Complex Care Management Requires HIT, Analytics Improvements

Health systems will need to improve upon the current state of analytics and health information technology infrastructure in order to fully realize the potential of complex care management, according to researchers from Massachusetts General Hospital and The Commonwealth Fund.

"The analytic approaches and HIT required for effective CCM remain underdeveloped," researchers write in a perspective paper published in The New England Journal of Medicine. "Better algorithms could be developed for identifying patients whose care offers the greatest opportunity for reducing expenditures, health information exchanges could be created to provide real-time data to CCM teams, and software for population management and care manager work flow could be improved."

Although increased adoption of CCM will require new policies and practices, it can be achieved without increasing the total costs of care. “Successful CCM not only pays for itself, it also directly addresses our tripartite goal of lower costs, improved care, and improved patient experience,” note the authors, who added that more evidence of the savings possible from CCM programs is needed.

Among the most formidable barriers to instituting successful CCM programs are fee-for-service payment structures, lack of startup capital, and unrealistic short-term savings expectations. The authors also said that solo and small-practice physicians can successfully participate in CCM organizations by sharing "key" resources including patient registries, CCM staff, and HIT.

The full paper is available here.