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Transitioning to a Remote Discharge Planning and Case Management Workforce

by Mary Kay Thalken, RN, MBA on Apr 24, 2020

Remote Case ManagerDoing so is possible, but it requires careful planning and specific infrastructure needs.

The COVID-19 pandemic has caused everyone in the healthcare field to rethink previous policies and consider new ways of doing things. Some of these may be temporary adjustments that help get us through the crisis, while other, more substantial processes may stick around.

Case in point: the number of team members and organizations that have been forced to switch to a remote work structure. At no point in history have so many people worked from home at one time, and we at Ensocare are no exception, with our staff having been in a work-from-home status for over a month now.

But if there’s one field resistant to such a work setup, it would be the interactive, people-centric act of caregiving. It’s true that telehealth has made some basic appointments possible over the internet, but when it comes to coordinating care within the walls of the hospital, that work must necessarily be done by people on site.

However, we’ve slowly been seeing institutions get creative with how they approach staffing during this pandemic, particularly in the areas of discharge planning and case management. Hospitals are rethinking the idea that these teams need to be within the hospital in order to accomplish their goals. Some hospitals had moved to this type of system already with their case managers, having transferred responsibility of those functions to an outside call center, but the patient coordination and discharge sectors are where we’ve seen organizations become truly inventive with how they approach the situation.

If your organization would like to protect employees and patients alike by reducing the number of people on site, thus limiting potential exposure to the coronavirus, case management and discharge planning are great areas to consider. But there are certain pieces you’ll need to have in place.

Three Must-Haves for Remote Discharge Planning and Case Management

The first hurdle you’ll need to clear in order to set up a remote workforce is simply having the technology in place to make such a transition possible.

When determining if you could even begin the process, there are three factors to consider:

  • Hardware

Do your case managers, nurses and social workers have access to smartphones and computers that would enable them to accomplish the same work they do in the hospital? Is this something your IT teams could conceivably provide in the coming weeks?

  • Software

If your team members do have access to the hardware necessary to accomplish their jobs, do they also have access to the same apps they would use in the hospital? Will those apps work properly outside your facility, or are they geofenced in some way for security purposes? Which leads to the final consideration…

  • Security

HIPAA regulations and data protection haven’t gone away during the pandemic. In fact, security protocols are arguably more important outside the hospital, where, for instance, your team may not have the same network protections they would within the facility.

Case Management and Discharge Resources  During the Coronavirus Pandemic

Security: A Closer Look

For the purposes of this article, we’re going to assume you’re able to connect your workforce to the right hardware and software.

The bigger challenge lies with security. You’ll need to work with your IT team to make sure the electronic health data that flows in and out of remote workstations is safe.

These are some of the things that will make doing so possible:

  • VPN: A Virtual Private Network can offer an additional level of protection to all internet activity moving through a location. These are available at the consumer level for a relatively low price.
  • Two-Factor Authentication: This provides an additional layer of protection to all interactions. When your team member logs into a given app or system remotely, he or she should be prompted with an email or text message that includes a code they can enter, thus ensuring that even if a password has been compromised, account access won’t be.
  • Protected Desktop Access: If your team members will need to log into a system stored within the hospital, i.e. mirroring their work desktop on their home computer, your IT team will no doubt need to use some type of software to enable this process.
  • Cloud Security: Rather than have data stored centrally in one location, cloud-based data provides even more of a security boost to your remote employees. This has the added benefit of improved team access to necessary data, because it’s not stored in a physical location requiring on-site interaction.

If you can receive assurances surrounding these things, or your IT personnel have otherwise given you the green light, then you’re basically at the starting point for a remote case management workforce transition.

So…what now?

Product Choice

In order to have a case manager or discharge planner continue their work outside the hospital, you need software that can function in that kind of setting as well.

That leaves manual processes out of the question. If you’re expecting an employee to communicate with post-acute providers in order to discharge patients to the appropriate care setting, that person needs to be able to do their work electronically. Faxing protected health data or making phone calls to various care settings, then making additional calls and faxes to report those statuses to the hospital, simply won’t cut it.

You thus need to rely on a product that lets you electronically communicate and coordinate discharge with post-acute providers, patients and family members.

How much can your organization save with automated discharge technology? Calculate your ROI.

Decide If You Need a Staff Member On-Site to Interact with Patients

There’s one component of patient discharge that’s a little harder to manage remotely, and that’s the actual interaction with the patient.

At some point along the line, a nurse or some other team member must present the patient and their family with their post-acute care options. Typically, this happens right in the room. But one consideration you could make is having your discharge team members use something like Zoom or GoToMeeting to interact with the patient through the screen.

If you have video conferencing with screen sharing capabilities, it’s possible to present the patient with their potential choices without actually entering the room. They can make their choice, the case manager can record it in your documentation software, and then the case manager can coordinate with the on-site clinical team to execute the successful discharge of that patient.

As a sidenote: making the actual documentation of patient choice electronic is something we’ve been adamant about for years. We’ve long encouraged hospital staff to use tablets to showcase PACs in a far more visually appealing manner, highlighting reviews, CMS scores, photos and location intuitively. Thus, the teleconferencing technology we’re recommending here is an extension of that, making the process seamless for your patients while protecting team members who don’t need to be on site.

ensocare-half-image-patient-choiceTraining and Regular Check-In

Finally, you might have the infrastructure in place, but it’s also important to be cognizant of the very real human challenges that come along with maintaining a remote workforce.

Not only will you need to train your discharge planning and case management teams on the processes inherent to their new roles, but you’ll need a management structure in place to monitor progress and adjust as necessary. Having a team that works from home will present you with challenges that never would have popped up in the clinical setting. Productivity, connectivity issues, burnout: all are very real issues, and they require the steady hand of leadership in order to identify and solve.

Your teams should be meeting regularly to touch base about best practices, challenges and lessons learned. You should continue to analyze the new workflow and identify areas of opportunity and difficulty. At all times, thought should be given to clinical outcomes, specifically if the switch to remote work is having a positive or negative impact on your patients’ recovery after they’ve left acute care.

Remote or Bust

As you’ve no doubt surmised, transitioning to a remote case management and discharge planning workforce is no easy feat. It requires careful coordination and planning to get such an effort off the ground. However, once you have the pieces in place, you have the opportunity to witness innovative, transformational care delivery, the type that benefits patients and your own caregivers.

Please let us know if you have any questions about remote case management and discharge planning, or feel free to share your own experience with a remote workflow in the comments.


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Meet the Author

Thalken brings more than 30 years of experience in health-care leadership to our company. Prior to joining the company, she served as Enterprise Vice President for Care Logistics in Atlanta, Ga. She has held executive leadership positions at hospitals in Nebraska and Iowa, including the position of System Quality Executive for Alegent Health. Thalken has presented on the topics of improving quality, patient flow and throughput at various industry conferences and webinars. Thalken holds an MBA from the University of Nebraska at Omaha. She is a member of the American College of Healthcare Executives, American Organization of Nurse Executives and American Case Management Association.

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