Physician's Guide (eBook)

Roger G. Kathol, MDAdjunct Professor, University of MinnesotaPresident, Cartesian Solutions, Inc.™Chief Medical Officer/Physician Board Advisor, Case Management Society of AmericaBurnsville, MN, USA  Katherine Hobbs Knutson, MD, MPHMedical Instructor, Department of Psychiatry and Behavioral Sciences, Duke University School of MedicineDurham, NC, USA Peter J. Dehnel, MDMedical Director for Case Management and Utilization ManagementBlue Cross Blue Shield of MinnesotaEdina, MN, USA

ForewordPrefaceAcknowledgmentsI. Overview of Case Management, Health Complexity, and the Integrated Case Management Approach1. Patient Health Care Assist and Support Services, Integrated Case Management, and Complexity Assessment Grids2. Health Complexity and the Interaction Between Physical and Behavioral Health Conditions in Adults 3. Health Complexity and the Interaction Between Physical and Behavioral Health Conditions in Children and Youth 4. The Organizational and Operational Setup of Adult Integrated Complex Case Management5. The Organizational and Operational Setup of Pediatric Integrated Complex Case Management6. Indirect and Direct Physician Support for Integrated Case Management in Adults7. Indirect and Direct Physician Support for Integrated Case Management in Children/YouthII. Guidelines for Physicians Working to Maximize Patient Outcomes in Collaboration with Integrated Case Managers8. Organizing and Implementing Value-Added Integrated Case Management9. Connecting Integrated Case Management with Integrated Complex Inpatient and Outpatient Care10. Physicians’ Contributions to Building and Participating in a Population-Based Case Management Center of ExcellenceIII. AppendicesAppendix 1. Integrated Case Management (ICM) Algorithmic Triage StrategiesAppendix 2. Adult Integrated Case Management-Complexity Assessment Grid (ICM-CAG) Variables and their Clinical Anchor PointsAppendix 3. Scripted Dialogue for AdultsAppendix 4. Elina’s ICM-CAG Assessment StoryAppendix 5. Scripted Dialogue for Children/Youth and Parents/CaregiversAppendix 6. Care Plan Development SheetAppendix 7. Measurement of Progress: Goals, Actions, OutcomesAppendix 8. Pediatric Record for Outcome Measurement (ROM)Appendix 9. Pediatric ICM-CAG Variables and AnchorsAppendix 10. Pediatric ICM-CAG Item Anchor Point ActionsAppendix 11. Understanding “Complexity Assessments” for Youth and Families Helped by Case ManagementAppendix 12. Understanding “Complexity Assessments” for Clinicians with Youth in Case ManagementAppendix 13. Notification Letter to Patient’s Clinician(s)Appendix 14. Universal Consent FormAppendix 15. Adult ICM-CAG Item Anchor Point ActionsAppendix 16. Understanding “Complexity Assessments” for Persons Entering Case Management Appendix 17. Understanding “Complexity Assessments” for Clinicians with Patients in Case ManagementAppendix 18. Barriers to AdherenceAppendix 19. Adult Record for Outcome Measurement (ROM)Appendix 20. Core ICM PrinciplesAppendix 21. Core ICM Practices Needed to Implement the full ICM ComponentsAbbreviationsGlossary of TermsIndex