Launching or expanding a care management program comes with certain challenges.
Whether providers or service organizations are starting Chronic Care Management or expanding to Remote Patient Monitoring, Annual Wellness Visits, or Advance Care Planning, they often face similar obstacles.
ThoroughCare’s Clinical Advisory Team helps organizations build competency, maintain compliance, and streamline operations to help make their goals a reality. We combine this expertise with a comprehensive software platform to help providers and care management organizations follow best practices.
Through our 10 years of experience, we’ve identified the most common challenges providers encounter and have recommendations as to how best to navigate them.
Challenges providers and third-party companies face
Challenge #1: Lack of clinical and operational standards
Solution: Create policies and procedures that match clinical, patient, and program objectives
Any successful care management program needs clinical and operational standards to guide daily activities.
Policies and procedures help care teams determine what tasks they should perform, how often, and for what purpose. They also know when to escalate to a physician or higher-credential professional for timely intervention.
Our Clinical Advisory Team has helped ThoroughCare clients create foundational program policies. These policies outline the standards for operations and workflow that align with desired clinical and patient outcomes.
Challenge #2: Inefficient task management slows growth
Solution: Streamline, automate, and deploy advanced technologies to make administration easier
Administrative tasks related to care management take time away from active care coordination and patient engagement. Task management and quick prioritization are key.
Today, Artificial Intelligence (AI) provides powerful capabilities that streamline administrative tasks, such as pre- and post-patient call activities.
Our Clinical Advisory Team implemented a client pilot with our partner, CareCo, to test the use of AI integration workflows. To date, care managers have realized an average increase in efficiency of 50%.
Using AI, a care manager can dedicate their entire time with a patient to the conversation, eliminating the need to split focus on taking notes and documenting during the call. Staff no longer have to rely solely on memory or the speed of note-taking, nor do they need to worry about capture errors.
What used to take 25-45 minutes now takes approximately five. Also, time spent auditing a call for quality now takes about half the time.
Challenge #3: Reporting doesn’t meet internal requirements
Solution: Tailor existing reports or develop new ones to meet needs
Care management providers may want to see patient, care team, or performance data to highlight specific metrics. They may use this reporting to meet requirements for value-based care contracts, general compliance, or for leadership decision-making.
Our Clinical Advisory Team works with ThoroughCare clients to identify tailored reporting needs. We help clients create reports that are readily accessible, precise, and provide timely summaries and insights.
Challenge #4: Patient assessments are too generic or don’t fit clinical objectives
Solution: Customize or implement evidence-based assessments to evaluate patients
ThoroughCare provides many evidence-based patient assessments, covering topics from health-related social needs to functional status, mental health, and activities of daily living.
Providers focused on particular patient populations, clinical scenarios, or non-medical needs frequently want tailored assessments or integration of assessments that they’ve created themselves.
Our Clinical Advisory Team has tailored or created custom assessments for various needs, including social risk and fall risk. These new assessments are seamlessly integrated with the ThoroughCare platform.
Challenge #5: Clinical services don’t align with operational workflow
Solution: Review current systems and determine workflow gaps
Many providers have unique steps in their clinical or patient engagement workflow they want to have available in their care management process. This ensures every real-world step is accounted for and documented seamlessly.
Our Clinical Advisory Team works to understand the desired workflow and operational standards, capturing all tasks the provider requires. This process can then be seamlessly incorporated into ThoroughCare’s software platform.
Challenge #6: The program is audited for compliance
Solution: Identify areas for improvement and enhance compliance through training and documentation
Providers often don’t realize documentation gaps until they face an audit. This is a costly route toward achieving compliance.
Our Clinical Advisory Team helps identify risk areas before they become compliance issues. Through tailored training and internal compliance awareness, we help providers feel confident they’re meeting all necessary regulations.
Challenge #7: Can’t keep up with program growth
Solution: Create a plan for scaling through efficiencies, technology, and upskilling
One positive challenge is when a provider or care management company experiences growth that outpaces its current staffing. While hiring and training more staff may be reasonable, there are other ways to increase internal efficiencies.
ThoroughCare’s Clinical Advisory Team has worked with care management companies experiencing significant growth.
We’ve helped train their staff, develop operational, documentation, and platform mastery, and we’ve demonstrated ways to use features, such as AI, to eliminate burdensome tasks.
Challenge #8: Staff skills aren’t keeping up with demand
Solution: Evaluate staff and program performance and create a training plan
With program growth, staff need to continue developing new skills related to best practices and the tools they use.
ThoroughCare’s Clinical Advisory Team supports ongoing education and training for care management staff. Surveys with our participants have found 98% felt our teaching was easy to understand and retain.
Also, 100% of surveyed training participants strongly agreed our instructors effectively presented clear and organized content.
Challenge #9: Performance targets and objectives aren’t being met
Solution: Conduct data analysis for targeted enhancement of clinical, financial, and operational outcomes
Every care management program should have clear clinical, financial, operational, and patient objectives.
If a program's goals are not being met, it’s crucial to uncover the root causes and adopt new strategies or adapt existing ones.
Our Clinical Advisory Team supports data analysis and helps customers identify key challenges. They collaborate to evaluate and implement strategies to improve quality and performance metrics.
Challenge #10: The program struggles to engage and retain patients
Solution: Determine engagement sticking points and recommend best practices
Engaging, enrolling, and retaining patients in programs can be puzzling. Finding the right combination of communication, education, encouragement, and timely motivation can mean the difference between a thriving program and one that’s struggling.
Through best practice training and developing new approaches and communication strategies, ThoroughCare’s Clinical Advisory Team can help find unique ways of engaging patients and helping them stay committed to results.
Key questions answered
What challenges are there when starting or expanding a care management program?
- Lack of clinical & operational standards
- Inefficient task management slows growth
- Reporting doesn’t meet internal requirements
- Patient assessments are too generic or don’t fit clinical objectives
- Clinical services don’t align with operational workflow
- Program is audited for compliance
- Can’t keep up with program growth
- Staff skills aren’t keeping up with competency demand
- Performance targets and objectives aren’t being met
- Program struggles to engage and retain patients