Archive for category Case Management

Case Management: A Progression in Investigation Case Handling

For law enforcement and internal affairs organizations, tracking become one of the most important methods to ensure accountability and increase the effectiveness of investigations. Apart from accountability, agencies must also ensure best practice internal processes throughout the investigation lifecycle-from instigation and the initial investigation through case finalization and review. Investigations address unique and seemingly endless demands and requirements that necessitate process efficiency with innovative tools, superior methodologies, and cutting-edge architectures. Silo-based approaches that employ multiple databases and systems create significant integration, information sharing, and data-quality challenges within the agency itself and across external agencies.

Case management paves the way for increasing investigative effectiveness and improved case solvability. In defining the importance of case management, Gartner, Inc., says, “At the most elemental level, case management is the electronic equivalent of what has supported business over several centuries: the cabinets, drawers, folders, forms and collaborative workflow processes supporting important human decisions. Case management captures the backward-and-forward nature of human interaction to reach a specific outcome”.

The Case Management Process Model

Agencies involved in investigation processes have to deal with vast amounts of information, both in physical and digital formats. A case management process model must exist and be able to easily interact with the physical investigation. It is also critical to have a proper mechanism to gather, share and access information. For detectives, this is a challenge that can directly affect the integrity and solvability of the case.

There are two primary process model requirements that any investigative case management solution must meet:

• The solution must be specific enough that general technology requirements for each phase can be developed (such as forms to eliminate manual processes, role-based security, notification controls, and reporting capabilities to meet compliance and audits).

• The foundation of the solution must apply to any investigative process (the workflow must be built in the system to address multiple facets of business process management, capable of withstanding minor customizations yet maintaining best practices).

Compliance is a key issue in almost every vertical market. Whether satisfying legislative requirements covering anti-corruption, identifying fraud, ensuring accounting standards, or preventing money laundering, process management technologies have earned their incitement to ensure compliance. Built-in workflow requirements such as preventing users from proceeding to the next stage of an investigation and maintenance of user access and data changes in a case ensure an auditable trail. Process management has proven its worth in recording all stages of an investigation to guarantee activities such as audits, compliance, evidence tracking, and data monitoring.. A proven process model must be built into case management solutions to ensure compliance.

The Criticality of Technology in Case Management Processes:

Over the last five years, there has been a noticeable increase in organizations looking to technology for automation, while maintaining agility with routine investigative activities. Law enforcement agencies are challenged to must close cases quickly and accurately, which is pressuring the adaptation of new tools and methods to increase productivity and effectiveness and lower costs. The most recent debates of case management versus business process management have been discussed in many online and analyst platforms, but the fact is that the two are not independent of one another. Automation plays a vital role in process management, and technological solutions establish a culture for continuous process improvement within an organization. An effective case management solution allows for process design and simulation, workflow control, integration tools, and business rules.

The role of technology in investigations will continue to grow to meet the explosion of digital content, social media, and cyber culture. Electronic evidence and information gathering have become critical components in an increased number of crimes and conflicts. From criminal cases, civil disputes, medical malpractice, and employee misconduct to acts of terrorism, if there is a computer, media device or digital file involved, the chances are very good that investigators will need to recover valuable evidence for analysis. Technology paves the way for investigation agencies to keep track of information and evidence. This transformation has also created a need for case management web based solutions-linking information to one or many cases and helping uncover complex relationships among matter (people, places, and things).

The primary drivers of a technology solution to improve efficiencies and maintain best practices for investigation handling and case management include:

- Incident Intake and Tracking

- Compliance

- Workflow Management

- Reporting

- Data Management and Collaboration

- Role-based Security

- Evidence Tracking

- Third-party Integrations (systems, databases, or data warehouses)

- Performance Measurements

- Internal Audits Read the rest of this entry »

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Medical Case Management Best Practices

It’s no secret that today that health plans and managed care organizations are putting tremendous amounts of money into proactively managing the small percentage of their subscriber populations who consume the majority of their health care resources. Case management utilization review, medical management and disease management are some of the generic terms that are used to describe this process. Independent review organizations act as a key support element in the health care decision making process. They help case managers, utilization review and utilization management nurses improve the health care delivery process so that critical care populations are getting properly attended to with the right treatments, each time, every time. Only independent review organizations can provide for this critical decision support to the managed care organization. Managed care organizations, utilization review and utilization management departments attempt to perform these functions internally without using the appropriate specialists with the latest training in active practice run the risk of not being able to distinguish between necessary and unnecessary treatments. Such decision making is the role of an IRO. Read the rest of this entry »

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Case Management – Your Guide to Available Resources

So, you’ve recently learned that your child has a disability. When the shock and worry lessen, you will start looking for help. If your child is under age five, your local branch of Child Development Services will assign a case worker to aid with placement in appropriate programs and therapies. However, once your child enters the public school system, CDS exits and he/she will be assigned a special education teacher who will supervise his/her education needs in accordance to the financial abilities of the school district.

Above and beyond this, you are entitled to acquire a case manager who will set goals according to state regulations, follow your child’s progress through the public school system, and advise you of special programs, treatment, and funding available. These counseling professionals are employed by public health centers or nonprofit organizations.

As a parent, the first concern you may have is cost. Because this type of counseling is outside the realm of public education, funding is the responsibility of the parent. Do not be discouraged. Many agencies are willing to help parents acquire insurance provided by the state, designed specifically for children with special needs, even if you already have a primary insurance. Depending on your income, your child may qualify for your state’s version of Medicaid.

If your income is too high for Medicaid, your case manager will advise you of additional insurance programs like the Katie Beckett waiver program. The specific eligibility process differs from state to state. However, this waiver allows parents of children with medical or developmental disabilities to apply for Medicaid insurance coverage using exemptions from the standard Medicaid rules. Read the rest of this entry »

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