A nurse case manager’s primary duty is to document patient data while assisting with clinical management and defending from negligence. Nurse case managers use medical records on a daily basis to inform their colleagues of the patient status and their healthcare needs. This is most commonly known as medical data management.

What is the role of a Nurse Case Manager?

A nurse case manager assesses and coordinates patients' long-term health alongside other healthcare professionals. Their responsibility is to update patient care plans while consulting with the patients to ensure optimal care is delivered. Nurse case managers also foster relationships with patients’ families to educate and advise on their loved one’s care plans. Their duties include:

• Completing new patient evaluations to determine healthcare needs and provide community services.
• Updating and revising medical records in adherence to patients’ ongoing care.
• Educating patients and their families on options available for their healthcare.
• Listening to their colleagues and implementing specific doctor or nurse orders.
• Reviewing medical test results and allocating information to their patient’s medical records.
• Monitoring patients for symptoms while performing diagnostic treatment procedures.
• Collaborating with insurance companies to ensure patients receive the most cost-effective care available.

How do medical records impact a Nurse Case Manager?

Nurse case managers establish, edit, and organize medical records for several patients per day. Due to legal concerns, it is imperative that they keep track of all treatments, including whether the patient went through with the procedure or not. In the event that the treatment does not occur due to the individual not being compliant, or there is an inability to contact them, this must also be documented in the medical record to prove the nurse case manager complied with legal and ethical responsibilities.

It is important to maintain citizen medical records as under the regulations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), individuals have the right to access and obtain a copy of their health information while maintaining the privacy and security of this data. Ensuring this information is up-to-date and thoroughly documented prevents health organizations from being liable due to inconsistent patient care. As long as these records are accurate, patients cannot take legal action if they refuse treatment and their symptoms worsen.

How Wisedocs streamlines the use of medical records for Nurse Case Managers

As the medical industry moves forward in technological advancements, electronic health records (EHR) have given nurse case managers the ability to do their job more efficiently through database healthcare. The use of bedside terminals and central station desktops saved nurses approximately 25% of time spent documenting during a shift. Wisedocs is an integral part of processing complex medical documents for nurse case managers. Our intelligent features make our cognitive document processing platform industry-leading. We leverage proprietary Intelligent Optical Character Recognition (ICR) to make unstructured documents in medical records searchable, thus improving overall document workflow, and saving nurse case managers valuable time. Wisedocs’ proprietary artificial intelligence technology allows handwritten documents like discharge notes, medical records, and after-visit summaries to be translated into digital for easy searchability.

Previous healthcare organizations that implemented Wisedocs’ artificial intelligence platform for medical record reviews and documentation automated 90% of repetitive work. If you are a nurse case manager or healthcare professional, get in touch with our team for a demo.