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Care management

Experience the power of integration

Care management and coordination is a key strategy for proactively supporting and managing the health of citizens in many countries, but is not yet a key strategy in the UK market. In the past the market has evaluated telehealth programmes with care management support but it has been hard for these programmes and support structures to integrate into the mainstream of care provision. Arguably, the drivers and strategy for moving the whole health and care system to population health management have not been there. Nonetheless, some UK integrated primary care teams are establishing new care coordination roles, as they recognise that the community holds a wide range of assets that can holistically support individual citizens, often with complex needs, to address the wider determinants of their health and wellbeing.

Creating a comprehensive view

Rather than having to work around siloed patient information, an integrated system means you can work off a single, comprehensive record. By taking available data from across the care continuum, a longitudinal record for each person is built up, providing all care givers a complete view of an individual’s health and wellbeing. This can save hours of time logging on to disparate information systems or reconciling different information available from different sources.

Introducing proactive health

Our community care management solution, HealtheCare® supports proactive coordination of all the relevant health services. From the longitudinal record, algorithms identify those within the population who meet specific criteria, set by the health system, qualifying them for community care management services using inclusion and exclusion criteria.

Build a personalised plan

By having access to a wide-ranging record, care providers can add context and insight to personalise an individual’s care plan. Armed with knowledge about family medical history, environmental risk factors and more, care providers can promote relevant education, undertake regular assessment, and schedule follow-up appointments with other members within the care system.

FAQs

What key care management challenges is Cerner helping to address through HealtheIntent?

  • Attributing the right citizens automatically to the right care managers to automate this process and ensure the best match of the service to make the most impact.
  • Providing a single source of truth of normalised data across the whole health and care system to save logging on to multiple local EHR systems to piece together what they need to know about the citizen.
  • Ability to establish a care plan that can be centrally tracked and managed with fit for purpose workflows to support the role of a care manager and the care management team in their roles.
  • Using the intelligence in the big data to optimally identify those citizens that are most impactable with care management services allows focused interventions on individuals that need the most support. By doing this, citizens that need the most help for their disease and risk factors, or are hard to activate in self-management, can receive it, rather than spending time and precious resources on citizens that are managing well.

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