Telephonic case management has the potential to allow targeted delivery of the right support, to the right people, at the right time.

It is intended as a complimentary approach to treating common musculoskeletal disorders and mental health conditions, alongside standard clinical healthcare.

Telephonic case management isn’t intended to replace face-to-face contact. Rather, it should be seen as a combination of triage, therapy, review and monitoring.

A recent UK report reviewed a large number of studies and found that the benefits of telephonic case management are strong but under-utilised. The reason for the lack of uptake of telephonic case management techniques is partly due to misconceptions about its role within case management as a whole.

“Telephonic contact has a dual role: to identify client’s needs and then signpost them to the right intervention at the right time,” explains the report. “A well-designed and delivered telephonic service can enable a substantial proportion of cases to entirely self-manage their health problem and work participation.”

The key positive outcomes using telephonic case management is to view the approach as a string to the case management bow. Use of telephonic case management needs to be well-designed, implemented and governed.

“The effectiveness of telephonic services in achieving positive work outcomes relies heavily on the training and skills of staff, and on the adoption of a strong work focus by all the key players, including support at the workplace.” Integration with existing case management processes is vital.

The report lists the ways telephonic case management can facilitate early return to work outcomes:

• Assessment: Identifying client needs and obstacles to return to work. This guides the RTW plan.
• Triage: A stepped-care model guides cases to the most appropriate rehabilitation pathway.
• Advice and information: Helping clients to build positive beliefs and expectations, and offering self-management advice.
• Case management: Telephonic case management offers advantages of speed and ease of access, reduced waiting times, optimised referrals to face-to-face interventions, and efficient use of resources. Using telephonic approaches can also significantly contain case management costs.

These are not new concepts to injury and RTW management. Integrating these steps helps facilitate a biopsychosocial approach to RTW. What is new is confirmation that RTW outcomes can be equally satisfactory via telephonic approaches.

One of the best features of telephonic case management approaches is the ability to avoid ‘over-medicalisation’ of cases. That is, taking psychosocial factors of cases and injuries into account, and dealing with them before they worsen – where possible.

What kind of activities can be conducted over the phone?

The report lists examples of activities that telephonic case managers can engage in:

• Telephonic triage. Traditionally, triage is a term referring to determining the priority of patients' treatments based on the severity, urgency and complexity of their condition. In a case management sense, triage is the process of evaluating progress of cases, and potential obstacles
• Easing the access of clients to necessary services.
• Facilitating client access to the appropriate level of care, healthcare providers and services
• Intervening in a timely manner and sharing real-time information
• Empowering clients/family/employers to assume responsibility for self-care and health management
• Identifying client health risk and instituting appropriate action or referral for services
• Engaging in cost reduction activities by promoting access to health services that are appropriate to the client’s condition, e.g. by preventing provision of care that is not warranted
• Following-up clients to ensure safety and adherence to a rehabilitation plan
• Coordinating and integrating services using evidence-based algorithms, protocols or guidelines, that include decision trees based on certain criteria or assessment cues/data
• Assessing and evaluating the client’s condition over the telephone, identifying problems and directing appropriate action. Assessment is guided by the relevant protocol and, depending on the findings, the case manager determines the urgency of the situation and decides on the necessary type of intervention or advice
• Answering questions and providing health advice

Telephonic case management can have even better outcomes than some traditional face-to-face methods if implemented and managed correctly. The research has found telephonic approaches are associated with high levels of satisfaction, which can exceed face-to-face approaches.

The report concludes that telephonic case management approaches that are well-designed and well-implemented can reduce the number of sickness episodes, lost days, the uptake of unnecessary healthcare, and the cost of a case/claim.