Why Patient Complexity Matters?

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Today, the practice in medicine is to develop standardized evidence-based treatment plans for patients. That is good science and seems efficient.

But, unfortunately, the one size fits all solutions don’t always work. This is because some patients are much more complex than others.

If complexity is not factored into the design of the treatment plan, then outcomes can be varied and suboptimal and disappointing.

That is why patient complexity matters.

Our message is that Jack and Jill need tailored and personalized treatment plans and not the same plan in order to get the best possible outcomes.

Here’s how it works at Rupert Case Management (RCM).

We measure each patient’s level of complexity using our own homemade coefficient of complexity. We know it is scientific because our actuarial consultant encouraged us to use a square root in the formula (LOL).

When we develop a treatment plan it must factor in the various elements that comprise complexity.  These factors range from the quality of an individual’s drug benefit plan to cover the costs of expensive specialty drugs to the medical literacy of the family members who are advocating for the patient.

Our job as medical case managers is to manage all the details. It is at this level of granularity that you start to understand complexity. Writing a prescription for a specialty drug and wishing the patient well is only the first of over 30 steps in delivering a quality outcome. And the quality of the outcome is what really matters!

Our case managers and associates at Rupert Case Management partner with our clients and their families to ensure that all the details of their complex problems are well managed and that the patient’s objectives are (hopefully) met.