Definition – What is Case Management?

There are dozens of definitions that try to pin down exactly what case management is. Often, they come from the legal and medical professions – but case management can be used as an approach to any non-routine process. Still as clear as mud? Let’s try to formulate a simple definition. Then, we’ll take a closer look at how case management works in practice.

What is Case Management?

Case management is a process that strives to achieve a specific objective by handling cases from beginning to end under the coordination of a case manager. This can involve a number of different teams, as well as a variety of processes.

To understand this better, let’s look at the medical and legal professions and how they use case management. We’re accustomed to talking about “cases” in this context. “The lawyer (or doctor) is handling my case,” we say – but just how is he or she doing that?

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How Cases Differ from Standard Processes

From the moment we approach legal or medical professionals, they keep records (case history) of every step they take on our behalf, and every interaction they have with us. In the medical profession, the doctor acts as our case manager, referring us to specialists or sending us for medical tests and treatments. The aim is to make us well, and although some cases are fairly routine, almost all of them will have at least some unique characteristics.

When a doctor first sees a patient, he or she won’t know exactly what should be done to reach the objective of wellness. The first step is to examine the patient and record the result. Now, the doctor looks at the patient’s medical history.

Using the unique information that these two steps bring to light, the doctor now decides what to do next. Should treatment commence immediately, or should the patient go for tests? Perhaps the doctor will want to refer the patient to a specialist or even to a hospital. But referring a patient doesn’t take the doctor out of the drivers’ seat: he or she is still the case manager.

Returning to the doctor’s surgery, the next patient walks in. Like the previous one, the patient wants to be well – but even if the symptoms are almost identical to those of another patient, the doctor will consider the case individually and may prescribe a completely different course of action.

How is Case Management Used in Other Professions and Industries?

You may not be a doctor, but you can still use the case management approach in certain situations. The characteristics of a scenario that requires this approach are as follows:

  • There is a defined goal.
  • The exact course of action to follow is unclear.
  • All the information that is gathered along the way may be relevant, regardless of how near or far the case manager is from the eventual goal.
  • A case manager must coordinate information and outcomes, often from several sources.
  • The case manager may need to access resources that are not at his or her disposal.
  • Human judgment is needed to decide between possible courses of action.
  • New information or circumstances may alter or influence the chosen course of action, bringing about the need for reassessment.

If we look at these characteristics of a case, we can begin to see how almost any industry could find it the most effective way to handle certain situations.

Unpredictability is the Key

Let’s use the simple doctor’s surgery example again. Our doctor sees five patients. All five say they have a stomach ache. But the doctor can’t just start prescribing medicine indiscriminately. And even when two or more patients have exactly the same condition, they may react differently to the treatments they’re given.

That means the doctor has to consider available information and be alert to new information as he or she handles the case. A process that was initiated at the outset may need to be halted or altered, new processes may need to be initiated, and the case manager must make several judgment calls along the way.

When a business embarks on a new project that falls outside of routine activities, case management provides a holistic, flexible framework for handling it. The case manager keeps tabs on everything from beginning to end, carefully adjusting the course of action on an as-needed basis. He or she uses the historical and new information to handle an unpredictable or non-routine situation and uses judgment to determine the way forward.

 

When is Case Management Most Applicable to Businesses?

As we’ve already seen, any process that has unpredictable variables provides fruitful ground for a case management approach. Each business and industry will have specific examples of processes that require this degree of flexibility, but one can usually count on the human element to introduce it.

Thus, HR and customer relationship management (CRM) would be great examples of situations in which case management applies. Let’s say your employee has been absent from work without notification for a week. The routine response would be to dismiss the employee, but what if you find that she has been unexpectedly hospitalized?

Here’s another simple example: a customer wants your product or service, but has asked for specific modifications to the way you usually work. If you then proceed as usual, you’re going to end up with an unhappy customer. Can you comply with the request? How would it alter your usual approach?

More complex examples could include the development of a new product or service. At the outset, you know what you want to achieve, but you’re exploring new ground, and you need to be responsive to real-world conditions. You’re receiving information from your tech team, market researchers, and major clients. At any point, this information could lead to a situation that requires you to adopt a new approach.

Complexity: A Drawback of Case Management Can be Overcome

Case management has very clear advantages. In particular, it allows for variation in processes depending on the available information. It becomes possible to achieve the desired outcome despite a large number of variables – but the sheer complexity of the information to be taken into account can mean that a crucial point is overlooked. There can be a lot of players to coordinate, too.

Case management, however, doesn’t have to be all that complicated. The right software can help orgnize information, analyze data, as well as coordinate tasks and to-dos. Learn how by scheduling a free consultation.

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