Medical Case Management Explained

Although many have heard of nurse case management before, people are often unaware or misinformed on what it actually is and what role it plays in the medical care process. Understanding case management nursing will help you understand not only the processes of medical care as a whole, but also how specific diseases or patient problems are managed differently than others, while still providing the care needed.

Brief Description

In short, case management nursing is a medical cost containment service focused on developing a comprehensive care plan, for a specific client, with a specific set of needs, over a long-term period. Most often case management is needed for patients with long-term diseases or injuries such as AIDS patients, workers compensation patients, and even children with long-term conditions. Most case management nurses specialize in a specific area of treatment. This ensures a comprehensive treatment plan for the patients and a more efficient diagnosis and treatment period. It's also common for there to be on-site case management nurses at some specific treatment locations and care facilities.

Function

The basic function of such services is to make sure the care that is needed is received on time and most effectively to meet a patient's and care provider's needs. As simple as this may sound, it's a very complex task. To create the most beneficial cost containment plan, with the utmost results, nurse case management directs and coordinates treatment over the course the entirety of the treatment period including PPO channeling and specialty referrals. For many illnesses such as cancer this can be a lengthy period of treatment including primary care visits surgery, chemotherapy and follow up care. Others such as such as workers compensation and surgery patients may have a smaller period of treatment or may require different considerations for their injuries or health problems.

Proper management can help optimize treatment time as well as recovery time, reducing expenses for care providers and getting those being treated back to work and living normal lives faster. Effectively communicating between patients, insurers and providers ensures comprehensive and timely care and is an invaluable asset to the medical industry as a whole. Undoubtedly as technology and comprehensive treatment continues to improve in the future case management could become a feature of medical care that follows you not only through the term of treatment but post treatment, especially for children who continue with conditions or health issues as they grow.
About this Author

David Hutton serves as an internet marketing source for CompComplete, a medical bill review and Managed Care Services provider in Lawrenceville GA.

Reasons Healthcare Biomedical Equipment Services Are Here to Stay

FIVE IMPORTANT QUESTIONS Regarding Biomedical Services That YOUR HEALTHCARE ORGANIZATION Will Want Answered!

Question 1: What is the economic outlook for biomedical services? The future outlook for biomedical services is, in fact, very positive.

Comment: Biomedical services have historically been a "sleeper" but significant "cog" in the "accountability" arsenal of healthcare providers. This has been true long before the legislated "accountable care" option was on the table. Do you know that even the U. S. Department of Labor has predicted that a continuous growth for employment for biomedical service technicians and engineers will be much stronger than the average for all occupations through 2016? This "reveal" is predicated, in part, on the increased use of electronic medical devices, biomedical and diagnostic imaging equipment. The obvious benefits of life saving diagnostic, therapeutic and remedial services that are "up and running" are broadcast each day through your balance sheet and also the ultimate consumers......i.e., your VALUABLE patients.

Question 2: How is your biomedical service department currently configured, and are you getting the best value for your dollars spent?

Comment: The need for health care services will continue to increase, and containing your costs will be a major interest to the final results you see in your bottom line. Consider that healthcare services comprise a large percentage of our GNP: Hospitals, Ambulatory Outpatient Surgical Suites, government owned/operated healthcare facilities, and privately owned institutional facilities. It is not going away, folks! The consistent growth of healthcare without any "major new events" or "drivers" is going to increase...along with costs, of course. Biomedical Services that affect your bottom line are a key to cost containment.

Question 3: How are you going to contain costs and increase value with your current biomedical services engineering team, and what alternatives are you considering?

Comment: You must be well aware that competition and reputation within healthcare providers is on the rise. Rarely a day goes by that there are not announcements about some new outpatient surgery centers, private practice consortiums and hospital group consolidations. If you subscribe to any of the top healthcare publications, then you have observed this as well. All of these facilities have to be concerned with marketing their services due to the onslaught of facility options and the fact that consumers are talking a lot online about their healthcare. Biomedical equipment repairs, maintenance and up time are key elements that keep your hospital's reputation "positive" in the minds of your ultimate consumers....the patients. Your patients are tweeting, chatting on Facebook, and talking about your services with very little, if any, concern about legal compliance. Believe us when we tell you that you CANNOT afford to have your reputation sullied because the company handling your technical services and maintenance does not have your best interests at heart.

Question 4: Are you thinking in terms of your patients' happiness quotient and your reputation when delays occur within your facility due to "down-time" of technology?

Comment: It takes an incredible capacity to keep on top of all the new types of compliance models that underwrite an even greater need for accurate diagnostics, preventative maintenance and timely repair of sentinel life saving equipment. Hardly a discussion goes by without some reference to accountable care, meaningful use or electronic medical records with varying context but with little reference to the biomedical technology so important to modern medicine. As such, we enourage you to do some of your own investigating and stay tuned to our informative emails in the future.

Question 5: How are you calibrating your internal biomedical services teams relative to the costs of highly competent and reputable "outsourcers?"

Comment: Your biomedical team is one of the most "mission" critical groups of individuals in your entire hospital as it relates to quality of care. Today, hospitals and outpatient facilities are processing more and more patients with little time for recovery should systems fail, become obsolete or even not get repaired in time for reliable patient care. More often than not, well intended, busy hospitals provide their own "inside" biomets who are normally good "tacticians" engaged in repair, maintenance, and recording of equipment information on a day-to-day basis. Most of these teams are competent at what they know and yet are largely undirected by hospital management staff. Frequently, when an "event" occurs (and it will) with negative consequences, it is typically an issue that management might have addressed proactively as opposed to reactively. Such "events" can trigger huge expenditures for hospitals and outpatient facilities. Risk Mitigation, a "bigger picture" view, biomet human resources management, proactive thinking, industry associations, vendor networks and a seasoned biomedical services management team are all benefits offered by a solid third party resources. These services can translate to huge costs savings for hospitals via effective compliance to regulations as well as timely patient care and ultimately your facilities' reputation.