Communication in the Evolving World of Case Management
| Autor: | Sharon M. Keigher |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
Male Social Work Health (social science) Health Services for the Aged Cost-Benefit Analysis media_common.quotation_subject HIV Infections Resource (project management) Health care Humans Aged media_common Acquired Immunodeficiency Syndrome Government Primary Health Care Social work Computers business.industry Communication Research Managed Care Programs Middle Aged Public relations Outreach Chronic Disease Utilization Review Managed care Female The Internet business Psychology Case Management Welfare |
| Zdroj: | Health & Social Work. 25:227-231 |
| ISSN: | 1545-6854 0360-7283 |
| DOI: | 10.1093/hsw/25.4.227 |
| Popis: | Social workers are constantly confronted with new problems, usually while they are still developing skills and capacities to respond to the preceding one. Sometimes the technologies required are too much, so that both crises and opportunities fly at practitioners so fast it is difficult to tell which is which. Take, for example, the formerly "simple" act of "communicating" Few of the modalities available for communicating today existed 25 years ago when this journal was founded. Now communicating requires voice mail (because no one is ever in), computers, modems, DSL, Internet, PowerPoint, streaming video, and dozens of things I don't understand like instant messaging, videoconferencing, Web phones, and wireless communications. One should be dexterous with pagers, cell phones, Palm Pilots, and laptops, sometimes all at once. And oh, yes, don't forget to upgrade your software each time you log on. It's not even simple to select a long distance carrier! Nearly everyone (except boys under 16) feels ill-equipped for the technological requirements of "simple communication" these days, especially academics who are more afraid of admitting it than almost anyone. Whatever happened to old-fashioned reading and face-to-face talk? Now compound this personal pressure with the one on agencies to adopt new record keeping systems, database management and retrieval, assessment instruments, evaluations of practices, and innovative programs. Increasingly comprehensive evaluations are needed, requiring ever-bigger data sets, as well as insight-rich descriptive, qualitative analyses clarifying micro-, mezzo-, and macro-processes and phenomena that most clinicians have barely noticed yet. Nothing in the design of interventions, how they are critiqued, how data are managed, or in how systems are turned around, is cheap or simple anymore. Recent developments in case management exemplify some of these communication challenges to social work practice, albeit on a more conceptual level. Some social workers claim case management is really nothing new; that we have been doing it since Mary Richmond's time. But the processes and requirements of managed care organizations have so befuddled some social workers that they believe the "science" of case management is beyond them. Others have become so obsessed with data, computers, and performance indicators that they have forgotten the patients the systems were designed to help. Case management, and its twisted sister, managed care, are terms now applied indiscriminately to fields as dissimilar as probation management, public assistance, and child welfare, along with mental health and home care. Case management has become a ubiquitous representation of the postindustrial information age. In 25 years someone surely will look back and label today the "Case Management Period." THE GREAT CASE MANAGEMENT TRANSFORMATION Two major transformations have made case management today a qualitatively different entity than it was a quarter century ago. The first is that the importance of case management has been elevated significantly since it was colonized by corporate medicine in the 1980s and 1990s. This recognition was absent in 1975, and certainly in 1910, when social workers were doing case finding (outreach), performing social diagnosis (assessment), planning service or treatment; making referrals (linking); ensuring follow-up care (monitoring); and obtaining financial assistance (advocacy). This enhanced attitude toward the importance and efficacy of case management is directly related to changes in health care reimbursement that emphasize cost containment. Fee-for-service reimbursement by both government and other third parties in the post--World War II period generally covered full costs, creating a slack resource environment and a relatively unpressured task environment for health care providers. Social workers and other h ealth care practitioners advocated freely for services to improve the health and rehabilitation of patients who had the means or insurance to cover it. … |
| Databáze: | OpenAIRE |
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