Case Management Workflow

Benefits of Case Management System in Healthcare


The top priority of every healthcare service provider is to care for patients. However, this involves a lot of mundane work—scheduling, paperwork, billing, and other planned and unplanned activities. The efficiency and quality of healthcare service delivered to patients are dependent on these processes and how efficient they are.

What is Case Management in Healthcare?

Over time, healthcare providers have been leveraging technology to simplify these processes and make them more efficient. Technology has drastically improved certain functions such as registering and maintaining patient information, managing prescriptions, tracking diagnoses, and monitoring the overall patient lifecycle process of interacting with patients in clinical settings.

While some case management systems focus on general healthcare and patient lifecycle management, others are designed specifically for the handling of complex cases in healthcare settings. These automated case management tools assist caseworkers to tackle complex patient-related queries, incidents, and claims at healthcare environments such as hospitals, care homes, and health insurance centres.

What is the role of a Case Manager in a Healthcare Organization?

The exact role of a case manager in the healthcare industry depends mainly on the functional area they serve. For instance, a healthcare caseworker in a hospital is responsible for ensuring that patients get the necessary medical treatment they need while they are in the hospital and continual therapy after they leave. They may deal with scheduling hospital visits, escalating cases for appropriate treatment or further tests, and ensuring patients’ records, diagnoses, and prescriptions are appropriately managed.

This is different from the role of a health insurance case worker whose job is to ensure that the best quality medical care is made available to patients in the most economical way possible. The health insurance case manager would be responsible to liaise with healthcare providers, physicians, and with the patient themselves to ensure parity and manage their coverage claim as efficiently as possible.

In either case, both case managers are responsible for assessing the needs of the patients and ensuring they get access to the services and resources they need. However, the cases they are likely to encounter, and the processes for solving them will be different. Both situations may involve potentially complex cases that must be organized and properly handled for optimal results.

Benefits of Case Management In The Healthcare Industry

Modern automated case management solutions are designed to handle the numerous needs of the healthcare case management process and ease the burden of case managers. Employing software that automates case management is a step in the right direction in a bid to improve healthcare service delivery for any medical practice.

Here are some of the benefits of automating case management in the healthcare industry:

Keeping patients informed

Most automated case management tools are designed to allow knowledge workers to seamlessly interact with patients through various channels. Case management software also makes it easier to access patient profiles which contain relevant information such as histories, test results, and diagnoses that may be needed to create a holistic patient experience.

Urgent approvals

Some patient requests are simple and straightforward. Others are more complicated and will require several approvals before they can be carried out. A major surgical operation for instance may require multiple levels of approvals and authorizations not just within the hospital but also with external parties such as health insurance providers. Without using an automated system, such approvals might take a lot of time. This may delay patient care and hinder case resolution. Automated case management software will make it possible to pass these approval requests along with faster to avoid delays and bottlenecks in the healthcare delivery process.

Quick escalations

An automated case management solution promotes faster and more efficient case escalations. When patients have complaints or are dissatisfied by the way the appointed case manager is handling their issues, they can request to have the case handled by another service professional or higher up. The centralized database that an automated case manager provides makes it possible to simply pass along patient data to the managers or higher-ups to take charge of the incident and attempt service recovery.

Dynamic case management puts users in control

Seamless collaboration between departments

Inter-departmental collaboration is an absolute necessity in the healthcare sector. Case management software makes it possible to seamlessly refer and transfer patients from one department to another. An efficient platform may also make it easier to grant healthcare providers access to information such as their medical history, or billing information.

Streamlined operation for quicker resolution

An automated case management software greatly streamlines administrative tasks involved in healthcare service delivery. On the one hand, this will make it easier to resolve cases quickly and more efficiently. And on the other hand, it also eases the burden on medical staff by streamlining administrative duties while allowing them to focus better on delivering the best care to patients. Simplifying the process this way also improves accuracy and ensures caseworkers make fewer errors. This can make a world of difference in a healthcare case management setting.

Security of sensitive patient data

Automated case management tools provide a centralized location for sensitive patient-related data. This may include their contact information, notes about the case, appointment history, scheduling, billing, claims, etc,.

With an automated case management solution, caseworkers and other stakeholders can store, access, track, and amend this information in a safe and secure manner. Caseworkers can also seamlessly transmit required pieces of information digitally for doctors and other healthcare providers to access remotely and across devices. A dynamic case management solution also ensures role-based access—only authorized personnel are allowed to access and operate data.


In recent years, automated healthcare case management software has been helping caseworkers set new standards of excellence in the healthcare industry. A versatile tool has a range of helpful features that facilitate better service delivery, increase the efficiency of processes and overall operational effectiveness of case management in a healthcare or insurance setting.

Kissflow Workflow is a case management platform specifically designed to handle multiple use cases. It can be easily customized and configured to suit the needs of your practice without having to employ product experts or the need to learn how to code. Learn more about how you can improve case management in your organization today. Try Kissflow for free.
Kissflow Workflow - Case Management Software