Case management programs are part of several industries, including health care, the legal profession, the insurance industry, social services, and investigative agencies. A case is a series of actions and events that are spread over a period of time and linked to servicing the needs of a client or patient. Various software solutions are used in case management programs to automate the sometimes tedious tracking and monitoring often required to oversee situations spanning weeks, months, or even years.
The health care, insurance, legal, and social service sectors use case management programs. These service providers employ tracking strategies for cases under their management that ensure timely, responsive, ongoing follow-up occur. Case management entails more than just providing services or monitoring and tracking events and people. In short, case management programs keep essential time-sensitive tasks from falling through the cracks.
Delivery of health care services is often done through a case management system, particularly for those in which ongoing care is required. For example, a one-time visit to an urgent care center to treat a sprained ankle injury that is incurred by a normal, healthy individual may not involve the services of a case manager. Yet, if the injured person is frail, lives alone, or lacks an ongoing support system, the treatment provider may place that patient into a case management system. In the field of health care, case management is also used to take care of long-term or critically ill patients who may receive services from a team of health-care professionals over a period of time. Management of cases may occur on both an inpatient or outpatient basis.
Insurance claims and legal cases usually may involve legal systems. In more complex legal cases, a team of lawyers may spend months gathering evidence, preparing briefs and assembling witnesses. In large-scale cases of damage to property or personal injury, case managers will likely use tracking systems to ensure claims for damages are moved forward, and appropriate paperwork and claims are filed in a timely manner.
Case management professionals also operate within the nonprofit sector and in government. In the social services sector, case management software is used to assist caseworkers, who often have large case loads, to prioritize tasks so that vulnerable people under the supervision of courts or social service agencies are not neglected. Law enforcement agencies also employ case management programs to track and coordinate efforts in locating criminals and also ensuring parolees are complying with court orders. A case may be an individual, a group of people, a legal entity or entities, or even a natural resource such as a polluted river, that requires ongoing monitoring and follow-up by a team of individuals or multiple agencies.