Case Management in Healthcare

22 January, 2020


Case management is a health care management technique. The method uses integrated systems to deliver comprehensive services to various groups of enrolled patients. Case managers are often responsible for the management of multiple aspects of healthcare, and they may employ different approaches to control clinical actions. However, the government has used different methods in case management; the plan still faces various problems. One, the funding inadequacy makes it very hard for the multiple case managers to handle the clinical cases effectively. Geographical conditions and distances are also significant challenges to the approach, coupled with the inadequacy of health care providers. To solve these problems, Pronix intends to contribute to case management systems by using their Advanced.

Steps to case management

 The first step is the referral of new patients. This may happen if the patient relocates to another region or jurisdiction or if he or she does not meet the target requirements in the previous service. For example, if an out-patient situation becomes worse and he or she needs a higher level of care, the healthcare facility may need to admit the patient to the in-patient category. The second step is the planning and delivery of healthcare services. Third, an evaluation of the results for every patient is necessary. This is followed by adjustments to the care-delivery plan. The fourth step is to evaluate the effectiveness of the whole program and decide if it is worth it. Various modifications are made depending on its effectiveness and deficiencies. 

Solutions to Case Management Challenges

The collaboration of various healthcare organizations has allowed the active development of case management technology and Pronix has played a big part in the collaboration. New analytical tools can now generate patient's portfolios, which are prioritized using the actionable risk intervention suggestions. By creating these portfolios, Pronix can use the analytic tools to help the case managers to develop effective case management solutions, whose application can help the whole case group.  The analytical tools help in analyzing patients’ data like age, diagnoses, and medical history. This information can help in profiling patients with similar medical issues for similar intervention methods. Similarly, it can help in developing bigger and better modes of medical interventions.  For example, there are some devices that take the stratification higher. They create better client-configurable algorithms, which can consider the social-economic factors. As such, technological advancement has made it easier for case managers to reach out to the patients, group these patients, and develop effective methods of providing comprehensive healthcare to these people.

Effective Practices

The use of Advanced Analytics helps in almost every role that a case manager plays. Pronix’s Case management involves the advocacy and education of patients. This means that each patient acquires the needed knowledge and becomes an advocate for the required healthcare services. The advanced analytics, which uses the newest information technologies, helps in educating the patients and recommending the right advocate for the same patient.  Secondly, case management requires effective coordination of different aspects of clinical care to ensure the patient's progress. The use of computers, IT, and big-data systems in analyzing these aspects helps to coordinate them effectively. Utilization of the available funding to provide adequate services, the case manager or management team needs an effective program. It comes in handy for such a task. New medical applications have become very efficient in creating a patient's psychological profile, which then allows psychological and psychosocial cases' management.


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