Case management in a vertically integrated health care system

Area of Science:

• Healthcare Management
• Patient Care Coordination
• Health Outcomes Research

Background:

• Complex patient care requires integrated management strategies.
• Existing healthcare systems face challenges in coordinating medical, social, and financial support.
• Fallon Healthcare System identified a need for a structured approach to case management.

Observation:

• A comprehensive case management system has been developed.
• The system defines case management, specifies service goals, and outlines referral criteria.
• The implementation process for these services is detailed.

Findings:

• The developed system aims to improve multiple outcomes for patients requiring complex care.
• Key components include defining case management, setting goals, and establishing referral processes.
• The system's implementation process is described.

Implications:

• This initiative has the potential to significantly improve patient well-being and resource utilization.
• The structured approach can serve as a model for other healthcare organizations.
• Formal program evaluation is planned to validate effectiveness.