Fukoku Mutual Life Insurance in Japan is about to replace claim adjusters with a software robot from IBM. The computer will scan hospital records and other documents to determine insurance payouts, factoring injuries, patient medical histories and procedures administered. Could that be the future of case management?
Manufacturing jobs have been decimated by robots. A truck maker in Nevada is testing a big rig that can drive itself. A driver must be behind the wheel, ready to take over in situations the computer cannot handle, but in other situations, he or she would be free to take their eyes off the road. The “Botlr” is a service robot that looks a bit like R2-D2 and makes small deliveries to guest rooms. The Associated Press has begun experimenting with having machines write short business stories.
An October 15, 2014 Article in Risk & Insurance states,
“The development of robots connected to the Internet, big data, the cloud and advanced computing technology such as artificial intelligence (AI) algorithms are bringing a new class of robots into the workplace — those that can sense, think and act based on specific data and sensory input, and make routine decisions.”
In the paper: The Future of Employment: How Susceptible are Jobs to Computerization?” It is estimated about 47% of total US employment is at risk. They believe that data mining, machine vision, legal writing, and medical diagnoses will all be computerized, while persuading will not. With the availability of big data, a wide range of non-routine cognitive tasks are becoming computerizable. This can be aided by the machine’s absence of some human biases.
Fraud detection is an example. It requires both impartial decision making and the ability to detect trends in big data. It is almost completely automated now.
In healthcare, oncologists at Memorial Sloan-Kettering Cancer Center are using IBM’s Watson computer to provide chronic care and cancer treatment diagnostics for benchmarking and pattern recognition. This allows the computer to compare each patient’s individual symptoms, genetics, family and medication history, etc. to diagnose and develop a treatment plan with the highest probability of success.
Computerization is gradually taking on a number of the tasks taken on by paralegals, contract and patent attorneys. Law firms rely on computer that can scan legal briefs and precedents to assist in pre-trial research. Even education, one of the most labor intensive sectors, will most likely be impacted by user interfaces and algorithms.
While some aspects of case management may require some of the tasks above, particularly review of medical records, factoring in co-morbidities, benchmarking, and writing reports, I don’t believe anyone would define these tasks as the goal of the case management process. The major goal for the case manager is to facilitate appropriate medical care and a safe, timely and medically appropriate return to work for the injured worker. Human social intelligence is important in a wide range of work tasks involving negotiation, persuasion and care. The real-time recognition of natural human emotion remains a challenging problem and the ability to respond intelligently to such inputs is even more difficult.
The case management profession continues to evolve. The workers’ compensation case manager focuses on the importance of collaboration with the injured worker to ensure care is person-driven, culturally competent and evidence based.
In conclusion, my mother advised me to become a nurse, because I would always have a job. It looks like Mother Knew Best.