor's handWritten by Veronica Turner

 

Navigating the dynamic landscape of healthcare requires a nuanced blend of clinical competence, adaptability, and a persistent focus on patient satisfaction.

As medical professionals, your role isn’t confined to just diagnosing ailments and prescribing treatments. You’re the guiding force leading patients through their healthcare journey, making it as seamless and comfortable as possible. This process is also called the patient journey.

This article provides numerous top tips designed to help you rise to these challenges.

By adopting these strategies, from enhancing tech-savviness and promoting self-management to adopting patient-centric approaches, you can revamp the patient experience in your practice.

But first, we have to examine how the patient journey impacts the patient experience.

 

What is the Patient Experience?

Patient experience refers to interactions that the patient encounters throughout the healthcare journey. This includes interactions with nurses, doctors, healthcare staff, and facilities.

When we look at multiple aspects of the patient experience, we can assess whether patients are receiving respective, responsive, and individual care based on their needs and values. There are many ways that healthcare professionals can monitor and assess the client’s experience.

One way they’re doing this is through the use of technology and automation. For example, similar to how a peer-to-peer employee recognition platform improves your employee’s experience, healthcare apps like Practo improve the patient through doctor feedback.

 

Why Does Patient Experience Matter?

Here are a few reasons why patient experience matters:

  • Higher Patient Satisfaction: Patients who receive timely support and complete respect are more eager to follow plans from their doctors, thus increasing their satisfaction.
  • Improves Health Outcomes: when patients engage with their care team, they feel more confident about the treatment approach. Their compliance leads to better outcomes.
  • Increases Your Bottom Line: Happy patients are more likely to come back to your healthcare facility. Therefore, your bottom line will increase drastically.
  • Boosts Your Online Reputation: According to the National Research Corporation, there’s a link between a great patient experience and an improved online reputation.

When the patient journey is seamless, patient experience and satisfaction increase. However, it’s important to note that patient experience and patient satisfaction aren’t the same thing.

Patient experience is measured by the insights gained from patients, whereas patient satisfaction demonstrates to what extent their needs are fulfilled. Improving both is important to improve the health and wellness of your patients, so don’t focus on one and not the other.

How to Revamp the Patient Journey

Now that you know how patient experience is impacted by the patient journey, we can start creating one that works for your facility. Here’s how to revamp the patient journey.

 

Remove the Barriers in the Patient Journey

Transforming a patient’s healthcare journey requires removing potential barriers. Make information about appointments, procedures, and care plans easily accessible and understandable. Optimize wait times and foster an environment where patients feel heard.

Ease out complex procedures and streamline administrative tasks with technology. Incorporate regular check-ins post-treatment to ensure a continuous link of communication and trust. Every barrier you remove is a step towards personalized, dignified, and empowering care.

 

Make Efforts to Provide a Personal Touch

In healthcare, the personal touch really matters. It’s beyond just knowing a patient’s medical history. It’s about understanding their desires, fears, and lifestyle. Utilize patient interactions as an opportunity to connect on a deeper level. Do this through active listening and empathy.

Small but meaningful gestures can make a significant difference. For example, you might try remembering specific personal details they share or expressing sincere concern for their wellbeing. A personalized approach shows that you see your patients as individuals first.

 

Use Patient Engagement Software and an EHR

These modern tools facilitate interactive communication with your patients, streamline administrative tasks, and ensure a smooth continuum of care. EHRs specifically play a vital role in improving patient outcomes by creating easily accessible and organized medical histories.

Meanwhile, engagement software can send out automated reminders for appointments or medication refills. Embracing these innovative technologies will not only enhance your practice’s efficiency but will also greatly improve your patient’s healthcare experiences.

 

Offer Online Appointment Booking

Providing an online booking option is a step forward in enhancing patient convenience. This feature enables patients to schedule their visits at their convenience without the hassle of long waiting times on the phone. It becomes very useful for non-urgent medical inquiries.

By integrating this option into your practice’s website or patient portal, you ensure ease of access and keep pace with the digital age’s expectations. It also optimizes your administrative tasks and increases overall efficiency and productivity within your healthcare practice.

 

Automate what Can be Automated

Automation is key to minimizing mundane tasks and maximizing efficiency in the healthcare sector. Various administrative tasks like registration, appointment scheduling and reminding, billing, and even prescription refills can benefit from automation.

Utilizing software for these processes saves time and greatly reduces the chance of errors. This increased efficiency allows medical professionals more time to focus on patient care. It’s about working smarter, not harder, and ultimately leading to a better patient experience.

 

Gather and Utilize Data Insights

In an era of data-driven decisions, harnessing the power of data can optimize your practice. Systematically collect, analyze, and interpret patient data to gain insights into their needs and behaviors. EHRs, patient surveys, or wearable tech provide a treasure trove of such data.

Leveraged effectively, these insights can guide tailored service delivery and preventive healthcare strategies, improving patient engagement and satisfaction overall. Incorporating this approach propels your practice towards evidence-based care that is personalized yet effective.

 

Have a Patient-Centric Culture

Imbibing a patient-centric culture within your practice is crucial for revamping the patient journey. This approach prioritizes the needs, expectations, and experiences of patients above everything else. It underscores empathy, active listening, communication, and shared decision-making.

By shifting from disease-focused to patient-focused care, you emphasize treating the person as a whole rather than just addressing their symptoms. This cultural shift positively affects your practice’s operations and clinician-patient relationships, leading to enhanced patient satisfaction.

 

In Conclusion…

Embracing these top tips in your medical practice marks the beginning of an enhanced patient journey. Each small step you take to focus on patient care can have profound effects. Start by identifying potential barriers, then systematically address them using tech advancements and empathetic approaches. Use every opportunity to connect with patients on a personal level.

Author Bio:

Veronica Turner is a health and lifestyle writer with over 10 years of experience. She creates compelling content on nutrition, fitness, mental health, and overall wellness.

 

 

Please also review AIHCP’s Case Management Certificate program and see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification.

The Growing Role of AI In Healthcare Management Systems

View of Doctor holding Artificial intelligence icon with half brain and half circuit 3d rendering

Written by Claire Ward

The recent advances in generative AI is no secret, and their impact on various businesses and industries is undeniable. Yet, one area that remains relatively under-the-radar in this regard is healthcare management, where legacy systems, processes, and technologies continue to dominate.

Healthcare management is often riddled with inefficiencies, ranging from excessive paperwork, to redundant systems and processes. These inefficiencies eventually end up getting passed onto consumers, either in the form of increased wait-times for crucial procedures, or unaffordably high prices.

Fortunately, the rising tide of AI has left no-stone-unturned, and is headed for the stubborn walls of global healthcare in all its fury. In this article, we take a deep dive into the exciting changes taking place within this industry, and its implications for patients, practitioners and other stakeholders.

Enhancing Efficiencies With Streamlined Operations

Over the normal course of operations, a significant portion of time and resources in a medical practice gets lost in largely unproductive activities. This includes billing, filing insurance claims, managing medical records, and a lot more.

As a result, the bureaucratic bloat in the industry has grown to unfathomable levels today, outnumbering physicians and nurses 10 to 1. This is clearly unsustainable, and leaves plenty of room for AI-enabled tools to work their magic and unlock substantial value in the days ahead.

AI, when applied to existing EHR and healthcare management systems can help automate numerous routine administrative processes, in addition to scheduling appointments, optimizing resource allocations, and reducing paperwork substantially.

The last decade saw a steady rise in the use of a management system for health homes, unlocking massive efficiency gains in the process. The 2020s will take this further by pairing the same tools and systems with AI, with limitless possibilities and potential for disruption.

Improving Diagnostics

Most errors and instances of malpractice in healthcare take place in the diagnostics stage, and as a result, the use of AI-enabled tools can help unlock substantial value for patients, practitioners and the broader industry alike.

No matter how experienced and skilled physicians get, they can never match machine learning algorithms when it comes to analyzing vast amounts of patient data and coming up with insights based on the same, often at a small fraction of the time and effort.

In recent years, plenty of AI-enabled tools have entered the fray, offering enhanced capabilities for radiologists when it comes to detecting anomalies that can be missed by clinicians. The capabilities of these tools still remain at nascent stages, but are growing exponentially each passing year.

Clinicians, however, need not worry about being replaced by AI, after all, patients place their trust on other human beings, never bots or programs. Radiologists have feared technology replacing them for over two decades, but despite the monumental advances, disruptive tech has only served to augment their capabilities and expand their reach.

Enhancing Patient Engagement

Technologies such as wearable devices, smartphones, and personalized health information have already done wonders in enhancing patient engagement, but add AI to the mix, and the result is absolutely phenomenal.

There are endless possibilities when legacy technologies are matched with advanced generative AI, particularly when it comes to healthcare. Right off the top, we imagine use cases such as chatbots, which can answer questions for patients, clarify doubts regarding their records, appointments, treatments, and more, without having to disturb a doctor or nurse in the process.

In addition to this, doctors have an option to remotely monitor their patients, get alerted about abnormalities right away, before they turn into life threatening emergencies.

Doctor And Robot Shaking Hands

Facilitating Data-Driven Decision Making

Data is at the core of healthcare management systems, and the volume of healthcare data is growing exponentially. AI algorithms have the ability to process and analyze large datasets, uncovering meaningful insights that can inform decision making.

For instance, AI can identify population health trends, predict disease outbreaks, and optimize resource allocation based on real-time data. By leveraging AI’s capabilities, healthcare organizations can make data-driven decisions that have the potential to improve patient outcomes, reduce costs, and enhance overall healthcare quality.

Hospitals, nursing homes and clinics have long generated copious amounts of data, which have largely gone unused for the most part. With AI and advanced analytics, this data can finally be put to use, helping practitioners add plenty of value to patients in the long-run.

Addressing Ethical & Privacy Concerns

While the potential benefits of AI in healthcare management systems are immense, it is important to address the ethical, privacy, and security concerns associated with its use. As AI algorithms rely heavily on data, it is crucial to ensure patient data privacy and security.

Striking the right balance between data access for AI systems and protecting patient confidentiality is a complex challenge that requires robust data governance frameworks and regulatory oversight.

Additionally, ethical considerations such as transparency, accountability, and fairness in algorithmic decision-making processes must be carefully addressed to maintain trust in AI-powered healthcare systems.

Many of the ethical and privacy concerns pertaining to the use of AI for healthcare are yet to even be fully understood.

The issues will only come to light when there have already been instances of abuse, and this makes it pertinent to have ethical frameworks in-place, in addition to laws and regulatory frameworks, which often tend to be outdated fairly quickly, as more and more disruptive technologies come to fore.

The Road Ahead: Collaboration & Human-AI Partnership

As we embrace the growing role of AI in healthcare management systems, it is essential to recognize that AI is not a replacement for human healthcare professionals but a tool to augment their capabilities.

Collaboration between humans and AI is key to harnessing the full potential of this technology, and as such, any resistance to the adoption of such technologies must be dealt with using extensive training and awareness programs for all stakeholders involved.

Healthcare organizations should invest in training their workforce to understand and effectively utilize AI-powered systems, fostering a culture of continuous learning and adaptation. By embracing a human-AI partnership approach, we can ensure that AI serves as a valuable ally in delivering high-quality, patient-centered care.

 

 

Please also review AIHCP’s Health Care Certificate Programs and see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification.

Certified Case Manager: Starting Their Own Business

By – James M. Katz, BA

As a certified case manager, starting a business from home can be a great way to achieve financial independence and enjoy the flexibility of working from your own space. You have the unique opportunity to provide specialized services to clients that may not be available elsewhere. With the right planning, you can develop a successful home-based business that meets the needs of your clients and generates an income. In this guide, we’ll provide you with tips and strategies to get started on your journey as a certified case manager working from home. We’ll discuss the importance of setting up a solid business plan, what you need to consider when setting up your workspace and how to market your services effectively. As a certified case manager, you’ll have the opportunity to make a real difference in people’s lives – and with the right preparation, you can make your home-based business a success.

As seen in the article below, becoming a certified case manager sometimes isn’t enough. Starting your own case management business is the next logical step. However, without the proper strategies in place it can be a treacherous one! You not only need to take care of your patients but you need to run your own business as well.

“Case management is a specialized field of health care that focuses on coordinating services and resources to improve patient outcomes. It involves assessing a patient’s needs, developing a plan of care, and providing follow-up support. An independent case management business provides these services to clients in the private sector, such as hospitals, health care providers, insurance companies, and other organizations.

Starting an independent case management business can be a rewarding endeavor, offering the opportunity to work with a variety of clients and make a difference in the lives of patients. However, it does require extensive research, planning, and preparation. This guide provides an overview of the necessary steps to get started and outlines the key considerations for successful business operations.

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Benefits of Starting a Home-Based Business as a Certified Case Manager

If you love working with people and helping them through their challenges, then starting a home-based business as a certified case manager might be a great option for you. It’s a great way to help people in need while earning a steady income that lets you set your own schedule. If you want to travel the world, start a family or simply pursue a different career path, this is an ideal way to do so. There are a number of benefits associated with becoming a certified case manager. One of the most significant is the ability to help people who might not otherwise have access to quality services. You can use your business to help clients obtain benefits, file for Social Security disability, receive Medicaid/Medicare and more.

Setting Up a Solid Business Plan

Every home-based business starts with setting up a solid plan. This includes examining your case management goals and examining what it will take to achieve them. You’ll need to examine what it will take to make the business successful, both from a financial and a personal growth perspective. This will help you determine how much time and energy you should devote to your business. You’ll also need to examine your skills and determine what kind of clients you’re most suited to work with. Ideally, you should be working with clients who have similar challenges to your own clients so that you can provide them with the most value possible.

Establishing Your Home Workspace

The first step in starting a home-based business is setting up your workspace. This includes selecting a professional space that meets your needs and acquiring all of the necessary equipment. A professional workspace will help you maintain client confidentiality and improve your efficiency. It’s important to establish your home workspace before diving into marketing your services. This will help you avoid wasting time and energy on areas that don’t directly impact the success of your business.

Marketing Your Services Effectively

If you want to succeed as a home-based business, you need to understand how to market your services effectively. This will help you find new clients and grow your business over time. It’s important to understand that marketing is an ongoing process. You can’t simply sit back and expect clients to find you. You need to be creative and use a variety of methods to reach potential clients. Some of the most effective marketing strategies include networking with other certified case managers, networking with your professional association, blogging about your services and adding value to online communities.

Tips for Staying Productive and Organized

If you want to stay productive and organized as you start a home-based business, you need to be intentional with your time. This means knowing when you’re taking on more than you’re able to handle and avoiding multitasking. It’s important to create a schedule that addresses your responsibilities and activities. This schedule should include both work and personal commitments. If you don’t have a schedule that includes both work and personal commitments, you’ll be overwhelmed with the demand placed on you.

Networking Opportunities for Certified Case Managers

Networking is an important part of marketing your services. This is especially true if you’re just starting out as a home-based business. Networking provides you with opportunities to meet potential clients in a relaxed setting and discuss your services. This can help you identify potential clients and build your network of professional connections. Networking can be challenging if you don’t know where to start. Networking opportunities can help you overcome this challenge. Some of the best networking opportunities include attending professional association meetings, participating in online communities and attending networking events related to your industry.

Conclusion

There are many reasons why people choose to start a home-based business. One of the most common reasons is to earn more money. While it is important for you to earn more money through your home-based business, it’s also important to enjoy what you’re doing. You don’t want to become so consumed by your home-based business that you no longer have time to pursue interests, friends and family. If you find yourself in this situation, it’s important to take a break and reassess your priorities. There are many benefits associated with becoming a certified case manager. One of the most significant is the ability to help people who might not otherwise have access to quality services.

A healthcare certification can open the door to new career opportunities. With a profession as vast as healthcare, it is easy to specialize yourself. Nursing and other healthcare professionals have dozens of different fields they can go into and explore, increasing their value. If you are interested in becoming a certified Case Manager, you should visit our Case Management Certification Page Here.  

References:

Wikipedia Case Management Page – 

CDC Case Management Page – 

Additional Resources:

Applying Project Management Methods to the Creation of a Start-up Business Plan: The Case of Blendlee, Jolita Kiznyte, et al, PM World Journal. Vol. V, Issue ZV – May 2016
Access Here – 

Making a business plan for starting a transitional pain service within the US healthcare system, Sun EC, Mariano ER, Narouze S, et al Regional Anesthesia & Pain Medicine 2021;46:727-731.
Access Here – 

Advanced Practice Nurses: Developing A Business Plan for an Independent Ambulatory Clinical Practice Johnson, Joyce E Johnson, et al. Pitman Vol. 35, Iss. 3, (May/Jun 2017): 126-133,141.
Access Here – 

The relationship of personality traits and entrepreneurship tendencies with career adaptability of nursing students, Oznur Ispir, et al. Nurse Education Today Volume 79, August 2019, Pages 41-47
Access Here – 

 

The Use of Technology in Diabetes Care Management

By – James M. Katz, BA

Diabetes is one of the leading causes of death worldwide, but with the increasing presence of technology in our lives, it has become much easier to manage this chronic disease. Technology has revolutionized diabetes care management and is helping people with diabetes to monitor, analyze, and adjust their health. Smartphones, wearable devices, and apps enable people with diabetes to track their blood sugar levels, exercise, nutrition, and medications. With the help of technology, diabetes management can be done more accurately and efficiently, allowing them to live a healthier and more productive life. Additionally, technology has enabled doctors and healthcare managers to provide better quality healthcare to their patients by quickly and accurately diagnosing any issues and making adjustments to their treatment plans. Technology is also providing new treatments and therapies that can help people with diabetes better manage their condition. In short, technology is transforming diabetes care management, providing new opportunities to lead a better, healthier life.

The article linked below goes into further detail on the emerging use of new technologies in diabetes healthcare management. It looks in-depth at the use of insulin delivery systems, blood sugar monitoring devices, as well as other health care management apps. For more please read the quote below and press the link.

“The revised standards, issued this week, include a section devoted to technology, including continuous glucose monitoring (CGM) devices that allow people living with diabetes to check their blood glucose levels at any time, automated insulin delivery systems and digital health tools that offer coaching and access to resources.

The guidelines recommend that anyone living with diabetes have access to FDA-approved technology to manage their chronic condition, especially seniors and underserved populations. The ADA also points out that technology can be used to improve access to care and care management for those dealing with health inequity, or barriers to care caused by social determinants of health.“

WHY TECHNOLOGY IS INTEGRAL TO DIABETES CARE MANAGEMENT Health Leaders Media  BY ERIC WICKLUND  DECEMBER 14, 2022

Access Article Here

An infograph about diabetes care management

Commentary:

Overview of Diabetes

Diabetes is a condition in which the level of sugar in the blood is too high. There are two main types of diabetes: Type 1 diabetes, which usually appears in childhood or adolescence, and Type 2 diabetes, which usually appears in adulthood. In Type 1 diabetes, the pancreas does not produce enough insulin, which is a hormone that helps break down the food we eat and turn it into energy. In Type 2 diabetes, the pancreas makes enough insulin, but the body cannot use it properly. In both conditions, a person’s blood sugar level rises above normal, and they need to take steps to lower it. People with diabetes often also experience other health issues like cardiovascular disease, kidney disease, and eye disease.

What is Diabetes Care Management?

Diabetes care management refers to the process of managing diabetes and achieving optimal blood sugar levels to prevent complications. In recent years, there has been a growing focus on improving the quality of diabetes care management, with an aim to prevent the development of complications and reduce healthcare costs. Technology is playing a significant role in improving the quality of diabetes care management. Through the use of wearable devices, smartphone apps, and telehealth technologies, people with diabetes are better able to track their blood sugar levels, exercise, nutrition, and medications. Doctors, healthcare providers, and technology are working together to provide better quality healthcare management, enabling clinicians to quickly and accurately diagnose issues and make adjustments to their treatment plans to improve patient outcomes. Additionally, technology is helping people with diabetes better manage their condition and achieve better health outcomes, allowing them to live a healthier and more productive life.

How Technology is Revolutionizing Diabetes Care Management

Wearable Devices – Wearable devices such as blood glucose monitors, activity trackers, and sleep trackers can be used to track a person’s blood sugar levels, daily activity, and sleep quality. These devices can send data to a smartphone app and can also be programmed to send alerts when a blood glucose level is too low or a food or medication is scheduled to be taken. Smartphone Apps – Diabetes apps are available in a variety of forms, including lifestyle apps, social networks, blood glucose tracking apps, and medication reminder apps. Lifestyle apps can help people with diabetes track and improve their nutrition, sleep, and activity levels. Social networks allow people with diabetes to connect with each other and receive support and encouragement. Blood glucose tracking apps allow users to track their blood glucose levels throughout the day and receive alerts when the levels are too low or too high. Medication reminder apps can help people remember when to take their medications and make adjustments when the time is incorrect. These apps are designed to improve the quality of diabetes healthcare management by enabling people to track their blood sugar levels, exercise, and medication intake more accurately and efficiently.

Telemedicine

Telemedicine is the use of information technology to provide medical care remotely. This technology is revolutionizing diabetes healthcare management by providing remote monitoring of blood glucose levels and medication adherence. In addition, remote monitoring enables patients and providers to detect health issues at an earlier stage and make appropriate adjustments to treatment plans to prevent complications. Remote monitoring also provides access to care for people who might not otherwise have access to physicians and diabetes management specialists.

Benefits of Technology in Diabetes Care Management

– Improved Compliance with Treatment Regimens – Technology can help patients adhere to their treatment regimens, which is essential for managing diabetes. When patients forget to take their medications or take them at the wrong times, their blood sugar levels are likely to increase and they are at a higher risk of developing complications. With the help of technology, patients can easily and accurately track when they took their medications and can receive alerts when they forgot to take them. – Improved Quality of Life – Technology is also revolutionizing diabetes care management by improving the quality of life of people with diabetes. It can help people track their blood sugar levels, exercise, and nutrition to a greater extent than they are able-bodied. Additionally, technology can help people with diabetes stay connected with others and feel less isolated. – Real-Time Data Accessibility – Another benefit of technology in diabetes care management is its ability to provide real-time data accessibility. Real-time data access allows people with diabetes to track their blood sugar levels and adjust their food intake or medication dosage if needed. Real-time data access also allows doctors and healthcare providers to track their patient data and make adjustments to their treatment plans as needed.

New Treatments and Therapies for Diabetes

Blood Glucose-Sensing Injectables – New blood glucose-sensing injectables are revolutionizing diabetes care management by delivering insulin directly to the bloodstream through a small, painless needle. This can help prevent low blood sugar during periods of exercise or after eating a meal. Artificial Pancreas – An artificial pancreas is a device that analyzes a person’s blood glucose levels, insulin levels, and food intake to determine the right amount of insulin required to keep blood glucose levels within a healthy range. This device automatically delivers insulin to the bloodstream, allowing people with diabetes to live a more normal life. Gene Therapy – Gene therapy is a new treatment that aims to stop the progression of Type 2 diabetes. In this treatment, a virus is injected into the bloodstream, where it travels to the liver and inserts a gene that produces insulin-producing proteins. This therapy aims to halt the progression of Type 2 Diabetes by controlling blood glucose levels and allowing people with diabetes to live a healthier, more normal life.

Conclusion

Diabetes is a serious and growing concern, but technology is revolutionizing the way it is managed and treated. Wearable devices, smartphone apps, and telehealth technologies are helping people with diabetes track their blood sugar levels, daily activity, and medication intake more accurately and efficiently to enable better diabetes care management. Additionally, technology is helping doctors and healthcare providers provide better quality care, enabling them to quickly and accurately diagnose issues and make adjustments to their treatment plans to improve patient outcomes. New treatments and therapies for diabetes are providing hope for people with the condition, enabling them to live a healthier, more productive life.

Diabetes and other health conditions require dedicated healthcare management professionals. Keeping up to date with the latest trends and technology is paramount to giving patients the best care they deserve. If you are in the care management field and would like to add to your education, you should visit our Healthcare Management certification program by pressing here.

References:

American Diabetes Association

Mayo Clinic Diabetes Overview

Additional Resources:

Smartphone-Based Technology in Diabetes Management. Doupis, J., Festas, G., Tsilivigos, C. et al.  Diabetes Ther 11, 607–619 (2020).

Access Here 

Psychology, technology, and diabetes management. Gonder-Frederick, L. A., et al American Psychologist, 71(7), 577–589. (2016).

Access Here 

A Systematic Review of Reviews Evaluating Technology-Enabled Diabetes Self-Management Education and Support. Greenwood DA, et al.  Journal of Diabetes Science and Technology. 2017;11(5):1015-1027. doi:

Access Here 

Active Care Management Supported by Home Telemonitoring in Veterans With Type 2 Diabetes: The DiaTel randomized controlled trial. Roslyn A. Stone, et al. Diabetes Care 1 March 2010; 33 (3): 478–484.

Access Here 

Exploring the Benefits of Case Management in Long-Term Care Today ‍

By: Dominick L. Flarey, Ph.D, RN-BC, ANP-BC, NEA-BC, FACHE
       Board Certified, Adult Nurse Practitioner
       Board Certified, Nurse Executive Advanced
       Fellow, The American College of Health Care Executives

Photo of a collection of words related to the topic of Long Term Care

In today’s health care system, case management is becoming an increasingly important way to ensure quality care for long-term health care patients. Case management is a process that involves a team of health care professionals, who work together to coordinate and provide comprehensive care for patients with long-term health care needs. This team of professionals is responsible for assessing a patient’s medical needs, developing a care plan, and monitoring the patient’s progress. Case management has numerous benefits, from reducing hospitalizations and emergency room visits to improving overall quality of life. It also helps to reduce costs, as case managers can ensure that patients receive the most appropriate and cost-effective care. By exploring the benefits of case management in long-term health care, we can better understand how it can help improve patient outcomes and reduce costs.

What is Case Management?

Case management is a process that involves a team of health care professionals, who work together to coordinate and provide comprehensive care for patients with long-term health care needs. Rather than having health care providers treat specific issues, case managers consider the entire individual and how different aspects of their care are related. This team is responsible for assessing a patient’s medical needs, developing a care plan, and monitoring the patient’s progress. Case management has been used in different areas of healthcare for some time, but in recent years, it has also gained prevalence in long-term care. This type of care typically involves a combination of services, such as nursing, pharmaceutical, social work, and rehabilitation. Long-term care services are generally needed by individuals who have a chronic illness or disability that requires ongoing care.

Long-Term Care

Long-term care is an interdisciplinary field of health care encompassing a range of services and supports for individuals who are chronically ill or have a disability. This type of care is used to provide assistance with activities of daily living such as bathing, dressing, grooming, and eating, as well as instrumental activities like housekeeping, shopping, and managing finances. Long-term care can be provided at home or in other settings such as adult day programs, assisted living facilities and nursing homes.

Benefits of Case Management

Case management has numerous benefits, from reducing hospitalizations and emergency room visits to improving overall quality of life. In exploring the benefits of case management in long term care today, it also helps to reduce costs, as case managers can ensure that patients receive the most appropriate and cost-effective care. By exploring the benefits of case management in long-term health care, we can better understand how it can help improve patient outcomes and reduce costs: 1). Reduced Hospitalizations and Emergency Room Visits, when patients receive coordinated and comprehensive care, they may spend less time in the hospital, as well as in the ER. This is particularly true for patients with chronic illnesses and/or long-term care patients. 2). Ensures greater quality of care, due to the interdisciplinary approach of case management, patients are often provided with more thorough care. This can help to ensure that each aspect of the patient’s care is addressed, which can ultimately improve overall quality of life. 3). Case Management in Long-Term Health Care, one of the primary ways in which case management is used in long-term health care is to help provide an ongoing assessment of a patient’s care, as well as their needs. 4). Provides for a more collaborate approach to long-term care delivery, long-term health care has traditionally been managed by physicians, who have been responsible for both diagnosis and treatment. With the implementation of case management, however, other types of health care professionals, such as nurses and social workers, are also able to provide care. This helps to provide a more interdisciplinary, collaborative approach to long-term care delivery.

Helps to improve patient outcomes

index card on table that is written on it Long Term Care with a blue stethoscope laid around it and a red heart and a pair of eyeglasses laying next to the index care

Case Management is also known as care coordination and/or care management. When individuals in long-term care are involved in case management, there is a potential for improvement in their overall health outcomes. Patients in long-term care who participate in case management are more likely to receive the medical care and services that they need. This could include medications, nutrition therapy, or specialized therapies such as physical therapy. People in long-term care who receive the services that they need may experience better outcomes in terms of their mental health. This may include a reduction in feelings of depression, anxiety, and/or feelings of isolation. People in long-term care who receive the services that they need may experience better outcomes in terms of their ability to live independently. This may include a reduction in the amount of assistance needed to perform daily living tasks, such as bathing or eating.

 

Challenges of Case Management

While case management offers many benefits, it is important to note that it is not a cure-all for the challenges that exist in today’s long-term health care system. One challenge is that not every patient who needs long-term care has access to it. Although long-term health care is becoming increasingly common, there are still not enough resources available to meet current needs. There is also not enough consistency in the services offered throughout the long-term health care system, as there are many different types of providers, who offer long-term care. This means that patients and families may not receive the same level of care from one provider as another. Another challenge of case management is that it is not always the best option for all patients. While it can be beneficial, it is not appropriate for everyone. This can make it more challenging to identify patients who will benefit from case management services.

Conclusion

Case management is a growing trend in long-term health care, as it offers numerous benefits and helps to improve outcomes. Although it is not a cure-all, it can help to improve the quality of care patients receive and reduce costs. While challenges remain, case management remains a promising way to improve long-term health care.

Education and Certification in Case Management

Are you a registered nurse, social worker or a health care professional who is interested in case management? If so, the American Academy of Case Management offers a unique, online curriculum of core courses that leads to a full Certification and Fellowship Status in the Academy. You may access this link for full information on the program. Courses are continuing education courses with Board approvals and may be taken one course at a time until completion. All of the courses are online with faculty mentoring as needed and there are no travel requirements. Any questions may be addresses to: info@aihcp.org

Suggested Readings

1. Can post-exposure prophylaxis for COVID-19 be considered as an outbreak response strategy in long-term care hospitals? Sun Hee Lee, et.al. International Journal of Antimicrobial Agents. Vol. 55(6): June 2020. access here.

2. Case management in capitated long-term care. Rick T. Zadwaski, Catherine Eng. Health Care Finance Review. National Library of Medicine. December 1988. access here.

3. What Does “Managed Long Term Care Service” Mean in the United States? A Concept Analysis From a Case Manager’s Perspective. Kyungmi,Woo, et.al. Home Health Care Management & Practice. Vol.33(3):November 7, 2020. access here.

4. What do we (still) need to know about long-term care management? Howard B. Degenholtz. Generations Journal. American Society on Aging. Spring 2021. access here

 

 

The Benefits of Telehealth in Patient Care Management Today

Doctor Talking To Patient Through Video Chat On LaptopWritten By: Dominick L. Flarey, Ph.D., RN-BC, NEA-BC, FACHE

Telehealth is the use of digital information and communication technologies, such as computers and mobile devices, to access health care services remotely. It can be used to provide real-time clinical services to patients in remote locations, as well as to store and share medical data. Telehealth  has the potential to improve access to care, quality of care, and patient outcomes.

In recent years, there has been a dramatic increase in the popularity of telehealth services. This trend is likely due to a variety of factors, including the increasing accessibility of high-speed Internet and mobile technologies, the rising cost of healthcare, and the growing demand for convenient and accessible healthcare services. Telehealth allows patients to consult with their healthcare providers from the comfort of their own homes, which can be a more convenient and affordable option than traditional in-person appointments.

Telehealth Care Benefits for Care Management

The use of telehealth in patient care  is on the rise due to its many benefits. Telehealth allows patients to consult with their doctors from the comfort of their own homes, which is especially beneficial for those with chronic illnesses or mobility issues. It also saves time and money by eliminating the need for travel to and from appointments. In addition, telehealth can improve communication between patients and their care providers, leading to better overall health outcomes.

Despite its many advantages, there are some challenges associated with telehealth. For example, not all medical conditions can be effectively treated via teleconference. In addition, there may be technical difficulties that can impede the quality of the consultation. Nonetheless, telehealth is a promising solution that can improve patient care in a number of ways.

There are many benefits to telehealth, including increased access to care, improved patient outcomes, and cost savings. Telehealth can improve access to care by providing care to patients in rural or underserved areas. Additionally, telehealth can improve patient outcomes by providing timely and convenient care. Finally, telehealth can save money by reducing the need for travel for appointments and reducing the length of hospital stays.

 

Ease of Access to Health Care Management

The use of telehealth has improved access to care for patients by providing them with more convenient and affordable options. Telehealth allows patients to connect with their care providers from any location, which can be especially helpful for those who live in rural areas or who have difficulty accessing transportation. In addition, telehealth services are often less expensive than traditional in-person visits, which can make them more affordable for patients.

Telehealth is the use of digital information and telecommunications technologies to support long-distance clinical health care and patient care. By using telehealth, medical providers can more easily and conveniently provide care to patients who may not be able to come into the office for an appointment. This is especially beneficial for patients who live in rural areas or who have difficulty traveling. Additionally, telehealth can be used to provide follow-up care or consultations, which can help improve patient outcomes.

 

3D illustration of computer keyboard with the script "Telehealth" on pale blue button. Remote service concept.Compliance to Health Care Management

The increased comfort for patients using telehealth is due to the ability to consult with a medical professional from the comfort of their own home. This reduces stress and anxiety related to seeking medical care in-person, which can be particularly beneficial for those with chronic conditions or mental health concerns. In addition, telehealth appointments are typically shorter than in-person visits, which can also contribute to patients’ increased comfort levels.

There is evidence to suggest that the use of telehealth can help to reduce the number of missed appointments among patients. This is likely due to the fact that telehealth can help to improve communication between patients and their care providers, and can also provide patients with greater flexibility in terms of when and how they receive care.

The ease of patient care for patients who live far away from health care centers of providers has greatly increased due to the implementation of telehealth services. Through the use of video conferencing, patients are able to consult with their doctors or specialists from the comfort of their own homes. This increases accessibility to medical care and decreases the need for travel, which can be difficult for those with chronic health conditions.

Telehealth also allows for more timely appointments and shorter waiting times. This is beneficial for both the patient and the provider, as it reduces the overall time spent on each case. In addition, telehealth appointments can be scheduled outside of normal working hours, making it easier for patients who have difficulty taking time off work or school. Overall, telehealth has had a positive impact on patient care by increasing access to medical services and reducing wait times.

 

Cost Reduction and Improved Outcomes

The use of telehealth services can help reduce the overall costs for patients. This is due to the fact that telehealth services can help to improve communication between patients and their healthcare providers. In addition, telehealth services can also help to improve access to care for patients. By using telehealth services, patients can avoid having to travel to see their healthcare provider. This can help to save time and money for patients.

The use of telehealth can result in improved patient outcomes. This is because telehealth provides patients with access to care that they would otherwise not have. Additionally, telehealth can help to improve communication between patients and providers, and can provide patients with education and support.

 

Case Management by Telehealth

Telehealth has been shown to be an effective means of providing case management services, particularly for patients who live in rural or underserved areas. Certified case managers can provide a wide range of services via telehealth, including assessment, care planning, coordination, and advocacy. This type of care delivery can help to ensure that patients receive the comprehensive care they need, while also reducing travel time and costs associated with traditional in-person visits.

The use of technology in case management for in home care telehealth by nurse case managers is essential to providing quality care. Technology allows nurse case managers to keep track of their patients’ progress, schedule appointments, and communicate with other members of the healthcare team. In addition, technology can help nurse case managers educate their patients about their condition and treatment options.

The use of video conferencing by nurse case managers allows for real-time interaction with patients and families, which can be beneficial in a number of ways. First, it enables the nurse to build rapport and trust with the patient, which is essential for providing effective care. Additionally, it allows the nurse to gather information about the patient’s condition and needs in a way that is more efficient and convenient than traditional in-person visits.

Nurse case managers are using innovative technologies today to communicate with other team members. These technologies include electronic medical records, computerized provider order entry systems, and electronic prescribing systems. By using these technologies, nurse case managers can more effectively coordinate care for their patients and realize the benefits of telehealth in practice.

 

Conclusion

In conclusion, telehealth is a valuable tool that can improve patient care in a number of ways. By providing patients with convenient access to care, telehealth can help to improve health outcomes and reduce healthcare costs. In addition, telehealth can also help to increase patient satisfaction by providing them with more control over their own care.

Most all specialty practice in health care today are using telehealth in care delivery. This is seen even more frequently in the specialty practice of Case Management by professional Registered Nurses and professional Licensed Social Workers. The advent of more expanded technologies in patient care has allowed the practice of case management to significantly expand in recent years bringing significant benefits of telehealth to patients and to the health care team. The American Academy of Case Management offers a comprehensive continuing education and case management certification program for those who are practicing health care professionals. Professionals have a period of two years in which to complete the program but may accelerate if they wish. To learn more about the program, you may access here.

 

Additional Readings

Telehealth Benefits and Barriers. S. Garjarawala, N. Pelkowski. The Journal for Nurse Practitioners. Vol 17, Issue 2: 2021. Access here

Increasing Access to Care: telehealth during Covid-19. D. Hoffman. Journal of Law and the Biosciences. Vol 7, Issue 1: 2020. Access here 

Strategies for Evaluating Telehealth. J. Chuo, et.al. Pediatrics. Vol. 146. Issue 5: 2020. Access here

On-Demand Synchronous Audio Video Telemedicine Visits are Cost Effective. G. Nord, et.al. The American Journal of Emergency Medicine. Vol 37. Issue 5: 2019. Access here

 

Certified Case Manager Education: What is Population Health?

Population Health Management

Today’s Certified Case Manager is becoming more involved in assessing and working with information on population health. Population health looks at the data of an entire group instead of an individual patient and considers not only the general state of health of the population but typical outcomes as well.  “Population health is defined as the health outcomes of a group of individuals, including the distribution of such outcomes within the group.” (1)

 The term “population health” is a broad one and the group examined can be defined in a variety of ways; your chosen population could be a specific town or city, race or even age group. Viewing data across a broad population can help determine the best practices of care for that particular group and allow for that group’s needs to be anticipated and met. A definition of population health is: “The inherent value of a population health perspective is that it facilitates integration of knowledge across the many factors that influence health and health outcomes.” (1).    “The CDC, which has a Division of Population Health, is far wordier and gives more of a functional definition. Population health is interdisciplinary, according to the CDC website, and an approach that uses “nontraditional partnerships” among different sectors of the community — public health, industry, academia, healthcare, local government entities — to achieve positive health outcomes.” (2)  We see more content being added today to Case Manager Certification education curriculums on this interesting and important practice topic.

William Edwards Deming was a scientist and engineer and is best known for his principles of productivity; his approaches are often modeled by organizations looking to boost efficiency and quality while lowering costs. Deming’s involvement was a key component of Japan’s recovery after WWII; he also brought his unique take on the tie between quality and productivity to corporations in the US, including the Ford Motor company. This attention to quality helped Japan rebound after WWII and become a booming economy just a decade later; it also helped Ford and other US car makers understand why Japanese motors were outperforming homegrown products year after year. Applying these same principles to population health can help improve outcomes and as a natural byproduct of that improved care, reduce costs as well.

 

The Deming Philosophy and Healthcare

The Deming philosophy or approach at its most basic states that when an organization focuses on improving quality, costs will naturally fall over time. Case managers work with this philosophy everyday and are at the forefront of guiding quality, cost-effective care.  Conversely, an organization that is focused on costs will find their quality dwindling over time. This philosophy can be applied to a variety of industries – including healthcare. When we focus on improving care and outcomes, we can expect costs to drop; focus too much on costs and the quality of care can easily slip. Case managers know this well and serve as educators today to teach this to others on the health care team.

 

Applying Deming Principles to Healthcare

Managed Care = Managed Processes

The concept of managed care is less about planning the daily work of individual providers and more about the way that the entire process works. The broad approach that is taken to care will have a larger impact on the health of specific populations; engaging and including physicians and providers in the planning process is a must. These providers are the clinicians dealing with clients on a regular basis, and their insight could hold the key to improved overall process and better levels of care.

 

Engaging Physicians in the Process of Care

Including working physicians in the conversation will greatly improve both the approach to care and the outcomes. Doctors, nurses certified case managers and other providers are working “in the trenches” daily and already have the skills and knowledge to predict what methods will work and what will not. Incorporating frontline care providers in conversations about population health is a must if we are going to properly serve that population and understand what will work (and what won’t).

 

Accurate and Timely Data is a Must

“In God we trust…and all others must bring data.”
William Edwards Deming

This Deming quote is at the heart of why data is so important. If we can’t measure population health data, there is no way to tell if measures are resulting in improved outcomes, worsened outcomes or having no impact at all. The ability to measure and compare data from a specified population is a must; without accurate data and the ability to analyze it, there is no way to determine if measures designed to improve care have any actual impact at all.

The quality-based approach outlined by Deming offers many advantages and possibilities for population health and for healthcare in general.  For true gains to be made, the right data must be collected and accessible, front-line caregivers need to be involved in the planning process, and a broad approach to care for a specific population needs to be implemented. We need to continue to provide continuing education for our case managers and others on the health care team in the quality improvement process, including the use of quality improvement tools, data collection and appropriate interpretation of data.

Some reasons we should care about population health include; 1) it is people focused, 2) it seeks to improve the health of our society, 3) it helps to reduce costs as society becomes healthier, 4) it promotes medical science to deliver better care, 5) it leads to the ability to provide better access to care, and 6) it promotes better patient engagement (3). As such it fits very well into the role of todays certified case manager. It would be most advantageous if we provide our case managers more continuing education and opportunities to become involved in this area of practice. Becoming more intimately involved in population health will assist case management profession in its ultimate growth and expansion of specialized professional practice.

Are you a licensed health care professional who is interested in becoming a Certified Case Manager? If so, you may want to preview information on our Certification and Fellowship program at the American Academy of Case Management. You may access information here.

References:

  1. David A. Kingdig (Ed.) What is Population Health? Improving Population Health: Policy, Practice, Research. University of Wisconsin. Population Health Sciences.
  2. Karen Appold. Confused About Population Health? You’ve Come to the Right Place. Managed Healthcare Executive. Vol. 30, Issue 10. October 2020.
  3. Christina Rosario. Why is Population Health Important? Advanced Data Systems Corporation. July 8, 2020.