Don't Use EMRs for Case Management!

08/23/2021 By Todd Mueller

I’ve noticed a trend for a while that’s recently picked up more momentum and it involves organizations dropping their use of EMRs for case management. I believe this trend will continue and I will describe why I’m seeing this and what this means for case management software.

EMR History

The first EMR was developed in 1972 by the Regenstreif Institute and was lauded as a major achievement. Due to the high costs of such a system, this EMR was not widely adopted and was primarily used for government hospitals. In the 1990s, computers were becoming cheaper and more powerful allowing increased innovation and awareness of such systems. 

In the 2000s, additional funding and incentives have accelerated the adoption of electronic health record systems. EMRs continually evolved due to advancements in technology and policies to improve the process of capturing, evaluating, and reporting on electronic data.

EMR systems differ in size and specialization as you would expect so finding a system to cover all of one’s specific needs will be very difficult. Many systems offer the ability to add modules or subsystems on top of their main platform. The quality of these types of addons varies and the costs can quickly add up. Larger, and even some smaller public health agencies have chosen enterprise-level EMRs such as Cerner and EPIC, and try to use them as an all-encompassing system to cover all of their needs as it’s sold this way by the vendor's sales teams. The promise of being able to do it all comes with an incredibly expensive price tag. Once committed to the platform, hidden costs and lack of feature support leave some agencies having to go back to their Board and asking for millions in additional funding for features they thought they were getting out of the box the first time. This is a difficult situation for everyone involved.

Case management is often put on the back burner for EMR vendors as it’s not a big revenue generator for them. Sometimes workarounds are used to satisfy the requirements and it often turns out to be an ugly, complicated mess for caseworkers to use. EMRs are not meant to support case management as a first-class citizen. At best, it's a sloppy add-on and that's why I'm seeing more agencies go to a dedicated case management system. I believe this trend will continue as integrations of health systems improve and the focus on ease of use for case managers allowing them to work in an efficient and easy manner is imperative. 

Reasons for leaving

Here are some of the reasons why organizations abandon their efforts for case management in EMRs:

  • Not specific to case management
  • Cumbersome and difficult to use
  • Expensive
  • Lack of support and system updates

With a dedicated case management system like Olive, we are only focused on case management. Our product continues to evolve and with constant feedback from case managers, management, and other users we feel that with each new release, we improve our system to make case manager's jobs easier and more importantly, allow users to provide better care for their clients.

This feedback loop allows us to release and improve our system on a frequent schedule. One of the complaints I hear about is the lack of system updates and attention given to case management within these large EMRs.

Another significant downside of having case management as an add-on is the cost. Second-rate add-ons can cost millions of dollars and do not offer the same kind of support that the core EMR offers. This can be troubling for administrators and case managers that have good ideas about improving the software but have their requests go into a support black hole. This results in unhappy users and a lack of confidence in the system.

Spoke and Hub Analogy

I think that a specialized case management system like Olive is akin to the spoke that connects to the hub (EMR). The heart of the healthcare system is the medical record, so custom, dedicated systems can connect back to the EMR to keep the data in sync for providers, healthcare workers, and other data systems. 

Benefits of a Dedicated Case Management System

  • Specialize focus for case managers and their management team
  • Dedicated expertise in case management
  • Optimized User Interface
  • Decreased costs
  • Support

The Future

So where does Olive fit into this evolving landscape of healthcare systems? I see Olive continuing to grow in it’s functionality to support case management and its client needs while improving its ability to integrate into other healthcare systems. 

Here’s a short list of features we are actively exploring adding to the Olive development roadmap:

  • DOT (directly observed therapy) app integration
  • Billing Clearinghouse integration
  • Custom grant functionality
  • Improved Artificial Intelligence (AI)

Our roadmap is shaped by our users, trends, and regulations in healthcare. It’s the way case management should be done. Tell us your story and see how Olive can empower your team today.