Case management can mean a lot of different things, depending on the industry you’re working in. A case could be seeing a patient for a doctor, a legal proceeding for a lawyer, a customer request for a customer service team, an investigation for a corporate management team—we could go on and on. The bottom line is that case management is a way of working where activities are done around a central object to get to a specific outcome—a doctor addresses a patient’s condition with a treatment protocol, a lawyer cites evidence and precedent to ensure justice is served, a team solves a customer's problem by delivering the necessary services or goods, or an organization avoids risk by discovering the source of the threat and executing a plan to prevent it.
Because case work is so broad, it’s easier to understand if we break it down into four different types. Think of case management work on a continuum varying from more to less structured:
Process to decision.
Process-to-decision case work relies heavily on structured rules and processes. This type of case work is rigid, but it occurs on an ad hoc basis. Take a patient care case, for example. Each day medical providers have people come to see them for check ups, sudden illness, injury, or other concerns. The ad hoc nature of these appointments makes this work case management. But even though the cadence of the work is ad hoc, medical teams must follow specific procedures for each patient to ensure proper care and compliance with regulations. Since this work occurs ad hoc but the processes are rigidly defined, we thus categorize it as process-to-decision case work.
Examples of process-to-decision case work include:
- Regulatory compliance: For instance, a consumer requesting information under the guidelines of data privacy laws (GDPR, CCPA, etc.). The organization receiving the request needs to determine relevant data, track data inventory, map the flow of information across departments, and then provide the information to the requestor.
- Routine patient care: This can include patient interactions and interventions, lab work, appointments, prescriptions, etc., all of which can be logged in a patient portal for easy access by medical personnel and the patient.
- Pharmaceutical product management: This spans clinical study protocols, study monitoring, product registration, horizon scanning, and more.
Service requests.
Service request case work revolves around making decisions related to services, such as approval cycles, proactive maintenance across geographies, and complex customer service interactions. Service request case work also deals with ensuring contractual obligations are met.
Examples of service request case work include:
- Insurance claims management: Where teams need to intake the claim, collect many different pieces of information, detect potential fraudulent activity, work across different lines of business to resolve the case, and be able to reference and audit these claims over time.
- Field and site maintenance: Where an organization’s personnel are working face-to-face with clients and teams are trying to manage activities like dispatching staff, filling out client forms, ensuring overall safety, etc.
- Customer service: Where contact and call center support teams need to retrieve data from multiple systems in a timely manner to assist customers.
Incident management.
Incident management case work is an organizational process to mitigate risk by identifying and resolving incidents. It is largely proactive but can also be reactive.
Examples of incident management case work include:
- Facility management: Including initial reports or timed maintenance kickoffs, assigning work to staff, managing timelines, reporting on what was accomplished and what will need work in the future.
- Emergency response: Including dispatching units to scenes, notifying stakeholders on the status of the situation, and taking action on information for quick resolution.
- Trade surveillance: Where corporate teams need to monitor financial activities, proactively look into potential issues, and take necessary actions to reduce risk within the organization.
Investigations.
Investigation case work is typically a reaction to a specific event or circumstance. It involves collecting and processing evidence and capturing and analyzing information both from documents and research as well as human interactions and perspectives.
Examples of investigation case work include:
- Legal matters: Where attorneys gather information and determine the best course of action. In this type of case, attorneys use their expertise to determine the next steps and need the flexibility to control where they want to take a case or not.
- Accident investigations: Where police and other agencies are called to the scene and need to manage information, determine and execute next steps, and then report them into an auditable system of record.
- HR grievances: Where HR teams need to quickly gather information, analyze it, take any necessary actions, provide updates to the company, and audit how situations were handled.
It’s important to remember that this is a continuum rather than static buckets. Your own work may not fit perfectly into a single type of case management. In fact, it’s likely that different parts of the complex work you do are spread out across the continuum.
Take federal grants management as an example. While organizations need a standardized approach to handling grant requests and complying with federal regulations, they also need enough flexibility in their case management approach to improve agent efficiency and the requester’s overall experience. Agents need to be able to analyze data across different sources and do so from a single view or dashboard. This kind of comprehensive view of all the necessary data would allow them to make a more informed decision when approving or denying applications—and do so in a timely manner for the speedy delivery of funds. They need a solution that blends process-to-decision and service request case management. Appian delivered just that for the Federal Transit Administration (FTA), providing a case management solution that let them build out their own grants management app to streamline operations dramatically. Read more about how the FTA successfully deployed Appian technology for this and other mission-critical use cases.
To learn more about the case management discipline as a whole and how you could benefit from case management systems, check out the Appian Case Management Guide.
