The writing for healthcare is on the wall!

CA is about to introduce budget cuts of close to $1 billion.  

Whereas it’s  easy to understand that budget cuts are necessary at this time, the obvious concern is whether the bureaucracy will be proportionately reduced along with program cuts or will we end up with a larger than ever bureaucracy to “manage” the downsizing.  

What’s going to happen to the 70 natural parks  in CA that are being closed?

And, to put a focus on this post, what’s going to happen to healthcare services?

CA, of course, is not unique, cutbacks have already taken place elsewhere across the country and are taking place, and the big question for healthcare agency administrators is “What are your plans for 2012 and beyond?” 

One option is to scale down to where wait times become ridiculous, where services have deteriorated to the point your agency can no longer provide even essential services and where morale for the few remaining employees is in the basement.

The great EHR Meaningful Use (MU) incentive program was well intentioned in its planning but the math was not right. You cannot expect providers to invest in technology that has a focus on long term outcomes data analysis but does next to nothing in the area of improving outcomes for individual patients.  The EU did a major study on the ROI of EMRs/EHRs and found that the payback period was much longer than most investors’ financial attention spans.  Could have/should have.

The jury is still out on MU but one thing clear is that “dressed up” twenty-year old billing systems are not going to increase staff efficiency, increase patient throughout, decrease admin/clinical errors or improve outcomes for individual patients.  What agencies need is software that allows them to “do more with less”.

One sign things make little sense in all of this is why have “case workers” using billing software for patient management instead of using Case Management software?  

If you would like to learn more about Adaptive Case Management for healthcare you are at the right place – check out some of the more than 70 posts on ACM and Fixing Healthcare at this blog.

I suppose the result of this post is going to be that 500 EHR systems will overnight become ‘Case Management Systems’. 

This is where buyer research comes in – when you need to go into the market, do your homework by first documenting your strategy. What is it you wish to gain in the way of benefits from EMR/EHR software?

Ask the vendor to show you an end-to-end demo that features one of your programs.  To make sure the demo is not rigged, tell the vendor at the start of the web demo that you want to run the demo yourself. If they say no, you might as well move on, if they say yes, the “test drive” will give you a level of comfort with the proposed software solution.

Above all, don’t lose sight of what seems obvious but may not be – you need a case management environment to do case management. 


Management consultant and process control engineer (MSc EE) with a focus on bridging the gap between operations and strategy in the areas of critical infrastructure protection, major crimes case management, healthcare services delivery, and b2b/b2c/b2d transactions. (C) 2010-2021 Karl Walter Keirstead, P. Eng. All rights reserved. The opinions expressed here are those of the author, and are not connected with Jay-Kell Technologies Inc, Civerex Systems Inc. (Canada), Civerex Systems Inc. (USA) or CvX Productions Number of accessing countries 2010-2020 : 168
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