World over, the term care management is increasingly finding its way into the healthcare lexicon. Often confused with the concept of care delivery, especially in India, the concept of care management actually refers to a comprehensive group of services and activities that help to better manage the cohort of patients with chronic or complex health conditions. Although in its nascent stage in many developed countries such as the US and the EU, the global care management solutions market is estimated to reach $21.6 billion by 2026. With evident inadequacies in current healthcare systems around the world, it is important that we explore newer alternatives such as care management that can help support better healthcare outcomes for all.
ABCs of care management and why it is important
As mentioned above, care management is often conflated with the delivery of care/providing services such as testing, blood sample collection, physician visits etc. However, care management actually begins when patients step out of any delivery system such as a hospital or a physician’s clinic and are on their own thereafter. Typically, once discharged, patients face a huge burden of compliance. Whether it is adhering to a medication regimen or booking appointments for tests and doctor’s visits or following a self-care protocol/diet/lifestyle, managing all this by oneself can get overwhelming. Each and every one of these steps that a patient has to go through on their own via multiple touch points is a big hassle. In fact, in the US alone, patient compliance is a significant problem in the healthcare system, and it is estimated that each year noncompliance-related issues cost the economy anywhere between $100 and $300 billion.
Care management systems are designed to alleviate these pain points and are deployed immediately after patients are discharged from the hospital/or leave a physician’s care. They work to improve patient health by making sure that their general health markers are tracked and any red-flag symptoms are immediately reported so as to avoid recurrent hospitalisation or worsening of a patient’s condition. Care management systems can help to coordinate between physicians, clinicians, hospitals, patients and their caregivers so that the ultimate outcome is favourable for all stakeholders.
Care never really ends once a patient has been discharged or leaves a doctor’s clinic, in fact, it is the starting point of a long journey. A majority of this journey is lived outside the walls of clinics and hospitals and the entire burden for this falls onto patients who are unaware of the importance of following strict wellness, diet, and medication protocols. This is especially true for patients with chronic conditions such as diabetes and hypertension who need -frequent monitoring; one single physician visit is, thus, not enough to ensure that a patient is compliant on all fronts. Hence, there is a need for a separate entity to do this job and this is where care management systems come into play.
For care management systems to be instituted there will need to be a significant shift in mindset on behalf of healthcare providers, payers and patients. Hospitals have to understand that increasing footfalls aren’t the only way to boost revenues and that supporting care management systems can be beneficial to their reputation as it leads to better patient outcomes. For payers too, care management systems can help to optimise pay-outs. And lastly, for patients, it ensures the best quality of care with 360-degree attention to all their health needs.
Thus, as countries around the world, including India, strive to improve patient care and well-being, and simultaneously try to control costs, care management systems will play an important role in creating a new and improved healthcare future.
(Dr Suman Katragadda, CEO and Founder, Heaps.ai Views are personal)
