CMSA Today - Issue 3, 2014 - (Page 6)

President's Letter Chaos and the Second Law of Thermodynamics BY NANCY SKINNER, RN-BC, CCM G oogle the term "population health" and you will discover an oftenquoted definition from 2003 that describes it as "the health outcomes of a group of individuals, including the distribution of such outcomes within the group." This is one of those definitions that probably has great meaning to those in academic environments, but has little or no meaning to those of us that stand on the front lines of care coordination and case management. After spending several hours searching for knowledge that I could understand and effectively share with my colleagues, I decided that maybe epidemiology was not the topic I was really seeking, but rather population health management. So, I began another round of sorting through mountains of information, only to identify that population health management is really a form of case management. Here is my understanding of what population health management is from the many definitions that I reviewed: * The coordination of care delivery across a population to improve outcomes through disease/care/demand management. 6 CMSA TODAY * The actions necessary to attain the goal of achieving measurable improvements in the health of a defined population. * Prevention-oriented health management of populations with a focus on avoiding chronic disease rather than treating that disease. * The assessment of both the population as well as the environment that supports it, including factors such as: physical environment, availability of fresh foods and vegetables, finances, access to health care services, health literacy, genetic tendency for disease development, and ability to address appropriate care for both physical and behavioral health concerns. As I continued reading and seeking further information, each definition I reviewed brought me back to one thought: Care and case managers, as well as care coordinators, are engaged in population health management every day. Maybe we don't refer to it as such in our daily practice; perhaps we refer to it as coordination of care or care management. However, in my opinion, the role of the case manager includes assisting the patient to move Issue 3 * 2014 * DIGITAL toward self-management of their disease state and health status. It includes supporting the patient to achieve a goal of self-advocacy. And, it absolutely includes focusing on bringing some sense of order to a person that has compromised their health and thus disorganized their life, and must now incorporate disease management into many aspects of their daily life. My daughter is a research microbiologist who regularly offers me a view of life through the eyes of a scientist. Recently, she informed me that my role as a care coordinator is greatly influenced by the Second Law of Thermodynamics. Since thermodynamics has never been a subject that has gained my attention or touched my curiosity, I asked her to tell me more. I may be compromising the integrity of scientific validity in this explanation of that law, but my understanding includes the following: The Second Law of Thermodynamics is related to entropy, which is the degree of disorder that occurs. In all aspects of life, things tend to move from order to disorder. For example, did you ever play "pick-up sticks"? This classic childhood game demonstrates both entropy and the Second Law of Thermodynamics. In that game, a bundle is sticks is dropped and falls in a disorderly manner. The players then take turns picking up one stick after another without disturbing the remaining ones. It takes energy to carefully remove sticks from that pile and bring them back to order. The first player to disturb a stick while lifting another loses the game. Think of your home. Is your home orderly or disorderly? Things naturally tend to move toward chaos and disorder. Our lives, our homes, and our daily environments tend to move toward disorder and a higher degree of entropy. It takes energy to change or

Table of Contents for the Digital Edition of CMSA Today - Issue 3, 2014

President's Letter
Association News
CMSA Corporate Partners
Index of Advertisers
The Obesity Pandemic
Review, Recruit and Retain: Succession Planning Steps
The Case Manager's Role in Population Health

CMSA Today - Issue 3, 2014