7 Steps Towards Improved Patient Engagement

Engaging members is always a challenge, but particularly so for the case manager, whose interactions are often restricted to the telephone, especially in rural areas or when decentralization of members doesn’t justify face-to face-interactions, says Jay Hale, director of quality improvement and clinical operations at Carolina Behavioral Health Alliance (CBHA). Utilization review leading to discharge management is one way case managers can better engage not only their patients, but show their support to their patients’ providers.

This is always the challenge, and it is no different for telephonic engagement. It is very difficult for us because it is over the phone rather than face-to-face, so we do not have the same queues or ways of creating a relationship. We have found multiple venues to attract attention and begin the engagement process. The venues are letters and outreach calls to members, as well as partnering with the discharging hospital. One of the things that we want to do is be part of the discharge process. Therefore, telephonic case management is part of the discharge plan just as much as their visit with the doctor or therapist, medication regime, etc.

We are a small regional MBHO, so our case managers also do utilization management. They identify the cases early and are able to talk to the utilization review (UR) people at the hospital and say, “This is someone that we have identified,” which helps with that discharge process. The earlier we can talk to members, the better. We want to talk to members as quickly after discharge as possible. Having the support of that hospital adds weight to what we do, so it is key that they do not receive a random call. We want it to be something that is related to their treatment process. That is why we want to be part of that discharging.

The next step is to call the member once they have been discharged. We obtain contact information from our records or from the hospital. Our records are based on what the person gave to human resources at some point along the line, so they may not always be updated. The hospital frequently has the most recent phone contact information.

We obtain the discharge recommendation, which is part of our UR process, including appointment times. I contact the member and engage them in the process to assure that they attend their appointments. We also call their providers to say that we want to make sure that the individual attends their appointment.

We are the people who are authorizing the care, and these are in-network providers for us. Therefore, that is a relatively easy process. I feel comfortable with that because it is part of the treatment payment healthcare operations process. It also lets our providers know that we are doing this, so they should support us. It also lets them know we are not there just to plan, but also support what they do.

Source: Telephonic Case Management Protocols to Engage Vulnerable Populations

Telephonic Case Management Protocols to Engage Vulnerable Populations

Telephonic Case Management Protocols to Engage Vulnerable Populations examines the case management protocol developed by Carolina Behavioral Health Alliance, including the use of scripts and surveys to assess patients’ engagement in the treatment process and to identify patients at-risk.

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