Next-Gen Care Management Part I: Evolving Solutions to Meet New Demands

Joseph Grano

Care Management’s Changing Landscape

Care management today is a crucial part of the larger population health management picture. It requires
health plans and providers to:

  • Assess the care needs of both individuals and populations
  • Look at data both retrospectively and prospectively
  • Proactively engage members and patients to drive better outcomes at lower costs

As healthcare models evolve, IT infrastructures must also evolve to meet these new population health and care management demands. As good as some care management solutions may have been, the reality is that yesterday’s care management tools simply weren’t designed to provide the kinds of insight and communication needed to drive today’s targeted, proactive care management programs.

Past care management systems may hold good historical data. They also may be good at certain specific tasks. But they were not built to navigate today’s care management needs and support the emerging world of population health.

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Moving forward, effective care management solutions must:

  • Stand at the center of an integrated health IT infrastructure
  • Enable deep insights into both historical and real-time events
  • Support a flexible response to evolving needs

In other words, they must do more. This white paper will explore four key ways that care management solutions must expand beyond traditional systems.

What a next-gen care management solution looks like

The more data you have at your disposal, the more effectively you can manage care. Electronic health records, claims data, lab data and other existing information will continue to play a critical role in care management.

Moving forward, however, care management solutions will also need to accept new types of information from sources outside of traditional health data, such as patient-provided health information, environmental factors and care information from other individuals. As the scope of what you are expected to manage expands so will your data requirements.

Social determinants of health are a perfect example. Effectively managing social determinants of health will require healthcare organizations to analyze information from different sources, such as community care agencies and transportation service providers. Few existing care management systems were designed to incorporate that kind of data.

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