Now that you know what is Case Management and how do you know if you need a Case Management solution (part I of this article), let’s see Case Management in Action! By definition, Case Management is best applied across four types of work: process to decision, service requests, incident management, and investigations. What are the characteristics and components of these types of work? What are some use case examples? And, how can Case Management technology and professional services help you succeed?
Let’s dive into each of the four types of case work a little more deeply so you have a better understanding of how Case Management is applied in different circumstances.
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Process to decision
What is it?
- Case types that rely heavily on structured rules and processes to coordinate case work.
- Solutions that focus on driving to a specific decision with a high degree of context and known policies and procedures.
- Solutions with fluid change of rules, policies and procedures to ensure cases are in compliance with known rules and regulations.
What are some examples?
- Regulatory Compliance (e.g., federal compliance, government regulations, etc.)
- Ensures organizations are handling cases to remain compliant with laws, policies and procedures.
- Measures compliance of case handling.
- Allows for flexibility of rules and processes to adapt to regulation changes.
- Routine Patient Care (e.g., exams, immunization shots, etc.)
- Instruct healthcare workers on implementation of routine health care.
- Measure patient outcomes.
- Adjust procedures based on medical expert input.
- Pharmacovigilance (e.g., life sciences, pharmaceutical product management, etc.)
- Detailed tracking and reporting of outcomes.
- Measurement of aggregate outcomes to impact future design.
- Meet regulatory requirements for product offerings.
What are the characteristics of this type of case work?
- Informed decisions depend on completing a set known rules and processes.
- Follows a predictable, reliable path.
- Requires flexibility to evolve policies and procedures over time.
How can Case Management software and professional services make this type of work more effective?
- Creating a single view of all tasks, actions, data, files, collaborations, and history.
- Allowing business rules to provide the required structure, as well as flexibility when needed.
- Flexibility of control on how cases are handled with rules and processes that may be easily changed over time.
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Service requests
What is it?
- Service request case work revolves around making a decision on any particular type of service.
- This could be an approval cycle, proactive maintenance across large fleets, geographies, etc., or even complex customer service interactions requiring conformance to service level agreements.
- Service request case work takes into consideration contractual obligations and ensures cases meet those obligations.
What are some examples?
- Claims Management (e.g., insurance claims fulfillment, etc.)
- Fulfillment of complex claims.
- Many pieces of information to collect and consider.
- Ensure compliance with insurance contracts.
- Ongoing Maintenance (e.g., wind power, oil drilling, fleet management, check-in/check-out etc.)
- Maintain complex, large-scale assets, potentially across broad geographies.
- Identify issues and potential issues to be addressed proactively.
- Warranty fulfillment.
- Customer Service (e.g., customer issues, customer retention, etc.)
- Manage the lifecycle of activities to address customer requests.
- Navigate customer issues that require many steps be taken to rectify.
- Manage long-term customer relationships across populations.
What are the characteristics or components of this type of case work?
- Relatively high degree of structure.
- Limited understanding of context, especially at the beginning.
- Evolving (and sometimes escalating) stakes.
How can Case Management software make this type of work more effective?
- Instant access to complete, current information speeds the decision process .
- Alerts keep stakeholders always in-the-know.
- Mobility equalizes ability of office and field workers to accomplish necessary tasks.
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Incident management
What is it?
- The process of identifying and resolving unfavorable incidents.
- A largely proactive approach, but can be reactive.
- Mitigates organizational risk.
What are some examples?
- Facility Management (e.g., airport security, stadium operations, etc.)
- Identify potential issues.
- Automate steps to proactively address issues.
- Maintain comprehensive records and measures for risk mitigation.
- Emergency Response (e.g., first responders, hazard response, etc.)
- Engage field workers on incidents with mobile devices.
- Leverage automated Internet of Things (IoT) notifications.
- Quickly route incident responders for fast resolution.
- HR Grievances (e.g., equal employment opportunity, workplace dispute management, etc.)
- Guarantee all incidents are handled according to policies and procedures.
- Apply rules and regulations equally across cases.
- Resolve disputes, measure outcomes and improve future incident handling.
What are the characteristics or components of this type of case work?
- High-level process in place.
- Requires flexibility.
- Relies on cross-team or cross-organization collaboration.
- Mobile and on the field engagement.
How can Case Management software and professional services make this type of work more effective?
- Automatic, repeatable process and business rules drive a consistent approach to similar types of incidents.
- Social collaboration in the context of the case provides transparency and speeds contextual action.
- Audit trails provide the history of all content, process events, and collaborations in the context of the case.
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Investigations
What is it?
- Investigations are often a reaction to a specific event or circumstance.
- Investigations involve collecting and processing evidence to come to an informed decision.
- They depend on capturing and accessing of complete information from multiple documents, research, interactions, perspectives, etc.
What are some examples?
- Accident investigation (e.g., insurance claims, medical malpractice, etc.)
- Gather information.
- Determine cause.
- Analyze results and change future behavior.
- Legal investigation (e.g., financial, regulatory compliance, employment etc.)
- Analyze less clear areas of rules and regulations.
- Collaborate with experts.
- Recommend changes to rules.
- New Product Development (e.g., financial, manufacturing, retail, campaign, etc.)
- Measure potential growth of new product offerings.
- Analyze and collaborate on data.
- Measure execution towards business goals.
What are the characteristics or components of this type of case work?
- Takes place over a large amount of time.
- Little structured process. Context that must be built from across many variables.
- Dynamic business goals.
How can Case Management software and professional services make this type of work more effective?
- Convergence of all case information, including data and processes, in a single location.
- Fast, simple access to the complete, contextual picture speeds informed decisions.
- Case analytics provide key performance indicators and metrics.
… to be continued … don’t miss the next article “The non-negotiable characteristics of a Case Management solution to help you work better, save better, serve better, and decide better”.
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