Part 2: How is Health IT Impacting Public Health Case Management?

Installment 2: The ‘state of the art’ of Case Management

When asked, local health departments (LHDs) report overwhelmingly that case management is a service that is universally provided at the local health department level.  Of course there are many types of case management – Women and child health, TB, STD, HIV, Diabetes, Elder Care, Social services, etc.  In each of these examples, there are services that are provided and ‘case managed’ by the health department and there are services that are provided and ‘case managed’ by other entities.  However, care coordination is the key to success.  In this age of electronic health records, new ways of electronic messaging and managing care are cropping up and have the potential to improve efficiency and in return improve outcomes.

 

Today, case management often starts behind and struggles to catch up to what the client is experiencing.  The client may receive care and be referred to case management or become eligible for case management by diagnosis and the referral can take hours to a month to get to the public health case manager.  It can then take precious time and resources to find the client and encourage them to take advantage of the resources the case manager has to offer – resulting in missed opportunities for help.

  

However new technologies are coming along to change this picture.  In Olmsted County Minnesota, (part of the MN ONC Beacon Community Project) public health case managers are electronically connecting at the point of care.  So a patient could leave the emergency room and at that moment, the local public health case manager is informed electronically of the visit and given some summary as well.  This electronic connection makes the public health case manager a member of the care team – bringing a community focus to the point of care that has been absent in most communities.  This allows the public health case manager to impact the plan of care and connect the client to community resources when they are needed.

In support of this emerging trend, The Public Health Informatics Institute (PHII) has, with NACCHO’s assistance, partnered with local public health case managers to develop a requirements document for case management.  This document is useful in two ways: 1) It looks across case management types for commonalities and best practices and can be used to improve local case management programs; 2) It can provide a unified view of requirements for vendors to use when building systems that will support and enhance case management.  This document can go a long way to building consensus among local public health case managers about how an electronic case management support system should support their work.  Once there are agreed upon standards and requirements, vendors will have incentive to sell products to this new and growing market.

So what should I do?

NACCHO would love to hear your comments and stories.  How have you utilized technology to support case management?  What successes and/or challenges are you having?  What can we do in order to promote and improve this area of important local public health work?

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About Michael A. Coletta, MPH

After graduating with distinction from SMU in Dallas, TX, Michael Coletta worked as a CDC Public Health Advisor assigned to Chicago’s STD program from 1993 - 1996. He went on to work as a Coordinator of Research at Southwestern Medical Center in Dallas 1996-1997. From there, Michael left to receive his Masters of Public Health from UT-Houston School of Public Health in December of 1998. His thesis was entitled “Serological Reactivity To Acanthamoeba spp. In Selected Populations.” After graduating, Michael worked with the Georgia Division of Public Health (GDPH) from January 1999 – December 2004. During that time he worked as a District Epidemiologist, Knowledge Analyst, and Surveillance Epidemiologist. Michael was integral in instituting syndromic surveillance for GDPH during the G8 summit. He joined the Virginia Department of Health (VDH) in January 2005 and worked as their Enhanced Surveillance Coordinator until May 2011. In 2006, Michael and co-authors received honorable mention on their ISDS poster presentation entitled, “Resolving the ‘Boy Who Cried Wolf’ Syndrome”. Michael served on the ESSENCE Enhanced Surveillance Operating Group (ESOG) for Virginia, as Master of Ceremony for the 2008 EARS conference held in Boston, and in 2010/2011 as the Chair for the ISDS Meaningful Use workgroup that published “The Core Processes and EHR Requirements of Public Health Syndromic Surveillance”. Michael arrived at NACCHO in May of 2011 as the Lead Informatics Analyst. His interest lies in enhancing public health practice utilizing public health informatics and a practical knowledge of epidemiology.

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