Electronic Case Management Systems and Electronic Health Records (EHR)

Impact on Rehabilitation Programs

For those of us that have been around a long time, record keeping, and case management practices have changed dramatically.  I remember a time of large green and white computer paper with case management records printed from a dot-matrix printer, case notes created with a Dictaphone, and a secretary busily typing all day for multiple counselors and case managers. Our in-box waiting for signatures and our outbox waiting for filing became a thing of the past many years ago. Electronic case management systems have significantly changed how we serve our consumers and how we track performance for our various reporting agencies.

Vocational rehabilitation counseling, supported employment, and independent living are all driven by transforming the lives of people we serve. This is because the work is about pursuing quality employment (I have often described this as “cool jobs with benefits”) and living independently in the community. It is about choice for the person with a disability and the ability to control their future as they see it. Effective counselors, job coaches, employment specialists, and independent living specialists systematically assure choice, independence, and quality employment. High quality electronic case management systems are tools to improve their overall success and reflect a record for funding sources of the ongoing value of the services provided. Well-designed case management software tracks the services to the individual in an easily managed path and provides a comprehensive record of the program’s performance.  This reflects the success and value of the agency or community-based program. It also paints a picture of what has happened for the person served and for the program serving many individuals.

As a graduate counseling professor, I have taught several courses in case management. Students express a lot of concern about using case management software and spending too much time in front of the computer. My guidance to them has always been that case management software will make a giant difference for them and the people they serve. When the counselor becomes effective with the software, they manage their total caseload better, they organize the services to individual consumers better, and it provides an accurate reflection of how they serve their consumer and their community.

Vocational Rehabilitation Agencies

State/federal vocational rehabilitation programs began the move to electronic case management systems in the 1990s. Since the advent of the initial self-contained systems there has been a move to cloud based vocational rehabilitation case management software. The software has transformed the ability of state vocational rehabilitation agencies to document service(s) to consumers, maintain progress notes, manage individualized plans for employment, document training and employment, and track expenditures. It allows counselors to easily update plans and quickly adapt to the chosen path of the consumer. Digital tools not only streamline administrative tasks and case documentation but also significantly enhance the quality of care provided.

Quality case management software assists counselors with vocational and career assessment and helps counselors efficiently navigate career paths and training needs. These systems can streamline job training, resume development, work readiness support, and enhance overall employment outcomes. For the agency they provide a centralized platform for documenting pre-employment transition services (Pre-ETs). Effective vocational rehabilitation case management software helps monitor the effectiveness of the agency and provides quality analytics for decision making. These same systems allow for more efficient federal reporting (such as the RSA 911 report) and accurate response to the Rehabilitation Services Administration quarterly dashboards. The systems also meet federal standards for security.

Community Rehabilitation and Supported Employment Programs

Community rehabilitation programs (CRPs) are responsible for providing quality employment opportunities through supported employment and customized employment for people with the most significant disabilities. This makes them substantial partners with not only public vocational rehabilitation agencies but also with developmental disability agencies/Medicaid agencies and mental health/behavioral health agencies. CRPs range from very small providers in remote communities (only one or two employees) to agencies with more than 200 employees. Some serving in multiple states. They are vital partners in the vocational rehabilitation process. Recently CRPs have taken on additional key roles in Pre-ETs. This creates an essential need for effective case management software and/or web based electronic health records to provide services to their individual consumers and to provide required reporting to their partner agencies that serve as their primary funding sources.

Although there has been a trend among CRPs to use cloud based Electronic Health Records (EHR) software, many are still using more traditional systems. These include paper files, Excel record keeping and statistics, and online documentation from Google docs or other sources. This complicates their ability to capably manage services and provide employment services for their consumers. Of the more than 12,000 CRPs providing services to vocational rehabilitation agencies, fewer than half are using case management software. CRPs working with developmental disability/Medicaid agencies are using cloud based EHR software at a higher rate than those primarily serving state vocational rehabilitation agencies. The success of CRPs can be dramatically increased by selecting and successfully using vocational rehabilitation case management software or cloud based EHR software.

Several advantages can be seen for CRPs who move to web-based case management software. EHRs can improve job-coaching and support services by enabling better communication between all parties involved in supported employment. It can help them dynamically track employer and partner relationships. The use of cloud-based case management software allows for the collection and analysis of employment-related data, leading to more informed decision making. They optimize the use of resources by identifying the most effective interventions. Effective case management systems can reduce administrative burdens and free up time for direct consumer interaction. When staff are effective with case management software, they can give more personal time to the consumer and with their partner employers. They can help inform decisions about employment plans including employment selection, and when necessary, make changes in employment plans. Mobile systems allow job coaches and others to immediately record actions in the field without having to return to the office for reporting. Ultimately, they can assist with the consumer living independently, with obtaining the right employment, and promoting economic self-sufficiency.

Conclusion

Both web-based EHR software and electronic case management systems are pivotal in transforming vocational and community rehabilitation practices by providing structured, efficient, and client-centered services. They not only improve the workflow for providers but also significantly enhance the rehabilitation experience for clients, leading to better outcomes and increased independence. Tasks are streamlined, security is increased, reporting is improved, all leading to more efficient service delivery. By moving to web-based case management software, community rehabilitation programs can become more agile and responsive. They can use these systems to reflect their performance, improve consumer services, and exhibit the positive difference that they make. These systems can effectively transform services for CRPs, employment providers, and vocational rehabilitation agencies.