A few years ago, I was invited to speak at a case management conference. For 3 years in a row, my calendar was booked on the conference date. Persistence won out and we reserved a date, which finally arrived. I was excited to join in celebrating case management with this group of fabulous professional men and women. As it turned out, the conference theme was patient engagement. Although a buzzword-du-jour, engagement is a critical achievement for effectively working with our clients. Without it, we frequently find ourselves rowing against a current of apathy. With it, our clients achieve great things in learning how to improve their own health and health care. But what is required of case management to engage a client?

In asking that question of a few laypeople to find out what they would like to know if they were ever faced with a decision of whether or not to work with a case manager, one response caught my attention. Almost everyone I asked came up with a variation of the same interest point. They wanted to know if the case manager had been successful working with other people who had similar conditions to their own. In other words, they were interested in case management outcomes.

I got to thinking about outcomes, specifically ones that might be helpful to use when explaining case management to someone who was not working within health care. I found myself re-reviewing the Effective Health Care Program's Comparative Effectiveness Review (CER) #99. If you are not familiar with the Effective Health Care Program or the CER process, a general description is "The Effective Health Care Program was initiated in 2005 to provide valid evidence about the comparative effectiveness of different medical interventions. The object is to help consumers, health care providers, and others in making informed choices among treatment alternatives" (Hickam et al., 2013, p. 1).

The effectiveness of outpatient case management for adults with medical Illness and complex care needs is the topic of CER #99. One of several things in the report that caught my attention was that of the definition used for case management as "A health care service in which a single person, working alone or in conjunction with a team, coordinates services and augments clinical care for patients with chronic illness" (Hickam et al., 2013, p. 14). Do you recognize it? My guess is that definition does not sound familiar or even similar to those offered by established professional, accreditation, or certification organizations and perhaps that should be of concern to those of us who devote our professional lives to case management practice.

It is worth serious consideration because due to the existence of various definitions offered by case management-focused organizations, it places an undue burden on the health care industry to either select an existing one or create one to fit their particular purpose. The lack of consensus on a definition feeds into the misunderstanding as to what case management is (or is not). In turn, this makes proving the value of case management more challenging and muddies the waters on other issues (e.g., job title, position description, qualifications, compensation). This also affects the consistency of reported outcomes and evidence. Unless it is clearly stated within the research publication, it is impossible to clearly understand if the intervention applied was actually case management or if it was performed by qualified clinical professionals.

Perhaps most impactful is that the apparent schisms within case management create unnecessary challenges for working with legislators and regulators because each entity offers up a different definition of case management. This variation may be reinforcing the impression that, as a professional concern, case management is not sufficiently coordinated to exert meaningful political clout.

Is it time for a unified definition of case management? Consider the possibilities.

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