Case Management Focus: Using 'Back Channels' to Improve Care Coordination, Transitions of Care

Sarasota, FL (WorkersCompensation.com) -- On a workers' compensation support group recently, a colleague suggested a good doctor for someone to use but advised they might have to use ‘Back Channels’ to get the injured worker seen promptly as the doctor was very busy and the wait to get an appointment could be several months.  

Many in the support group wanted to know what he meant by a ‘Back Channel' and how to use them in their practice.  

In this post, I wanted to explain what 'Back channels' are and how case managers can use them efficiently and effectively in their roles.

According to Merriam-Webster’s Dictionary, a ‘Back Channel’, is a secret, unofficial, or irregular means of communication.

A 'Back Channel’ is a way to reach a person who is hard to get hold of or the office is very busy, so long waits can occur for appointments. In my role, I research to find the best contacts at a hospital, doctor’s office or other providers who can help me move through the red tape and get the resources or consults to meet my patient's needs. 

Here are some tips that I have learned over the years about ‘Back Channels’ and how they help me do my job better

Networking is an essential tool that helps me do my job. Attending national and local conferences is crucial to meet professionals with the products and services needed to meet our clients’ needs.  

When I go to a conference, I usually look over the attendee and exhibitor list to know who will be there and mark down who I want to meet. I typically start a conversation and build relationships with key people within the organization. I get their contact information and ask if I call them if I need to have a person seen in an expedited manner. If I use them to expedite care, I always follow up with a note to thank them for their help.  

Some offices that do workers' compensation work have designated people who work with adjustors and case managers to ensure streamlined communication. This type of team allows you to call if you have a question about the plan of care and offer alternatives if needed. They may also help you avoid a delayed appointment for an injured worker. If they don't have a dedicated team to work on workers' compensation cases, I meet the office manager and let them know who I am and my role as a case manager. Doing this has helped me cut through answering services and challenging front desk staff.  

For hospitalized patients, I gather contacts I may need to communicate with if I have an injured worker hospitalized. I usually start with the hospital case manager and let them know I am the contact for discharge planning, any referrals, or DME equipment or supplies the patient may need. I also meet the hospitalist and any consultants that may occur while the patient is in the hospital. I keep the adjustor, the employer, and the family updated regarding the plan of care and discharge needs. Care coordination and smooth care transitions are the goals so working with the entire team is essential.  

If I need to go higher than the case manager, I also meet with the charge nurse on the floor and the organization's risk manager/quality person. My goal is to ensure care is coordinated and that the injured worker gets the care they need to address their injuries. Often, they need to be used to the worker's compensation system, and working closely with the hospital team can streamline the process.  

Durable Medical Equipment, outpatient services, and community resources are also crucial in meeting my patient's needs as a workers' compensation case manager. I work with the adjustor to find vendors in the managed care network. I can also suggest resources as needed. If I come across a resource I need but don't know, I contact colleagues who might have had a case where they needed the same resources. Sharing information with colleagues is a critical way to learn, network, and do the research it takes to meet the needs of my patients. 

The key reason for using ‘Back Channels' is to have the contacts that help me do my job as a workers' compensation case manager efficiently and effectively. 

I am always courteous and advocate for injured workers to ensure they get the care they need, when they need it, in the least restrictive environment and for the most cost-effective price. 

Let me know how you have used 'back channel's to improve your work as a case manager!

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