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Case management that supports care

Strengthen the quality of care and care transitions

The transfer of health information is instrumental in a patient’s care journey. Case managers, clinicians and other end-users need access to quality content in a timely manner to support patient safety in the hospital and beyond.

A clinically driven revenue cycle connects clinical and financial information, allowing case management teams to proactively manage readmission rates, avoidable days and retrospective denials. Cerner embeds third-party collaborators within our case management software to help automate workflows. When case management is powered by a clinically driven revenue cycle, data is aggregated within the physician record. This saves clinical staff from spending time on disparate or duplicative entries and helps enable smooth care transitions.


Features


 Utilization management  icon

Utilization management

Manage a patient’s length of stay with utilization management. With InterQual® AutoReview, medical review automation is made possible through Change Healthcare, our embedded collaborator. Robotic processes help create the initial medical review when an admission order is entered and help lower staff time spent on manual chart review activities.

Our utilization management workflow enables you to:

  • Manage resource utilization and assist in care coordination by sorting the patient list according to the desired workflow
  • Forward a request for a secondary review with the physician advisor from within the workflow
  • Share completed review and parts of the medical record with the payer for authorization approval
  • Compare the working review Diagnosis Related Group (DRG) with the possible review to justify a more specific diagnosis grouping



 Care transition planning icon

Care transition planning

Automate the search for appropriate and available care transitions. With our care transition planning tools, match patients with appropriate post-acute care based on key clinical and secondary services and quality ratings.

Our care transition planning workflow enables you to:

  • Perform post-acute care coordination activities in the same medical record as the provider and prevent network leakage to facilitate consistent patient discharge to high-quality downstream providers
  • Designate informed patient choice and view patient's post-acute choices in workflow
  • Electronically track and communicate with post-acute placement facilities, allowing staff to focus on other referral management strategies
  • Gain insight into the efficiency of hospital teams and external providers with proactive reporting capabilities

When searching for available and appropriate post-acute care, our tools like Ensocare and naviHealth can help automate the care transition planning workflow. These collaborations allow care transition planners to electronically search for matching providers and share patient information to help prevent toggling back and forth between the EHR and stand-alone care transitioning platform to document information.





FAQs

Which venues does acute case management support?

Cerner Acute Case Management can add value to any Cerner PowerChart® client including general short stay acute hospitals and health systems, children’s hospitals, rehabilitation hospitals, critical access hospitals, and behavioral health and development facilities in the long-term and post-acute care (LTPAC) venues using Cerner PowerChart® as well.

Extending  Cerner Acute Case Management  to the post-acute space builds upon what is already available as a product and can be licensed now for use in other venues of care. We are constantly evaluating use cases for any venue that is capturing medical necessity criteria and care transitions for the benefit of the care giver and the safety of the people in the community*.

* All solutions/services under development. Cerner makes no assurances that the capability described herein will be provided in the solution/services.

Acute case management is aligned with case managers, utilization nurses, documentation specialists, discharge or care transitions planners, social workers and other clinical roles supporting readmission prevention, denials and appeals, and multidisciplinary teams focused on utilization, length of stay and care transition planning.

For utilization management, clients can choose to use either InterQual® or MCG Health medical review guidelines within Cerner Acute Case Management. Medical Review guidelines are not sold on Cerner paper. Clients will need a separate license with InterQual® or MCG Health prior to embedding content and launching the third-party applications within Cerner Acute Case Management.

For care transition planning, Cerner Acute Case Management has invested in embedding naviHealth's nH Discharge and Ensocare Transition to support care transitions for patients discharged from acute care and needing post-acute care placement and services. Cerner resells the post-acute care transitions (naviHealth's nH Discharge) and post-acute referrals (Ensocare Transition) solution integration and support.

Revenue cycle management offerings