Technology has made a do-over for the past years in the health care delivery system leading to faster transactions and effective communications in providing immediate and timely delivery of care. The Net Generation grew up in the world of computer interface and raise to be socially-connected through the assimilation of different social media outlets. Millennials, as the future hospital managers can easily fit into the Case Management System. The merge of technological innovation and social acclimation with a clear focus on patient-centered care may advance into a favorable return in transforming health care settings by meeting the chain of supply and demands.

health care delivery system

The Case Management Society of America defines Case Management (CM) as a collaborative medical-nursing process of assessment, planning, facilitation, care coordination, evaluation and as an advocacy for treatment options to health services in conformity with the patient and his family’s comprehensive and individualized health needs without compromising the patient’s bills of rights through proper channeling of medical services and utilizing appropriate resources to provide cost-effective quality care.

On the other hand, American Case Management Association inferred Case Management, as a process to mechanize communication in facilitating immediate care and services during hospital confinement by utilizing efficient coordination resources, which aims to achieve optimal health, accessibility to any health care services and appropriate management of resources in consideration with the patient’s rights to self-determination.

CM is a multi-faceted systematic, collaborative and holistic approach in rendering coordinated health care services. Rossi includes five components of case management process which includes: assessment, planning, implementation, evaluation, and interaction. Interaction involves the use of efficient communication skills through personal, telephonic, SMS, computer-programmable communications and computer-based referral systems to facilitate a fast phase hospitalization following prioritization strategy.

Commission for Case Manager Certification explained that Case Management is a cross-disciplinary and interdependent specialty practice within the health and human services profession who involves directly and indirectly in the execution of patient’s care guided by the principles of autonomy, beneficence, non-maleficence, and justice in promoting wellness through advocacy, planning, communication, education, identification of required service resources and mobilization of medical care by utilizing evidence-based guidelines. Moreover, CCMC stressed the vital roles of human services professions from different backgrounds including nursing, medicine, social works, rehabilitation counseling, medical insurance, mental-behavioral health, and hospital managers. 

However, Frankel viewed Case Management as an administrative tool utilizing problem-solving process that manages access to full range of medical services made to be available and accessible within a realistic and appropriate time frame in meeting the unique and changing needs of the patients and their family, with focus on the two essential yet conflicting purposes in improving quality of care while controlling its costs.

Case Management of Australia & New Zealand & Affiliates, cited the work of Marfleet, describing case management as a process with key phases such as: a.) client identification through screening; b.) assessment of health problems and related issues; c.) risk stratification; d.) goal-oriented planning strategy following prioritization approach; e.) implementation through proper care coordination; f.) monitoring on patient’s care flow guided by clinical pathways; g.) transitioning with the use of effective decision-making in troubleshooting; and h.) evaluation of the outcome. 

Case Management is an advanced practice combining health and social care professions that work collaboratively with a comprehensive and holistic care plan (assessment to identify health care needs, coordinate services, education, advocacy in providing various options to care and support system) to maintain the continuity of optimal patient-centered care and to provide appropriate care setting with positive economical out-turns 

Case management in health care system is designed as collaborative actions of multidisciplinary teams working to reach goals such as: (a.) lessen hospitalization length of stay; (b.) faster and safe delivery of care from admission to discharge through proper utilization of medical resources; (c.) early discharge of patients; (d.) prevention of complications from prolonged hospital confinement; (e.) continuity of care after discharge; and lastly, (f.) prevention of readmissions. The multidisciplinary teams of Case Management comprise of coordinated efforts from patients, family, physicians, specialty practitioners, nurses, social workers, community/home healthcare providers and the Case Manager (who leads the team).

future health care system

The Case Management System (CMS) leverages the efficient decision making of the Case Manager to respond effectively to the real-time hospital situations in both favorable and under pressure circumstances while maintaining the highest level of coordination in collaborative works among the multidisciplinary teams making both ends meet.

Vogenberg & Santilli, enumerated the new Health Care Trends for 2018 which could pave way for the wide acceptance of Case Management System in any health care setting around the globe. The study revealed the following trends: strengthening rural healthcare, consumerism in healthcare, workforce change, integrated health for population care, transformative consumers from technological acceleration, employer’s transformation on medical benefits claims, and governmental legislative changes on health care policies these would play a pivotal task in re-organizing the health care delivery system with the inclusion of CMS as the frontliner.

Technology has spread world-wide web connections reaching even the far-flung areas of the land, moving both borders closer. Community health care providers and hospitals will continue to turn to the use of technology for faster communication and referral system. Consumerism in healthcare will occur as the use of online resources may influence the future of the healthcare delivery system. This advancement in integrated healthcare delivery will escalate the demands in ambulatory, outpatient care, community and home health care to decrease the health care costs.

The Case Management Model, as an emerging trend in a health care facility, loomed from the hospital’s restructuring efforts in trailblazing delivery of patient care. Clinical pathways of quality patient care, resource mobilization strategy and cost-effective measures while integrating with the technology and interpersonal communications are the cornerstones of this model which redefines the health care delivery system in the new millennium.

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