article Case Management: The Missing Link in BPM in The Next Big Thing

Case Management: The Missing Link in BPM

Fred Cummins — Wed, 08 Jul 2009 04:30:00 GMT

At its June meeting, the Object Management Group has considered the issue of a draft RFP of case management modeling. The pending vote sparked considerable discussions and proposals of changes to the draft RFP resullting in postponement of action until the September meeting.

Case management modeling has been a topic in discussions for many months. Henk de Man of Cordys first proposed work on this topic as a presentation to the OMG Business Modeling and Integration (BMI) task force in December 2007. A Request for Information (RFI) was issued about a year ago, and work on the RFP evolved over the last several months with presentations and discussions in the Government, Finance and Healthcare task forces as well as BMI. There is considerable interest in the business value of case management modeling. However, the recent RFP discussions have been focused more on reconciliation of case management modeling with related modeling specifications, BPMN 2.0 (Business Process Model and Notation), and UML (Unified Modeling Language).

Case management involves the coordination of goal-directed actions that focuses on a particular subject matter (a patient, a lawsuit, an insurance claim, etc.) The sequence of actions cannot be pre-defined but depends on the evolving subject-matter situation along with decisions that typically involve human judgment. A case management process evolves to meet the requirements of the case.

Bruce Silver discusses the concept of case management and the potential development of a standard in "Will OMG Set a Standard for Case Management? " Bruce suggests that case management should be addressed as an extension to BPMN 2.0. I agree it should be possible to integrate prescribed sequences of activities with ad hoc, goal-directed decisions, and actions.

Henk de Man provides an extensive review of past approaches to case management modeling in his BP Trends article, "Case Management: A Review of Modeling Approaches." A variety of approaches have been explored over the last ten to fifteen years. However, I see more differences in the approach to expressing the models than in the fundamental concepts of case management.

Derek Miers discusses his efforts over a number of years to define model case management in "Cases Managed the World Over. " He concludes that development of a standard is premature since case management is not well understood. At the same time, he lists 13 vendors that have implemented case management approaches, and I believe the time has come.

The lack of a case management modeling standard is a barrier to effective Business Process Management (BPM) because significant activities cannot be represented in business process models. Automation of case management support is not uncommon, but is implemented in conventional programming languages so that the associated business logic is obscured from the view of business people and is more difficult to change. Many record-keeping applications support human decision-makings and also incorporate constraints on possible actions. For example, employee records are essentially case files. In addition, implementation in application programs increases the complexity of integration of case management with modeled business processes.

I believe there is a body of knowledge and potential for consensus on a standard that could, at a minimum, support modeling a vast majority of case management situations with substantial business benefit. Modeling of case management provides the basis for automation to support case management record-keeping, decision-making, and initiation of actions. Here are some of the potential business benefits:

Clarification of the scope of responsibility and discretion of a case manager or parties performing related actions

More complete representation of business processes to support problem resolution and process improvements.

Capture and accessibility of records about a subject that are relevant to decision-making and support accountability for actions

Control of access to subject records to ensure accuracy and confidentiality

Control of initiation of actions based on subject circumstances and decision-maker authority

Timely initiation of human or automated actions based on events relevant to the subject circumstances

Improved decisions based on guidance or constraints, reducing human errors and oversights

Restrictions on actions for compliance with policies and regulations

A standard for case management modeling must recognize the diversity of case management requirements. Cases may arise in the context of well-defined business processes, and these cases may invoke well-defined business processes to perform required actions. Also, cases may involve subordinate cases to achieve certain goals in the context of the overall case. Furthermore, there is a continuum of types of cases from those with relatively well-defined sequences of actions to those that are entirely ad hoc; which are determined by the judgment of the case manager. Processes may evolve from ad hoc to well-defined over time as practices become better understood. Some case management processes should include both defined sequences of activities, ad hoc decisions, and actions.

I believe the greatest challenge in defining a modeling standard may be in the definition of a suitable notation to express the models in a way that is easily understood by business analysts, managers, and participants in case management activities. The greatest challenge for automation of case management support may be the linkage between the case file data, the decisions, and constraints that depend upon them.

re: Case Management: The Missing Link in BPM

Anonymous — Fri, 17 Jul 2009 20:26:42 GMT

Great post Fred. Your second to last paragraph raises some pretty critical points. First is the continuum concept, and capturing that in a modeling notation is likely to be quite a challenge (especially for the more ad-hoc end of the spectrum). I'd also contend that some case-types should provide more ad-hoc capabilities based on skill set or qualifications. For example, a novice underwriter has less discretionary capabilities than a more experienced or senior underwriter, so therefore may forced to be more constrained in his or her activities.

I also believe, as you point out, that some processes will become more well defined over time, so clearly analytics is a core part of case management, even if it is not part of the notation of it.

re: Case Management: The Missing Link in BPM

Anonymous — Sat, 18 Jul 2009 00:01:44 GMT

Tom,

Thanks for your comment. I agree that the continuum may be a challenge. In the near term, we may need to allow for solutions that address prescribed and ad hoc processes separately.

Regarding the more or less skilled participant, that's a good point. Rules may need to consider the qualifications of the assigned person in addition to the case. There also may be multiple people involved, with different skills and authority as for doctor, nurse, orderly in a hospital.

re: Case Management: The Missing Link in BPM

Anonymous — Tue, 04 Aug 2009 13:32:15 GMT

As a Business Analyst, this is an idea with some merit. Given the length of time it has taken to further this debate, I'm wondering firstly, if the approach to achieve a really useful place to start, rather than attempting a whole solution from the get-go, is not being considered as a valid approach.

This is massive - its proposed to model a business process or many business /by Industry sector. As a start it would seem practical to look at our own client sectors and build a simple tool (with or without graphics or modelling) that allows Business Analysts to plug in data based on Industry and Roles as they discover it. This would become very powerful over time. Key drivers= Knowledge Management, Client Management, Change Management. Usage of Tool=Must be Mandated.

re: Case Management: The Missing Link in BPM

Anonymous — Tue, 04 Aug 2009 22:45:52 GMT

Ingrid,

There are several BPMS vendors that provice some form of case management capability. A standard will clarify and unify this capability with BPMN, and probably make it more robust. This is reinforced in more recent work on the Request for Proposals which I discuss in my more recent blog on Knowledge-Driven Processes for Healthcare.

Re: Case Management: The Missing Link in BPM

Jack — Sat, 16 Jul 2011 10:42:21 GMT

I am the newbie in this group, therefore I might not fully understand the case management methodology and modeling, but from my personal opinion, case management is not missing link in the BPM under conditions of:

1. if a business process contains continue improement activities within the process.

2. if process performance can be measured and anaylsis very careful.

3. if process maturity model applied in the organization which also containing continue improvement process.

if above conditions satisfied, good case and poor case can be analysis and evaluted automaticlly. once improved process defined and approved, new process quality baseline will be set.