How to Make Case Management in Hospitals More Efficient

Case management in hospitals supports positive outcomes for all stakeholders, as long as effective processes and supporting technology are in place.

While case management has been around since the 1920s, evolving technologies continue to deliver more efficient processes. For example, it is possible to reduce lengths of stay while providing more comprehensive care services for patients. How can this be achieved?

Advanced healthcare solutions, especially artificial intelligence (AI), can offer valuable information, analysis and forecasting, which can be helpful to not only case managers but to . also many other teams and departments across a hospital or health system.

Consider these applications of AI that lead to less administrative waste and more efficiency in healthcare.

Automating Manual Tasks for Case Management in Hospitals

Administrative tasks with substantial manual components, such as prior authorization, require a significant amount of time and attention from staff across the healthcare industry. Culprits for this could include anything from ever-evolving payer requirements and policy changes to issues with documentation – any delays or inaccuracies of which could ultimately stall patient care.

Automating manual activities can reduce the administrative burden placed on employees. Professional Case Management highlights this benefit, along with the clinical insights that can be gained by AI solutions, all while supporting a greater emphasis on patient interactions.

Automation enables case managers to invest more time into duties that directly affect patient health and well-being, such as care coordination, transitions of care, and discharge planning.

When AI can take on processes in utilization management or revenue cycle operations and support more efficient communication with payers, staff have more time available to focus on exceptions and emergencies. Some XSOLIS customers have even referred to our AI-driven technology as nurses have their own “personal assistant”, constantly helping case managers as they prioritize their day. Healthcare organizations that implement AI-driven custom healthcare solutions can therefore become more agile and better able to respond to time-sensitive needs, whether clinical or administrative.

Supporting Clinical Decision-Making Through AI Analysis

Utilization review is designed to support the provision of high-quality, relevant care to patients – and control the costs associated with it.

Managing so many details related to patients, care, and clinical merit, it can be difficult to juggle the various considerations. Worse, without the right technology solutions at play, the lack of standards can ultimately relegate staff to focus on subjective criteria, as opposed to viewing the patient on a more accurate and individual basis.

Advanced healthcare solutions that incorporate AI can increase and maintain focus on clinical merit and patient needs, supplying valuable context and insight to support clinicians’ own knowledge and experience. Ultimately, hospitals and health systems can better serve patients while controlling costs by ensuring only medically necessary care is provided.

Better Case Management in Hospitals with XSOLIS

When your hospital partners with XSOLIS, you can count on an AI-driven, predictive analytics-focused solution for optimizing utilization and case management.

CORTEX®, our utilization management and review solution, has been developed from its inception to support a clear view of medical necessity for each individual patient. That keeps utilization management efforts focused on the patient while also managing costs, facilitating better payer communication, and addressing denial risk.

Ultimately, all stakeholders can benefit from implementing AI into key clinical and administrative tasks, starting with providers and payers. With increased focus on the right patients receiving the right care at the right time, patients also stand to benefit from efficiency gains, lowering costs back to the patient. Since its existence, XSOLIS has brought increased efficiency and hundreds of millions in savings to its customers – eliminating waste through the science of data to ensure appropriate care settings.

Learn more about the benefits of incorporating an AI-driven solution into your case management and utilization management workflows: Schedule your demo with XSOLIS today.