Measuring Client Outcomes with an Integrated Case Management System
by Diane Stanley-Horn
March 11, 2016
Like many human service organizations around the globe, you’ve likely witnessed the shift over the last decade or two from reporting on activities and outputs towards program and client-based outcomes measurement, client-centric care and results-based accountability.
Today, most of the organizations we speak with at Athena Software have some preferred client outcomes measures that they use, and may be working with or reporting to one or more stakeholders that use well-developed, sector-specific, outcomes-based frameworks.
Examples of the latter are numerous; to name a few, there’s:
- the Ministry of Social Development, New Zealand Outcomes Framework
- the Department of Human Services, Victoria, Australia Outcomes Framework, and
- the North Carolina Partnership for Children Inc. Smart Start
Although an ever-evolving, ever-improving and sometimes daunting field, the shift toward outcomes measurement has swept the globe, to the tremendous benefit of the wellbeing of the populations served.
Simultaneously, the last decade has seen a massive transformation within the human services sector from the use of record-keeping tools that include paper or the use of a range of disconnected systems, to the use of integrated applications and the electronic sharing of information between systems and stakeholders.
Selecting the best approach to measuring and achieving client outcomes and organizational or program performance goals can be challenging given the myriad of options, approaches, and perspectives.
One aspect of measurement and analysis that is clear is the value in capturing client outcomes within an information system that also measures inputs and activities, workflows and outputs, and that captures a wealth of both qualitative and quantitate data about your clients and the services you’re providing to the benefit of their wellbeing.
Some of the benefits of using an integrated system are straightforward. Staff are busy. They are focused on the wellbeing of their clients and managing their busy schedules and caseloads.
The thought of a training session on another technological system does not always create a buzz of excitement around the office.
Using an operational system that manages the vast majority of their day-to-day operational requirements not only reduces the number of systems they need to learn, it also makes the tool they are using more, well, useful.
Incorporating all of the information they need so that it’s right at their fingertips, and bringing embedded service practice tools and outcomes measures into their client files with workflows and alerts, scheduling, communications and service delivery tracking simply makes their lives easier when compared to using five different tools for five different tasks.
By having a single comprehensive client file, data redundancy is minimized and accuracy improved as well, while a single view of the client ensures that multiple programs are not presenting the clients the same questions and assessments unnecessarily.
With the introduction of any client outcomes measure, and perhaps moreso where an electronic record is used, staff may be concerned about the fact that the progress of their clients may reflect badly on them if results are viewed by other staff that may not have all of the information needed to interpret the results.
Using an integrated system with appropriate user profile access controls ensures that information is available on a need-to-know basis only.
More importantly, an integrated system can capture a wide range of information about the case complexity, environment, etc. that can help contextualize the outcomes appropriately, giving deeper insight into the results.
We all know that there are likely a range of factors and constraints that contribute to outcomes.
Capturing a more complete story about the client will assist staff and supervisors and help to separate the performance of the staff person, to which they are accountable, from the outcomes of their clients.
From an operational perspective, program and clinical managers and directors also achieve the benefits of having outcomes information at their fingertips to use in conjunction with case studies and information on case complexity and other data, while supporting their staff more effectively and responding to concerns quickly via integrated workflows and communications.
From an organization-wide perspective, there are also the additional benefits of reduced costs of IT infrastructure and increased operational efficiency.
Outcomes measurement per se can be costly and time-consuming.
Resources saved on data collection tools are better allocated to training and supporting staff on the use and reporting of the measures themselves and on analyzing and interpreting the data.
What gets me most excited about the use of an integrated case management system for measuring client outcomes is the opportunity for the continual enhancement of outcomes themselves through the integration with service delivery and organizational performance measurement, and through the improved ability to interpret and respond to the results.
Establishing the validity of outcomes with respect to attribution to the program or intervention is challenging, particularly in the human services world where so many factors can contribute to a client’s wellbeing or lack thereof.
Collecting and analyzing additional quantitative data that can point to other explanatory or causal factors, reviewing comprehensive case studies to gain deeper insight, tracking the practitioner’s and client’s opinions about the meaning of the data and reviewing the data in light of the activities and outputs of the service, all help to tell the story and understand why outcomes are or are not being achieved.
An integrated case management system with outcomes measurement capabilities should be able to provide insight into the service delivery-related factors that can affect change and also allow organizations to track milestones in service, when appropriate, that can help to inform where service may be most effective.
The long and continuous shift towards outcomes measurement in human services has had an impact on service delivery and also on the direction of development of the information systems used by organizations.
As perceived risks around user adoption, changing needs, security and privacy and long term organization-vendor partnerships are overcome in the human services sector, the technologies are trending towards deeper engagement with stakeholders at all levels, from funders to community support partners to the clients themselves.
The latter, in particular, will facilitate client-centric care in new and exciting ways and allow organizations to serve even greater numbers of clients than ever before.
The future is exciting.
Penelope case management system incorporates many tools for measuring, and ultimately improving, client outcomes.
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