CMSA Today - Issue 1, 2012 - (Page 12)

Biocomputers Case Managers – The Biocomputers that Make the Biggest Difference BY MICHAEL TERPENING, BS our years ago, my 83-year-old mother-in-law was diagnosed with inoperable lung cancer. Her 85-year-old husband, suffering from deepening dementia, could no longer identify her. Days after her diagnosis, she broke her ankle in the shower at her assisted living facility. My wife and I moved to Florida to help her navigate the health care maze. My mother-in law-didn’t qualify for hospice because she wasn’t “actively dying,” so she was thrown onto the disjointed hospital/skilled-nursingfacility-(SNF)/physician-office merrygo-round, and we were along for the dizzying ride. Keeping the “system” from making her life worse, or shorter, was a fulltime job that included dealing with the orthopedic surgeon, who suggested a compression bandage prior to her ankle surgery. When we asked where the fluid would go, he said: “That’s not my concern.” A few weeks later, my mother-inlaw went from hospice to hospital to have lung fluid drained. The operation, scheduled for late on a Friday, was delayed. A Post-it® note on her door said: “No food or liquids.” The note had been there for hours; nobody checked the electronic record, so she had not been offered even a saline drip. F WELL MEANING, BUT … Each practitioner meant no harm but was working in his or her part of the fragmented health care system. Even a relatively advanced electronic CMSA TODAY record hadn’t helped, because it wasn’t integrated into the Post-it note workflow. It needed have gone that way. Many technology tools exist to help all treatment team members, marshaled by the case manager – the biocomputer of health care – deliver best-quality coordinated care. Fortunately for case managers and their patients, academic collaboration on evidence-based treatment guidelines and supporting care has produced an enormous body of clinical content and decision-support tools. These health care-related open-source toolkits include: • Workflow applications • Standards-based clinical content modules • Clinical guidelines • Health-risk assessments • Predictive modeling imitations • Clinical metric tracking • Calculators that populate the best comprehensive evidence-based decision-support products Most of these nifty tools can be accessed on a variety of devices. Some smart phone applications with add-on sensors offer health care consumers ways to track their own biometrics and to graph vitals. These tools also make information on a patient’s clinical situation available to caregivers. But achieving effective use of medical information available from tests, exams, labs, and other clinical sources is a challenge – one that requires a toolkit that allows all stakeholders to integrate clinical data related to removing barriers to restoring patient health. A holistic knowledge of supra-clinical elements at play must be developed. Until artificial intelligence can be programmed to accept nonhard data inputs of this kind, we must rely on the coordinating intelligence at hand – experienced human beings. We need to leverage the most important tool of all, the trained human biocomputer, best known as the case manager. Many recent movements to improve patient care look beyond diagnosis, treatment, and medication regimen. 12 ISSUE 1 • 2012 • DIGITAL

Table of Contents for the Digital Edition of CMSA Today - Issue 1, 2012

Technology U se Transforming the System
President’s Letter
Case Managers and Telehealth – Avoiding Potential Liabilities
Information Technology Takes on “Meaningful Use” for Case Managers
Case Managers – The Biocomputers that Make the Biggest Difference
The Evolving Role of Care Coordination in an Acute Care Environment – An Introduction (Part 1 of 3)

CMSA Today - Issue 1, 2012