CMSA Today - Issue 4, 2016 - (Page 17)

CM Systems Finding the "Right" Care Management System: "Must Have" Requirements + Structured Demonstration Process BY PAT STRICKER, RN, M.Ed., SENIOR VICE PRESIDENT, TCS HEALTHCARE TECHNOLOGIES W hat would you do if you were asked to be responsible for finding a new care management system or to be on the selection committee to decide which system to choose? Would you know where to start? What to look for? Would you feel comfortable with this responsibility, or would you be a little overwhelmed? You probably have business goals for the new system, such as improving workflow efficiencies (business and administrative processes), increasing the quality of care, enhancing patient outcomes, improving healthcare delivery, providing patterns of communication and collaboration, reporting and analyzing data to improve efficiency, easily integrating with other systems, and reducing costs. However, those high-level goals don't really identify exactly how the system should work or what features and functions it needs to have to assure the goals are accomplished. So how do you determine that? Where do you start? Keeping up to date on healthcare and technology trends and the plethora of systems available today is not easy. So your first task it to research vendors' websites, trending articles, and comparison studies available on the internet to help you become familiar with what products, features, and functions are available. And when it's time to actually begin finding a system, don't panic! Simply break the process into two basic steps to make it easier and more manageable: * Determining the "must have" requirements * Structuring the demonstration process NOTE: These tips are based on a series of articles, published in the CMSA Today online eNewsletter (www.naylornetwork.com/ cmsatoday) last year, in which I highlighted key factors to consider when looking for a care management system. Keep in mind that while this article is focused on selecting a care management system, the process can be used to look for any type of application. DETERMINING THE "MUST HAVE" REqUIREMENTS A requirements committee needs to be developed, consisting of representatives from the clinical, business, and IT areas that will be using or interacting with the system. Their key goal is to develop a list of "must have" requirements for each functional area (UM, CM, PHM, intake, TOC, IT, claims, client services, etc.). It is essential to identify exactly what is needed before starting to look at systems. All workflows and processes, especially those that are timeconsuming, difficult, or not working well, need to be reviewed to determine how they should be done, not what is currently being done. Define each step and be specific about what requirements are needed. Include automation steps throughout the process, even if you think they may not be possible. Set your goals high and let the vendor tell you if they can't be done. Once all the "must haves" are identified, add the "nice to haves." Your requirements document needs to include the key attributes all medical management systems should have (you should have found these when doing your online research). Each attribute needs to include your organization's detailed, specific requirements, as shown in the first example: * Flexibility and Adaptability: System can be easily modified (configured) by the client to meet required workflows. 0 Drop-down lists are configured to include client-specific codes/lists. 0 Customized care teams and functions can be set up in the system. 0 Work can be distributed from one team member to another or from one group to another. 0 A basic workflow can be configured differently based on a user, team, or department. * Ability to View or Link to Other Systems: Necessary to eliminate copying/pasting information, the need to learn/use multiple systems, duplication of work, convoluted workflows and "silos" of information. 0 Interface: A bridge between systems that uses custom code and import routines and/or utilities to transfer information. Data is maintained in both systems, so data mapping is required, but it results in a unified system that is easy to use. Issue 4 * 2016 CMSA TODAY 17 http://www.naylornetwork.com/cmsatoday http://www.naylornetwork.com/cmsatoday

Table of Contents for the Digital Edition of CMSA Today - Issue 4, 2016

President’s Letter
Association News
CMSA Corporate Partners
Triple Aim Requires Case Management “Target” Practice
Finding the “Right” Care Management System: “Must Have” Requirements + Structured Demonstration Process
Understanding the Health Insurance Appeals Process for Case Managers
Keeping the “Professional” in Professional Case Management
Patients Get Better Care When Doctors, Hospitals and Insurers Share a Common Interest
Index of Advertisers

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