Complete Guide to Clinical Case Management Software

4 years ago

Complete Guide to Clinical Case Management Software

Patient case management software improves quality of care and, ultimately, patient experience by optimizing the coordination of care across a hospital, practice, or ancillary care clinic. Patient case management software centralizes aspects of patient care such as scheduling, charting, treatment planning, and medical billing to accurately determine the health status of a patient.

Case managers can utilize patient case management software to facilitate clinical communication and collaboration, as well as deliver better post-discharge care. Therefore, patients, too, benefit from effective patient case management software, which can offer them personalized services tools similar to an interactive patient care system (IPC) that they would have had access to during treatment.

Why do you need Clinical Case Management Software?

The clinical case management market is growing! The rise in the adoption of mobile technologies, patient satisfaction initiatives, and an increased call to cut costs within healthcare are driving this digital market. In fact, the total market for digital health care solutions is expected to reach $140 billion by 2021; its growth attributed to factors such as:

• Patients have become more demanding

• There is increased collaboration between care providers

• Patients are demanding more personalization

The increasing need for state-of-the-art health care services is prompting clinicians to find innovative ways to deliver the level of care demanded by each patient. The Clinical Case Management practice is ripe for major transformation in the coming years.

The Case for Ready-to-Use Software

The increasing adoption of clinical case management software to implement better governance and processes to improve patient care is evident. As a result, the exchange of information and data within clinical and administrative departments has increased dramatically. However, the ad-hoc and poor execution of these processes has resulted in disruption to patient care and has increased downtime – particularly in the case of an emergency. The cost of these disruptions is high.

Case management software can help to increase the efficiency of these processes, transform how a hospital operates and drive the revenue cycle to new heights. In this way, integrating the workflow of clinical teams and administrative departments with patient records and patient care management leads to a much better flow of information. This leads to better decision making and, ultimately, better patient care.

However, within healthcare, enterprise solutions are not always a viable option. This is where clinical case management software can play a role and where enhanced practice management can contribute to improved patient care.

An effective clinical case management solution is highly configurable to ensure that it seamlessly suits a wide range of requirements. The configuration process must be easy to ensure that clinicians are not deterred from adopting it. In addition, a clinical case management solution must be intuitive and easy to use.

Therefore, when looking for clinical case management software, you should seek to configure it to suit your specific requirements, as well as have an intuitive, easy-to-use interface.

What to Look For

There are a few key things to look for and to ask when choosing your clinical case management solution. When determining your requirements, it is essential to think about the systems you will be integrating with, as well as whether you will need to track and manage patient medications, treatments, and other elements that come into play.

For example, you may chose to integrate your clinical case manager with a practice management system – and, in some cases, real time data collection solutions, physician documentation software or imaging systems.

A clinical case management solution should do everything you require of it easily and operate seamlessly.

Other information to consider is whether you want your case management system to integrate with your existing systems or roll out as a standalone system. In many cases, a software integration will be critical to integrating systems to increase the flow of information at every point of a patient’s journey. In this way, and due to the critical nature of providing information to get the right patient to the right place at the right time, the integration must be simple and quick to implement.

Certain system elements are also crucial, for instance, your own reporting tools. You must demand to be able to extract, analyze and report on key information – such as your patient waiting times and whether any new patients have been booked.

Other than that, you should automatically receive an alert when any patient medication or therapy has been activated or discharged.

Treatment protocols and workflow must be automated, so that providers are able to quickly and easily access this information. This is not just for efficiency purposes, but also to ensure that you can adhere to local clinical guidelines, while also ensuring that you deliver the highest levels of patient care.

Tracking treatments – such as referrals and other care, medication management, and triggering alerts if treatment exceed the parameters can be vital.

To improve the quality of care, you must be able to integrate your clinical case management with data collection tools or point-of-care (POC) patient monitoring or diagnostic devices.

Essential Features to Look For

When choosing a clinical case management solution, there are various essential features you should be seeking to ensure the system implements a comprehensive methodology for the successful delivery of patient care.

Clinical Information

An effective clinical case management system will have an integrated clinical information platform to support collaborative care between the multi-disciplinary team members alongside the best practice management. It also must have a platform that gives the patient a private launch pad with their own recording in one place to promote patient-patient relationships.

Your system should be equipped with an ADS (Advanced data collection system) that can manage the flow of information and data from all patient touch points into the clinical case management. This allows the support staff to effectively make better decisions that requires the collation of patient data and information.

Data & Information Management

In addition to contacting all systems (PACS, EMR, RIS, EHR), a clinical case management solution must also work efficiently. It should be able to help clinicians to select the best tool to document care and access real-time updates, and be easily navigated.


Clinical case management software should offer reporting with predefined and custom templates, to ensure that the information is user-friendly. Therefore, users can extract specific patient data and information from the patient case management system to track and monitor.

Reminders and Alerts

Clinical cases must be able to trigger reminders and alerts when their reminders are due or when patients are missing to ensure you maintain an accurate working knowledge of your patient’s health conditions to facilitate better treatment.

Integration and Compatibility

Clinical case management solutions should be integrated with existing systems. This enables the clinicians to have a patient chart and the relevant patient data right in front of them. This also allows the clinicians to discover vital patient data and information to assist them in making appropriate decisions.

Contact with the Patient

Clinical case management software should be able to channel all your existing patient communication systems, as well as from the various sources of data and information to offer a centralized approach to patient engagement across the multiple touch points.

Any clinical case management solution you evaluate, review or select must allow you to provide seamless, personalized, real-time communication with your patients – and any members of their care team. It must also support secure messaging and globally available patient portals, of course.

Through improved communication through real-time alerts, the patient will be able to clearly understand the treatment process and help them to be more engaged in managing their own health and care.

Technology Inside

The software must be flexible so that it is able to capture data in real-time and automatically adapts to new hardware and device. It must be capable of importing existing electronic health records or creating a new one for your patient to enable easier production of a paperless environment in your office.

Workflow Process

A clinically effective case management should not only document the patients’ clinical case but also knows how to work with the rest of the team to ensure patient care and treatment is coordinated effectively. A good clinical case management solution should be intuitive to use. Ideally, it should offer a simple clipboard tool that efficiently allows you to dynamically capture and communicate vital data and information, as well as allowing you to store and access relevant patient data and information.

The tool should also offer a patient portal with a sharing tool for patients and their care team members, as well as business units and any relevant stakeholders.

Effective communication is one of the most important elements to delivering excellent patient care.

Clinical case management software should allow providers to file patients’ clinical record on progress and other important clinical data, thereby ensuring that accurate and timely assessments can be achieved. It also should automate the flow of information to the right patient, care team and business unit based on the specific patient requirements. By performing effective decision support, the system enables managers to have the necessary information to ensure that the right patient gets the right care at the right time and place.

Other Software Options to Keep In Mind

When evaluating clinical management software, you will want to know what other options are available.

Your EHR is one option. You should bare in mind that EHRs are designed to meet your clinical needs, and are typically used for electronic patient medical records. On the other hand, a clinical case management software is designed to manage patient care and workflow, and offer electronic patient care plans. Clinical case management solutions should also be integrated with your EHR.


In this article, I have highlighted just a few things to consider when choosing the clinical case management solution that is right for your practice, including:

• Effective usage of mobile connectivity to provide a real-time connection that allows you to access patient records from wherever you are

• The ability to automatically close loops and automate workflow processes to reduce your staff’s workload

• The ability for the clinical case management to facilitate the exchange of patient data and information between all the stakeholders of patient care

• In addition to patient-triggered communication, you should also consider the need for automated communication to your teams to increase workflow efficiency

• The ability to build upon clinical team collaboration to aid in the management of complex clinical cases

• The ability to create clinical care plans and schedules that help you explain care

• The ability to manage and track ongoing credit balance (out of pocket costs) in real-time

Pinpointing the clinical case management solution that is right for you and your practice will help you achieve your goal of becoming a more efficient and effective medical practice.

Benefits of Clinical Case Management Software

A clinically effective case management allows you to understand all your patients’ clinical records including their test results, treatment data and health history digitally in an organized manner.

Medical practices rely on clinical case management software to store and receive clinical information for treatment and communication for effective treatment delivery. Patients also get their own case management program to help them to manage their health records and help them and their care team members to manage their health and care.

To ensure that your clinical management software fits these goals, you can look for the file types of clinical information that can be stored and received on the system.

Storing of data:

The system can store patient’s clinical data including:

• Overview of support documents

• Medical records

• Diagnosis

• Treatment plan

• Progress report

• Outcome

• Adverse event

• Referrals

• Clinical Practice Guidelines

• Educational material

• Notes

• Video Consultation

• Online webinar

Quality Assurance:

Quality assurance is a significant area to look at when evaluating clinical case management software. Good case management software is able to offer quality control by ensuring that employees follow the protocol, trigger reminders and reminders and alerts when necessary and document the clinical information.

Significantly, it should also play an essential role in continuous professional development both in the context of developing clinical knowledge and gaining new skills.

Patient Engagement And Follow-Up:

A clinically effective clinical case management can help with patient engagement and follow-up by sending messages and interesting materials to you to keep you updated on your patients’ condition and any alterations in their treatment protocol.

Improved Communication:

A clinically effective case management should offer seamless communication between the patients and their care teams, as well as any related business units and any stakeholders involved.

Reduced Costs:

A good clinical case management software should allow you to have an estimated time and cost to complete every clinical management task, and create an interactive timeline that enables you to allocate resources to ensure a healthier patient population.

The software should also help you to manage more patients more effectively by improving communication, thereby increasing productivity, and reducing errors.

You can use this software to keep track of the resource utilization and create reports on the use. Clinical case management software should be able to highlight areas of waste so you, as the practitioner, can then keep track of the use of resources.

In addition, if you have multiple clinical case management software, consolidation can help to reduce the number of data entry points while consolidating the data together. It improves the usability and usability of the system. Replication also helps to ensure that needed data are available in real time when needed.

Increased Patient Safety:

Clinical case management software that is clinically effective helps to improve patient safety by ensuring that issues are dealt with immediately.

This software also helps with the continuous delivery of care by allowing an interaction between practice management and care provider. They ensure that the process is performed properly and efficiently.

Improved Organizational Process:

A good clinical case management software should be able to help you understand the level of process improvements and offer insights regarding areas of improvements.

This also helps with building improvement teams to enhance the overall patient care, workflow and business processes. You can use the clinical case management software to develop a concrete plan for improvement.

Efficient Practice Management:

A clinically effective clinical case management software should be able to integrate with practice management software to ensure that the processes and procedures that already exist in your clinical practice are covered in case management.

You will also be able to use the clinical case management to remind staff about appointments, checklists, and other important tasks. The software can also be used to create reminders and alerts of these tasks.

Managing And Tracking Patient Care Costs:

A clinically effective clinical case management system should allow you to monitor and track patients’ care costs in real-time.

You can analyze the data in service and help you to reduce the use of important resources.

Improve Quality Care:

A clinically effective clinical case management system can help to improve the quality of care by allowing you to manage and document clinical cases.

You can use the software to record the patient notes, manage documents and other important information.

Clinical case management systems can serve as an important IT platform that should be integrated with other IT platforms to facilitate the exchange of patient record and information.

It can also offer a suite of tools that are clinically efficient for the practitioner and their treatment teams.

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