When research started for this article, I made the mistake of reading “virtual” as telephonic. I could not have been more incorrect! So, let’s travel through time and look at virtual case management.

First and foremost, the definition of virtual case management (VCM) is “the use of digital communication and remote work technologies to coordinate and deliver case management services and programs.” One might contribute VCM’s beginnings with telehealth where video calls, texting and other databases are utilized. VCM is a process that will leverage digital tools and platforms to manage cases and client interactions remotely. Studies have demonstrated it improves efficiency, accessibility and convenience by utilizing many different technologies. It enables real-time updates and ensures continuity of care, especially where face-to-face interactions are challenging.

VCM is bringing a new way for case managers and clients to interact. As we continue to fly into the future with artificial intelligence (AI), the future of case management will start to look at an organization’s ability to adapt and create working boundaries. The multiple tools that are involved with VCM offer great options for communication and collaboration. However, if not fully researched, VCM can backfire and could inhibit the case manager’s ability to work with clients. It will be important for an organization to determine what their best practice is and how to establish and enforce regulations.

Virtual case management is a great option due to the nursing shortage as it can help to minimize challenges healthcare is facing today. We all have heard stories about understaffed hospitals that lead to difficulty meeting patient care needs. This could result in longer length of stays, decreased quality and just dissatisfaction.

In order for VCM to be effective, the organization needs to have a robust workflow in place. Therefore, before deciding to implement VCM, the organization may want to fully assess their current workflow and how it can and probably will change based on VCM usage.

VCM also allows for tracking and sharing information based on security levels that permit other agencies to view notes and comments and assist with the case. It can also greatly augment in-person case management in several ways:

  1. Accessibility and Convenience—both clients and case managers can communicate and exchange information anytime or anywhere, thus decreasing the need for travel and in-person meeting.
  2. Efficiency—Use of digital tools can streamline administrative work such as scheduling and documenting, to name a few, which would allow the case manager to have an increased focus on client interactions.
  3. Enhanced Communication—Think about all of the phone tag, texts and emails. A virtual platform can assist in providing multiple communication channels such as video calls and emails, which again can complement in-person meeting and ensure constant communication. Of course, you need to ensure you have firewalls built for security purposes.
  4. Real-Time Updates—Think back to when you may have had to wait hours, days, weeks to have a client progress update. With virtual case management the progress can be updated in real time, which will allow all stakeholders to have immediate access to the latest information, which can lead to timely decisions.
  5. Resource Optimization—When you combine virtual and in-person methods, there is a better utilization of resources, and decreased overhead costs that can be associated with office spaces as well as travel.
  6. Broader Reach—VCM can extend services to remote or underserved areas. This will ensure clients who cannot attend in-person meetings due to distance, travel insecurities or physical issues can still receive the necessary support.

The many tools that are involved in VCM do offer great options for communication and collaboration; however, without the foresight to use them with care and a state of awareness, VCM could potentially inhibit the case manager’s ability to work with their clients. It is important for each organization to determine the best practices for virtual case management and establish regulations.

With all of this information, how does one build a successful, safe VCM? The examples below are from various companies.

  • Hire case managers who understand and know how to use technology. Sadly, not everyone these days is well versed in technology. During the pre-interview stage, have a small quiz that has the potential employee demonstrate their knowledge in technology. Can they set up a chat room, do they have the proper security on their PC, do they fully understand HIPAA and what PHI is? You will need to make sure the case managers have the necessary education and can successfully teach back what they learned and how it will be used in their day-to-day practice.
  • Does the virtual case management process adapt to your needs as well as the needs of the client? Not all tools in VCM or best practices are suitable for each client. Know how to assess what, when it will be used and how it will be used.
  • Do the clients know and understand boundaries? The clients need to understand how to navigate a VCM system. So, if you provide senior case management, your clients may not be the best clients to use VCM. Are your clients in a part of the city where internet is too expensive for them? Perhaps recommending a library to use the computer or VCM just may not be the best tool for them. You have to assess all insecurities, environments, etc.
  • How is the security? Is there compliance? Does your organization have policies in place? VCM can be a great asset to your organization. However, it can also make you vulnerable. We have all heard stories about large databases being hacked. Don’t become that statistic. Unfortunately, no matter how many securities and firewalls you have, it is not if but when you will have a breach. It is up to the organization to complete their due diligence and ensure they have managed the security status to the best of their ability and beyond. When discussing security, it is more than data encryption. It also involves usage of digital and internet-based communication resources by the case manager. Video conferencing needs to be private and have safety standards. Can a record of the conversation be kept in an encrypted client file?
  • Is your case management system robust and can it support VCM?

What are some systems that are included in VCM? Video conferencing tools such as Zoom, Microsoft Teams, etc. However, this may bring up questions regarding privacy and data security. Texting has become very popular, and again, there are concerns surrounding security. Using text messaging can assist the case manager in establishing boundaries to determine who they can talk to and interact with from a client’s point of view.

Digital documenting has become more popular. This helps to decrease a case manager’s workload, decrease use of real estate in terms of filing cabinets, etc.

As with any workflow, technology or new process, there could be issues and advantages of software. How accessible is the software and how easy is it to use? There will always be a need for human connection despite the increased use of technology and/or AI. Lastly, security. What is in place to decrease the chances of a breach?

In the end, healthcare is changing, evolving and if case management fails to evolve it may be left behind. Case management will always be necessary (this writers’ opinion), and VCM can assist the case manager to become more accessible to our clients and to become a better, more available client advocate.

REFERENCES

https://caseworthy.com/articles/virtual-case-management/#:∼:text=Virtual%20Case%20Management%20(VCM)%20is,case%20management%20services%20and%20programs.

https://www.virtuallatinos.com/find-talent/virtual-case-manager/

https://caseworthy.com/articles/best-practices-for-virtual-case-management/

https://shearwaterhealth.com/improving-healthcare-with-virtual-case-management/

sandra zawalski

Sandra Zawalski, MSN Ed, RN, CRRN, CCM, ABDA, MSCC, is a registered nurse with over 40 years of experience in a variety of clinical settings that include orthopedics, brain injury rehab, and neonatal intensive care. She has extensive experience in case management for payers and providers. Sandra holds a master of science in nursing with a focus on education, is a board-certified case manager through Commission for Case Manager Certification (CCMC), and is a designated ATD Master Trainer. She has published numerous articles in case management professional journals as well as a speaker at CMSA’s National Conference and CCMC’s New World Symposium. Sandra is a former commissioner for the CCMC. She currently serves as a principal clinical educator with MCG. Her spare time is spent exercising, reading and spending time with friends and family.

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