Many people have reminded me recently that Case Management is not new. So, why all the fuss now? If you hold these feelings, keep reading, because this post is dedicated to clarifying how case management and adaptive case management (ACM) are related, and hopefully dispelling some misunderstandings about the ACM movement.
Jana Koehler gave a plenary talk at BPM2012 about Case Management. She had attended the ACM Workshop the day before and seemed very put off. In an exasperated tone she declared “Case Management has been around 30 years, is a well known practice, why are you even talking about this?” Of course, this is true. My question: what gave her that impression that the presenters did not know this? A couple other attendees agreed with her! What is going on here?
Her paper, “Capabilities and Levels of Maturity in IT-based Case Management,” is a study where they compared the needs of case managers with the capabilities of case management software systems (CMS) in social work, health care, and the handling of complex claims in insurance. It is a reasonable paper, high quality research as you would expect from a peer reviewed conference like BPM2012. During the talk, however, she gave a number of side comments that seemed unnecessarily antagonistic. Here is a summary of these side comments:
- There is nothing new about Case Management. It has been around for 30 years and a real authority on the subject is the Case Management Network of Switzerland.
- Case management is inherently adaptive, and therefor there is no reason to call it Adaptive Case Management.
- There are hundreds of case management applications existing today so why not just study those?
- The current discussions are just Marketing. Delivered in a tone implying this is on the same level as eating human babies. 😉
Each of these represents a misunderstanding about the ACM movement which I will address individually.
1. Nothing New in Case Management
Some people have the impression that the people writing about ACM believe they invented case management as well! However, in the Mastering the Unpredictable book we cite that case management has been around for a long time specifically in four main fields: medical, police/detective, legal, and social work. When the term “ACM” was coined, there were many who argued that ‘case management’ was the right basic concept because it has been around so long and is well known. Connie Moore and Craig Le Clair named their landmark article “An Old Idea Catches New Fire”. Recognition of the background of case management is widespread.
Is there really nothing new? The new interest in case management at this time is because we see this old technique extending well beyond the traditional fields, and maybe across all verticals. That is new. We envision board members, product managers, executives, architects, and any number of other knowledge workers using case management that never used it before.
Recent inventions open new opportunities for case management. Data mining, social technology, and process mining are techniques that have not been employed in traditional case management. These have the potential to significantly transform the way that case management is accomplished.
2. Hundreds of Case Management Applications
She said there is no reason to be interested in new movements around case management, because there exist hundreds of applications already deployed in industry.
Of course, we know that there exist many custom applications for specific organizations or fields. This reminds me of the time period when workflow was being defined, and many people pointed out that there were hundreds of applications that implemented workflow. Similarly, before databases were invented, there were hundreds of applications that stored and retrieved data.
IT evolves in this way: applications are built the hard way many times, until a point that commonalities are recognized. What happens next is that it takes significant effort to isolate the capabilities that are needed, which can be separated out into packaged forms that can be reused. The storing and retrieving of data existed long before databases were invented. The invention of the database was simply isolating this into a module that could be easily reused. The ACM movement is an attempt to isolate the capabilities that many case management applications will need and can reuse.
Dr. Koehler does not recognize that the ACM movement is not about making bespoke case management applications. Instead it is about packaging common capabilities into a form, and that can be easily reused in many different knowledge worker environments. Learning what capabilities need to be packaged for reuse, and how to do this, is not something that you would learn by looking at existing case management applications. Instead it is a vision for what might exist, and what might be useful. We are looking over the horizon, but at the same time we don’t deny that applications exist today.
There is no exclusivity: ACM is defined by a recognized need and a set of criteria of systems that should meet this need. It is NOT defined as a particular existing product. We know there are hundreds of teams working ACM-like capabilities all over the world, and have used the ACM Awards to attempt to find and publicize these when they are recognized, and the ACM Workshop did the same.
The whole point about developing a new middleware category is not that you are making applications that have never been seen before, but instead that you are providing reusable capabilities that make it easier than ever apply the approach into a wider field than has been possible before.
3. Just Marketing
This is probably the most severe accusation. Many make this claim, that ACM is just a made up term to sell products which are basically identical to previous products. It is a low blow and unfounded. One might notice that neither I nor my company sells an ACM product. Many others who write about ACM are the same. Even though some do try to sell products, it seems a bit disingenuous when BPM2012 is sponsored by companies that sell BPM products, and many of the professors are directly involved in companies that sell the very same technology they write papers about. An effort to sell a product does not ipso facto discredit the design principles behind the product.
ACM is an industry initiative, and in such an environment it is important to try to communicate over a lot of noise. Marketing is a way to communicate. I fear that the academic community often regards marketing as a lot of empty claims, maybe even a kind of lying. If it is marketed, it can’t be true. It is a fair criticism to say that much that is written about ACM is untrue, but not all of it.
Industry discussions are not as clear as academic conferences. One of the reasons I like coming to BPM2012 is that the academic process allows people present complicated topics in a disciplined, informative way. In some ways I am jealous of the commitment to clear and accurate communications. Solid evidence must be provided; exaggeration avoided. Failure to sustain this quality results in rejection. This is a refreshing change from the industry trade shows I normally attend where speaking slots are garnered by payment of a sponsor fee. Sad, but true.
It is the content, not the form that should be at issue. Though it is perceived as marketing, the real question should be whether there is substance to it, and let that be the subject of discussion, and not dismiss it on the grounds purely that it looks like marketing. A lot of people have volunteered a lot of time to communicate what they believe to be an important technology trend.
4. Case Management is Inherently Adaptive
… so there is no reason to call it “Adaptive Case Management.”
She is right that case management when done properly must be adaptive. Case managers have to be in control, and have to be able to do what they need to do.
It is important to remind people that the proper approach must be adaptive. Perhaps Dr. Koehler is not aware of the industry initiatives to define case management in a non-adaptive way. Many people in the BPM community are promoting fixed diagrams that prevent adaptive behavior. Many people in Information Technology attempt to reduce complex interactions into combinations of relatively simple, and relatively fixed forms — however this does not work. That is precisely what we were worried about, and why we made it clear that we were talking about Adaptive Case Management when writing Mastering the Unpredictable. We saw a need for an approach that would not go the way of BPM and become simply a way to automate repetitive work.
In order to talk about a specific approach, we did need a name. In some ways any name would do, simply a handle to use in order to be clear about which kind of approach we need. You see this need even in Jana’s paper: in the title she calls it “IT-based Case Management” and later calls it “Case Management Software System” and later still calls it “Consumer-Driver CM”. People invent names so they can talk about thing. We chose Adaptive Case Management because we felt it was a good description of what we wanted to talk about, not perfect, but good enough.
The paper proposes a maturity model for case management practice. It measures the maturity of an organizations use of IT for case management work. It makes no difference whether the organization constructed their CMS from low level Java programming, or by building upon an ACMS, it measures how well they are performing the case management. This quote best supports explains why we need an ACM movement:
Knowledge Complexity high/Relationship Complexity high: The domain of highly qualified work combined with comprehensive collaboration needs. Workers use various IT systems, but are facing insufficient IT support today.
They distinguish two types of case management:
- Consumer-driven CM: “It is strongly client-centered and purely driven by humans, i.e., the case managers. Case managers work fully self-dependent and maintain the responsibility over the process. Their work style is problem- and solution-oriented.” This corresponds to what I have called Adaptive Case Management (ACM) in the technology spectrum.
- System-driven CM: “system-driven case work is usually state-driven. In system-driven CM, the CMS plays a more active role in driving and monitoring the case work” This corresponds closely with what I have called Production Case Management (PCM).
Interestingly, they point out one of the main concerns that the ACM community speaks often about, that case management system offer quite different features than a BPMS. The more I read the paper, the more I agree with it:
This type of adaptive behavior depending on the role played by a responsible stakeholder in a process is not yet well-reflected in today’s BPMS.
The case management maturity model include these five levels:
- Individualistic – no CM software
- Supported – CMS introduced
- Managed – Including data analysis for management
- Standardized – assessment standardized and visualized
- Transformative – comparisons to find best practices.
What about the state of the market:
The IT landscape of CMS is currently characterized by local providers and solutions. We could not identify global players with global, but customizable products in the case management IT market.
If you look carefully, you actually will find good examples of highly customizable products today, but there is no widespread awareness of them. The point of the ACM Awards program is to increase the visibility of good products and solutions. That is why the ACM community exists; widely adopted standards for such products do not yet exist, yet we clearly see there is an opportunity for them, so we want to lay out criteria that IT people can use to identify good ACM capabilities, and to guide people around the potential pitfalls that often accompany a new and rapidly expanding market.
Hopefully this addresses the concerns of some people:
- We know that case management has been around for a long time, but it is now spreading into fields beyond the traditional fields that this paper studies;
- There are many local case management system, and there is a still a challenge to isolate the common features that everyone needs;
- It is not just empty marketing used to hype an existing product, but instead is a category defined by recognized needs and identifiable criteria;
- Use use the term “adaptive” in order to stress that successful case management must be allowed to be adaptive and to avoid non-adaptive approaches.
If we ignore a few unnecessary jabs at the ACM community, the paper presents a Case Management Maturity Model that might be useful to assess the organizations that use an ACMS and determine how well they are using it. While there may be nothing new in “Case Management” there is lots still to be done to spread the ideas of ACM across all the fields that can use it.