Here is an article I wrote for Workforce Solutions Review, a well produced magazine from the International Association for Human Resource Information Management (IHRIM). It seems that there is some interest in Adaptive Case Management from a HR perspective — and for good reasons. When I get the details of the publication issue I will include that here. Meanwhile, this post outlines a vision for ACM and Human Resources & Management.
In the past two years we have seen a dramatic increase in interest in a new approach for systems that support office workers. Much of the focus for information technology deployment has been on automating or even eliminating less skilled jobs. This has been largely effective, and organizations today are able to much more with fewer people. People today spend less of their time on routine tasks, and more of their time on things that make a difference, than was possible just ten years ago.
The challenge is to determine how to support higher skilled modes of work. We call this kind of work “unpredictable work” because one cannot predict in advance the exact course of what will be done. This is technology for the rest of us: managers, decision makers, executives, doctors, lawyers, campaign managers, emergency responders, strategist, and many others who have to think for a living. These are people who figure out what needs to be done, at the same time that they do it, and there is a new approach to support this.
The trend goes beyond being just a technology trend. We are seeing a fundamental shift in our workforce, and in the ways they need to be managed. Not only are companies engaging their customers in new ways, but managers are engaging workers in similarly transformed ways. The office is being transformed from an assembly line for the processing of forms, to far more agile and effective patterns for accomplishing organizational goals. This is enabled by recent technology developments, and at the same time demands new technology approaches.
It is a trend that has been forming for a half century. To best discuss it, let cover some terms and concepts.
Knowledge worker productivity is the biggest of the 21st century management challenges. In the developed countries it is their first survival requirement. In no other way can the developed countries hope to maintain themselves, let alone to maintain their leadership and their standards of living. 
– Peter F Drucker
Knowledge workers have a high degree of expertise, and the primary purpose of their jobs involves the creation, distribution, or application of knowledge.
– Thomas Davenport
Knowledge work is work that requires thinking. It requires not just skill, but also expertise. Knowledge workers make decisions like executives or a managers. Knowledge work involves putting facts together like a detective. Knowledge work requires experience with the details of the situation in order to make the right plans. Knowledge workers are all around us: all levels of management, lawyers taking a case to court, the judges that preside over those cases, elected representatives crafting new legislation, detectives following up on a crime, business people drawing up a new plan, stock traders trying to corner the market, product designers determining the feature set for a new product, marketing staff deciding a media campaign. All of these require specific insight into a situation in order to make the right decisions for success.
Peter F Drucker made the first reference to knowledge work in his 1959. He calls attention to the uniqueness of each knowledge worker’s job when he describes a knowledge worker loosely as “someone who knows more about his or her job than anyone else in the organization.” Each knowledge worker may need to do things different ways, depending upon the specifics of the situation. Ironically, information systems have focused in past on making everyone work in exactly the same way.
Drucker also reflects that knowledge, and by extension knowledge work, is constantly in flux. “Knowledge is different from all other resources. It makes itself constantly obsolete, so that today’s advanced knowledge is tomorrow’s ignorance. And the knowledge that matters is subject to rapid and abrupt shifts-from pharmacology to genetics in the health-care industry, for example, or from PCs to the Internet in the computer industry.” Jobs based on knowledge will change when the knowledge does. Processes that depend upon knowledge, and at the same time produce knowledge, have a compound dynamic which makes them especially difficult to manage.
The opposite kind of work, routine work, is predictable and repeatable. It is just a matter of time until all routine work becomes automated. Because knowledge work is not predictable, we find that the work force has to shift to do more knowledge work. As the percentage of routine work diminishes, the percentage of knowledge work is growing.
Unpredictable Processes & Agility
The future is uncertain…but this uncertainty is at the very heart of human creativity
– Ilya Prigogine
Knowledge work is described as being unpredictable. We should be clear about what is really meant when we say it is unpredictable. The process of fulfilling an online book order may be considered predictable, even though the size of shipment and the destination vary significantly from case to case, because these factors don’t affect the pattern of things that must be done to complete the shipment. Even if the outcome is uncertain, such as bidding at an auction, the process might still be considered predictable with branches representing the various courses of action.
By “unpredictable”, we mean that the sequence of significant human acts is not knowable in advance, and the course may vary from case to case in new and unexpected ways. The course will depend greatly on details of the situation itself, and the details may change before the work is finished. More importantly, while many steps in the sequence might be normal routine steps, it might be impossible to know ahead of time which steps will be needed, and how many times. There is always the possibility of needing to do something that has never been done before.
Note also that any prediction that an organization makes on the course of events has to be based on actual information that they know at the time. Hindsight always tells us that if we had known more information, we would have been able to predict better the course of events. One of the limitations that organizations face is that is it not possible for them to be aware of everything which is knowable at that time. For instance, the medical history of a patient that arrives unconscious and without identification will not be retrievable, but care must be provided any way.
Consider the case of a hospital accepting a patient for care who has been in a car accident. The patient has to be accepted and care has to start before any detail about their condition is known. They will start with some investigative procedures: a blood test, examination of wounds, vital signs, etc. Then, based on what they learn, they will prescribe an initial treatment, but that is not the end of it: they will continue to monitor. The signs of a blood clot in the brain may not show up for many hours. When it does, that may warrant emergency surgery but there are many factors that need to be considered having to do with the condition of the other wounds. The point is that nobody could say at the time of admission that this patient would need surgery – the information necessary to make such a prediction could not possibly be known.
In an unpredictable world, sometimes the best investments are those that minimize the importance of predictions.
– Gökçe Sargut and Rita Gunther McGrath
Typically knowledge workers will prepare for uncertainty. The hospital is prepared to respond to many types of emergencies. The hospital staff have learned and practiced what to do, and have even tried to make certain procedures routine. The hospital staff work is not chaotic – it is not simply random tasks. The unpredictability comes from the way they are responsive to the situation. You might think that the only decision is to select the right treatment from a pallet of possible treatments, but the possible options themselves are constantly changing.
As you see, an unpredictable process is simply a process that has to be figured out; it emerges as the work is done. That is precisely what knowledge workers do. Once you understand this, you see that knowledge workers are everywhere that you have to decide what to do: executives, managers, problem solvers, designers, etc.
Adaptive Case Management System
Case Management (CM) is an approach which has been used for years in the fields of health care, social care, the courts, and law enforcement but now we are seeing this basic approach being used for all knowledge workers across all industries. We call it case management because all the work is structured around a case, which is simply a place where everything for the job is collected. It is not just a folder, but is also has an implicit or explicit goal. Sherlock Holmes has the goal to solve the crime, so he keeps all the relevant information in a case folder. The case is considered “closed” when the crime has been solved. Today, that case is not a physical folder, but instead an information system structure that can be access by multiple people from multiple locations simultaneously, but it is the same concept.
A knowledge worker creates a case in order to accomplish any goal: recruit a new employee, plan a company event, run a conference, address a customer problem, treat a patient’s symptoms, investigate a suspected terrorist, resolve a billing dispute, and any sort of non-trivial accomplishment. There is always a person who is responsible to see that the goal is completed, and that person is designated the case manager.
For example, to treat a patient, we would put the results of all tests, and all other relevant information about the patient into a case. We also would associate specific people with the case in the roles like doctor, nurse, specialist, etc. so that they can access the information as they need to, and so that the information is protected from others not on the case.
We call it an Adaptive Case Management System (ACMS) when the system has certain properties that allow users to learn to do their job better. For a detective, it not only helps solve the crime, it also helps them to capture and communicate what was done along the way, so that others might learn from and reuse those techniques.
When you hear about an adaptive system, think about muscles. To increase the size or strength of a muscle, you exercise it. Conversely, lack of use causes muscle atrophy. Adaptiveness is not simply the capability to increase or decrease muscle size. Instead it is more about the ability of the muscle to self-modify to fit the situation; the ability to sense a need, & to respond to it in a kind of feedback loop.
Adaptive Case Management Systems automatically keep a record of everything that happened along the way, so that there is a complete history to learn from. The history is helpful in reaching the current goal, but even more valuable when many cases are reviewed to see what patterns are having the most success. Process Mining is a technique that is used to show what patterns of actions have been occurring, even when no process diagram was set up in advance.
An ACMS will have a way to make a formal request for something to be done from someone else. This replaces the email, fax, or phone call that might in the past have been used to ask for help on the job. Such a request goes beyond simply communicating the request, it will also send reminders, collect the responses, and optionally allow access to case information directly. Most important aspect of this request object, which is called a “task”, is that it is reusable in the future. Over time, case managers will build a collection of standard tasks and sequences of tasks (called process fragments) which they can use over and over again in future cases.
Some see ACM as the combination of social techniques together with dynamic business process management. It is certain that there is a confluence of technologies coming together at this time, and it is having a profound effect on the structure of our organizations.
Industry & Organizational Directions
As a result of these technological developments, new forms of organizations are appearing and winning against older companies that cannot move as quickly. The traditional way to structure an organization was to separate the brains from the brawn: centralized designers and planners would determine the right way to get a job done and the workers would perform the work as designed. The Industrial Age brought factories that were expensive to build, but could mass produce inexpensively and in quantities that made up for the expense of building the factory. In the business office, policies and procedures are put together for the same reason a factory is built: communications is expensive, and the coordination cost of a large organization increases exponentially unless standard, centrally planned ways are drawn up. Changes to the plan are expensive because communications is expensive.
This same rationale does not stand up when communications gets very powerful and very cheap which is exactly what social technology is doing. You might be able to move in ways never dreamed possible a few years ago. Imagine a potential customer who needs a small alteration in a product, and being able to contact exactly the right people almost instantly, propose and confirm a change.
Pull platforms are emerging as a response to growing uncertainty. They seek to expand the opportunity for creativity by local participants dealing with immediate needs.
-John Hagel, John Seeley Brown, Lang Davison
In their book “The Power Of Pull” John Hagel et. al call this a “Pull Oriented Organization”. A push organization is one where market research is done centrally, products and planned and produced, and then pushed out through the distribution channel where hopefully they sell. A pull organization instead allows the front line to work directly with the customer, determine exactly what they want, and then leverage the rest of the organization in an agile manner. Some companies today propose different product designs to customers, and get them to vote. The winning design is then produced and sold to a waiting audience. It is almost as if you can sell the product before it is designed. In all of these experimental approaches, agility is achieved by distributing control away from the center, and leveraging powerful new communications media to make people in the field more flexible than ever possible before.
These shifts in the workplace make Adaptive Case Management more important than ever – it gives flexibility to the user to evolve their own workplace. ACM is not deployed in the form of “applications” or “solutions” in the way that traditional IT approaches for pre-planned work support is. Instead, it is deployed in a plain vanilla form, and case managers start using it. As they do, they start building up patterns within the existing cases. They reuse those patterns as they deem worthwhile. Over time, the organization gets more efficient, not because it has been forced to use a particular work process, but because the system supports the right patterns for them.
Today, around 40% of the workforce can be called knowledge workers, and that number is growing. Never before has there been a systematic approach to making managers, executives, and other thinkers more effective at getting things done. The current knowledge workers will need to adopt this, or risk being replaced by the new people entering the workforce. As Drucker says, knowledge worker productivity is the biggest of the 21st century management challenges, and it is likely that Adaptive Case Management will be a part of addressing that challenge in the next decade.
 Peter F. Drucker. Management Challenges for the 21st Century. New York: HarperCollins, 1999.
 Thomas H. Davenport. Thinking for a Living: How to Get Better Performances and Results from Knowledge Workers. Boston: Harvard Business School Publishing, 2005
 Peter F. Drucker. Landmarks of Tomorrow: A Report on the New Post-Modern World. New York: Harper Colophon Books, 1959
 Peter F. Drucker. Management Challenges for the 21st Century. New York: HarperCollins, 1999.
 Peter F. Drucker. “The Future That Has Already Happened.” The Futurist 32, no. 8 (November 1, 1998),
 Gökçe Sargut and Rita Gunther McGrath, “Learning to Live with Complexity” Harvard Business Review, September 2011
 Keith D Swenson, Mastering the Unpredictable: How Adaptive Case Management Will Revolutionize the Way That Knowledge Workers Get Things Done, Meghan-Kiffer Press; 2010
 John Hagel III, John Seely Brown, Lang Davison, The Power of Pull: How Small Moves, Smartly Made, Can Set Big Things in Motion, Basic Books, 2010
Thanks are due to Roy Altman of Peopleserv for suggesting the idea of an article on this topic, and helping, along with others are IHRIM to make it happen.
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