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Care Management & Software Development
These health professionals help patients understand their disease (educate patients), work patients and with patients' clinicians to help with adherence to evidence-based interventions (support clinical services), connect the patients' to practitioners and clinical locations for services that will be paid through their contracted health plan benefits (assist with system navigation), and suggest community and/or health support resources that they might find helpful (augment likelihood of good outcome). Employee assistance (EAP) counselors, health care coaches, disability managers, and worker's compensation managers typically assist clients to prevent health problems from becoming chronic or complicated, whereas disease managers and case managers work with patients in whom illness has become chronic and complex and/or is spinning out of control (see Figure below). All work within a management system with software designed to document the services support given.
To date, with the exception of EAP programs and a few depression disease management products (occasionally loosely connected to other physical disease management activities), the majority of care management services are focused on assistance with physical conditions and their complications. Care management for a given patient may also be provided by more than one manager. For instance, a patient may have depression related to diabetes with heart and kidney complications and have been hospitalized twice in the past month. Such an individual may have a depression disease manager, a diabetes disease manager, a congestive heart disease disease manager, a renal failure disease manager, and a case manager who is helping with all of the health conditions since they are all under poor control and leading to intensive medical service use. In addition, the patient may be working with a disability manager who is assisting with disability benefits and an EAP counselor who will eventually help the patient/employee re-enter the workplace with restrictions. One patient with 7 managers. While this is an extreme example, it points to the need not only for physical health assistance to be connected with MH/SUD assistance but for the panoply of care managers to communicate and work with one another. Cartesian Solutions, Inc.™ works with companies that provide care management services and with software vendors to incorporate MH/SUD components into their products which presently address only physcial health needs, and vice versa. It also has developed a methodology for care managers working for independent companies to commicate with each other and coordinate services. Cartesian Solutions, Inc.™ is uniquely qualified to supply assistance with this task because it works with care management services provided at all levels of the health system, i.e. hospitals and clinics, health plans, and purchasers, enabling it to outline workflows, work processes, and communication approaches that maximize coordination and allow documentation of outcomes.
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One of the greatest challenges that patients in today's health care
world face is to navigate an increasingly complex health care system
in order to receive the right evaluation and treatment by professionals
most able to improve their health at the right time and at a cost that
is affordable. Unfortunately, many patients and particularly those
with chronic and/or complicated conditions have limited understanding
of general medical illnesses and their treatments, let alone how to
efficiently and and effectively get the care that they need. This is
where care managers (see Table below) shine.
