Case management

Case management

Written by Ana Canteli on 21 February 2020

People in a wide variety of roles and sectors require access to the information they need where and when they are.

This is especially important for those people who need to make decisions based on information that is continuously updated, either because they work in collaborative environments for operational reasons or for workflow requirements. All of this makes it difficult to anticipate changes.

The key to success lies in providing people with a work environment, intimately linked to the context in which they act, where information is not so present when they do not need to see it, but is available when it is essential. Thus the employees of an organization will be able to access the appropriate information, to make a call at the moment they have all the necessary data, not only to make the request they demand; if not also be prepared to answer the possible questions that may arise during that call or meeting.

The necessary technology to properly execute these types of decisions can be a document management system, which is a reliable tool for all members of the organization. Good document management software helps any company apply case management in an organized, solvent, and cost-effective manner. Case management is an approach applicable to any organization in any sector. With case management, we can better manage customer demands, internal procedures of the organization, its relationships with suppliers, interest groups, etc. Also, it allows better management of cases that pose a risk of conflict or litigation.

What is case management?

The term case management has different meanings, depending on who speaks the term and their role.

Initially, the term case management arose in the United States at the end of the 70s in the health sector, when Congress realized that many patients were discharged without adequate monitoring or evaluation of their needs, which increased readmissions, with the consequent risk of chronic issues. Thus, nurses, doctors,insurance agents and lawyers are more accustomed to the term case management. Also, tickets used in technical support services or customer service can be considered cases. Public institutions that publish contests to obtain products and services can treat the preparation of tenders as cases; As well as pharmaceutical companies that plan to launch a new product, following the strict requirements and regulations of the sector, can consider the project as case management. The case, depending on the context, can be a person (patient or client), an object (in the case of products), or a data set (such as a support ticket or a request).

Case management is a professional and collaborative process that evaluates, plans, implements, coordinates, monitors, and assesses the options and services required to achieve an objective (be it customer satisfaction, compliance with laws or regulations, or product creation). It uses the communication and resources available to promote the achievement of the objectives set without undermining the quality and profitability in support of the “triple objective,” to improve management, improve the experience at the global level, and reducing costs.

Case management is routinely used in incident management in service providers of all kinds. It is especially suitable for companies that manage sophisticated manufacturing processes; or for organizations that consider the development of new products and want to start a research and development process with guarantees. To undertake the creation of any new product or service is an ambitious goal, which in many cases involves significant investments in human and financial capital. Whatever the process, case management guarantees control over who has done what and when. However, the role of the document management system in case management is much more than an audit trail.

The OpenKM electronic document and record management system are capable of working with any business content, including documents or files, but also images, videos, emails, chats, and others. Case management triggers the execution of the necessary actions to obtain automatic responses in the most common processes: document capture, zonal OCR application, use of automatisms. All this helps to ensure compliance with internal procedures, regulations, and laws applicable to each business. Also, case management supports detailed analysis when it is necessary. The OpenKM case management system not only helps to manage content, but it also helps to transform the way we work.

Case Management Model

We can consider the use of case management models thinking of work as a case. Work is similar to a case when each work item requires unique management, which involves complex interactions between information, people, transactions, and the monitoring of the policies or regulations necessary to offer an optimal result.

Think for a moment about how difficult it is to make the right decision when there are many interconnected variables. This is why case management exists; make the results of complex decisions as fair, efficient, effective, and optimal as possible.

Four levels of case management

There is no universal definition of case management, nor is there a single way to approach their management as it depends on many factors - the organization, the sector, the different actors that participate in the environment in which the company operates. But programming an organizational plan will always help us benefit from it.

• From process to the decision: especially important when dealing with highly structured cases that must follow highly regularized procedures, which in turn can be updated at any time. Health centers, nurse managers in primary care centers are usually the most common work scenarios in which case management is necessary. Health center professionals are always in need of making informed decisions based on compliance with rules and processes.

• Request management: involves making decisions for each particular case. It can be the approval of service, the management of a claim, the renewal of a maintenance contract, or the management of the after-sales service. In these cases, we are faced with a considerable lack of information based on evidence and understanding of the case, especially at the beginning. These are procedures of a certain complexity (possibly of shared responsibilities), which in turn evolve, and that can be appropriately addressed thanks to the organization’s case management system.

• Incident management: this is the identification and resolution of unwanted events. Generally, proactive methods are preferred, but reactive intervention models are also used. Management of facilities in health centers, emergency management, or complaints regarding human resources can be better managed by identifying the basic concepts of the conceptual framework, which helps automate the steps to follow, improves care, and guarantees the monitoring of intervention programs.

• Research: it is usually the natural reaction to a specific event or circumstance. Investigations need the case management system to gather information and process the evidence that will help make a decision. For example, in the case that a nurse manager in a health center identifies a case of poor patient care, she needs to collect data, determine the cause and analyze the results to propose an alternative. Research is usually the result of processes that develop over time in complex informational contexts. They can lead to legal consequences.

Elements of a sound case management system

• Introduction: This is the first contact between a case manager and a new client. The case manager uses this time to gather information about the client, identify any immediate needs, and begin to establish the relationship. This first interaction is useful for a case manager to determine if a client would benefit from the services offered by his organization. If they did, they would then evaluate the individual needs of the client. If their needs fall outside your organization, the case manager works to identify and refer the client to an external resource.

• Needs assessment: this stage is based on the information collected during the introduction stage, deepening the individual challenges and objectives of the client. During this phase, the case manager’s primary goal is to identify problems, interests, and risks for the success of the relationship with the client. While a client goes through this phase when contacting an organization for the first time, it is essential to monitor, as needs and circumstances often change over time.

• Planning: this stage is particularly important in the relationship with the client. A case manager sets specific objectives and the actions that will be taken to accomplish them. The result of this goal-setting process is the management model that includes the possible products and services involved and the results that will measure success with the client. A management model must be attainable and measurable.

• Control and evaluation: evaluation is essential to understand the impact that programs and services have on a client, according to the model followed. Using the outcome metrics defined in the previous stages, a case manager must continuously monitor and evaluate the progress of a client. The evaluation and data ensure that success in relationships with clients is quantified and qualified so that you always learn from errors or deviations from the model, feeding the process of continuous improvement.

Benefits of a case management system

With OpenKM, your organization can implement a case management system, appropriate to the context in which it operates. The architecture of the OpenKM document manager allows the transparent integration of the program into the company’s software suite.

In addition, the system parameterization is complete, so that the company can implement the most convenient case management model, and even update it over time.

• Follow-up: automatic tasks, reports, subscription service, and user news. OpenKM offers a multitude of functionalities at the service of the user. This allows access to real-time global knowledge about the progress of the process or the achievement of the service.

• It increases efficiency and reduces costs: the use of automation, workflows and the Zonal OCR integrated into the system, makes the members of the organization able to work quickly and efficiently so that work processes flow and do not stagnate in repetitive problems.

• Identified incident, problem solved: if we use OpenKM as an incident manager, or as a document management system, a negative review from a client, or the response to a survey can be treated in detail by our staff and apply the established protocol to these cases, as part of the process of continuous improvement.

If you want to know more or see how OpenKM can help you, don’t hesitate to can contact us.