Integrated Case Management – What is it?

Ran across this term and was wondering what it was.  What I found was not what I thought of when I initially read the term.  It is not a new term, so lets start with a few (older) definitions:

  • The state government of Maine says: “Integrated Case Management (ICM) is a voluntary, family-focused, strength-based program that uses an independent facilitator to bring all relevant people, including providers, family and natural supports, to the table. This team then works in partnership with the family to create a safety-based comprehensive plan addressing the needs of all family members. This model is most useful when the families being served are involved with numerous systems and are not able to access targeted case management.”  Associated with this are references to actions being taking in 2002 & 2003.
  • Nursing Administration Quarterly has a 1994 article saying it is “an integrated, multisite approach to case management that uses the expertise of social workers, nurses, pastoral counselors, and therapists to develop client-centered plans of care across the continuum of need.
  • Springer Verlag published a 2010 book in association with the Case Management Society of America a book called The Integrated Case Management Manual says “Case managers need to learn and deploy a new set of skills in supporting multimorbid patients. It is essential to assess both medical and mental health issues in a single evaluation and to coordinate appropriate integrated health interventions and treatment planning to achieve effective strategies for safe care.
  • The June 2012 CMSA conference cites a talk on integrated case management which begins with: “Emergency Departments (ED) have become the primary care provider for the uninsured and under- insured, leading to overcrowding and inappropriate utilization of resources with decreased reimbursement. The objective of implementing integrated case management principles is to deliver quality healthcare, and increase medical collaboration and efficiency of available resources while maximizing reimbursement.

To put this in setting, the common theme is the medical field, and remember that health care is one of the four original case management vertical (along with legal, police/detective, and social).

We are seeing traditional case management, the integration then is an attempt to reach out of the normal boundaries.  One example is integrating medical with mental health.  Another is integrating emergency room with regular health care.  Another is integrating social work, medical work, and other disciplines.  Another is integrating across families.

The “integration” in Integrated Case Management refers to integrating people by being more inclusive — and that is no surprise.  This is a natural outcome of the advent of information technology, just like Web 2.0 and social technology.  We can easily involve people across distances, across disciplines, both inside and outside of organizations.  In a nutshell, this is what is driving the case management re-revolution.

What it really highlights is how case management in the past was not integrated.  Typically literally a physical file folder which could be held by one person at a time. Information technology should have a resounding effect on that.

Anyone see it differently?  Unless someone can point out something I missed, I am going to conclude that “Integrated Case Management” is just Case Management in the hyper-social integrated world of the 21st century.


5 thoughts on “Integrated Case Management – What is it?

  1. Pingback: BPM Quotes of the week « Adam Deane

  2. Keith,
    Good link to the real world where they can use our help.
    I think the healthcare people are more concerned about getting the right people engaged in working together for integrated planning and delivery of services than they are about the use of social technology, although technology can certainly help. The conventional approach is to have one person do the integration and the success of that depends much on the capability of that one person to communicate and coordinate. Conventional business process automation does not help much because it assumes we know what needs to be done in every case and must just follow the process–so getting people together to collaborate doesn’t mean much–the process is already defined. With adaptive/automated case management, we open the door to support collaboration by working from a shared case file/record of the case, providing mechanisms to engage persons when they are needed, including teleconferencing, and enabling the plan to be defined or adapted to the current situation. it’s probably the next best thing to having the people involved sitting in the same room with the situation mapped on the wall, for the duration of the case. Of course that’s not practical for most cases, particularly when the people are involved in multiple cases with different participants.

    BTW, the CMMN (Case Management Model and Notation) specification will be proposed for adoption at the OMG December meeting.)

    • Good to hear from you. Agree that the goal is to get the right people, the right specialists, even from different fields together (integrated) to help solve the problem. What is known as social technology is one thing that might help in getting people together, or in maintaining networks of people with the right skills, however I didn’t mean to imply that use of social technology was a requirement or that anyone would care whether social technology was used or not. I think you and I were assuming that whatever we did in the case management space would allow for this kind of integration. to put it another way: any system that didn’t allow for bring such people together to work would be so old fashioned as to be considered un-useful. This kind of integration is a requirement today.

      From what I hear about CMMN it appears to have plenty of “automation” features, but no real consideration for “adaptive” capabilities. While I am sure it is an excellent piece of work, clearly the support for unpredictable work was not a strong consideration. (No, pre-defined manual human tasks or optional tasks do not constitute unpredictable work.) It will be interesting to have a detailed discussion when the document is available for discussion.

      • Keith,
        CMMN does makes some assumptions about the runtime case management environment, but it is focused on providing the elements to be available for planning, coordinating, collaborating and tracking in the runtime environment. The CMMN tool implementers will have a lot of latitude in their approach to runtime support. I hope that they provide a lot of flexibility to the runtime user and (1) enable the runtime user to create his/her personal library of planning elements, and (2) capture the actual plans and support analysis for sharing of commonly occuring patterns. The persons doing the modeling will also be an important factor–it requires a different way of thinking about process and providing flexible support–useful building blocks– for the runtime users. If they get it wrong, many of the target users just won’t use it.

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