# A CMS cannot be a CRM #### What is a case management system? I started practice in 2007 in NUH. NUH was the first hospital to have a digital case management system, even as the rest of the hospital was still using pen and paper. The early exposure helped me to understand the significance of a well-designed system for practitioners, and what makes a system successful and what it doesn't. Two key criteria come to mind: 1. **Frictionless.** What needs to be done as a caseworker comes instinctively without training. Important actions are available within one or two clicks. 2. **Intuitive data input and retrieval.** Caseworkers don't need to think about the right place where information should go, or where it can be found. This should be achievable without extensive software training. Frontline officers have limited mental capacity for non-casework activities. Tools must be seen as an extension of their humanity, not an additional burden. #### Why do we need to talk about this now? Case management is being spotlighted when it comes to digitisation. Rightly so, as cases get more complex. Generic off-the-shelf solutions are being proposed and decided on by people who have not done casework before. The professionals' voices need to be heard directly. **The problem** There is a spectrum of case management needs. A straightforward use-case like running an active ageing centre or drop-in centre has a very different definition of 'case' compared to a protection specialist centre. Salesforce and other commercial systems like O8 are built on the concept of a CRM. The decision that a CRM-type system is the best fit has not been validated. The evidence points to the contrary. On the healthcare side, we use electronic medical records. EMRs are similar to a CRM in that there is data about a client, and interactions and activities are recorded accordingly. They are designed in fundamentally different ways. A CRM is designed around discrete activities. Each touchpoint, a call or a meeting, is logged, assigned and tracked along its own lifecycle. The data model is shallow. An EMR, by contrast, is organised around the evolving state of a person over time, using structured instruments, care plans and progress notes that reference each other. A CRM is concerned with what happened. An EMR is concerned with what is true about this person now, and how it has changed over time. Casework is shaped like the latter, not the former. **What this requires of a CMS** The sector comprises a diverse group of people from different backgrounds who share the same passion: to do what we can for the less fortunate. For Care360, a key priority was a system that my 50-year-old colleague could use without getting frustrated. When I conducted training for my team, one of my more senior colleagues said 'actually don't need training what'. That was success. A case management system built on the EMR paradigm must still be built for the frontline practitioner. If an agency requires data, the challenge for the product is how to obtain it through the practitioner's instinctive use of the system, rather than adding more fields to complete. With the technology available today, this is possible in ways it was not when I started practice. Agency leadership can access the information they need without designing it explicitly into the system. #### Conclusion The choice of paradigm has practical consequences. A CRM records casework as a sequence of discrete events. Context is lost or left in free-text notes that no one reads systematically. An EMR records the evolving state of a person, with structured instruments, care plans and progress notes that reference each other. Casework is closer in shape to the second than the first. The wrong choice makes it harder to see the client's situation as a whole, harder to hand over between agencies, and more frustrating for the practitioner to use day to day. Care360 and Social360 show that a case management system built on this paradigm can be delivered at reasonable cost. The question for the sector is whether the default assumption, that a CRM is the right fit, has been accurately examined, or merely inherited. *This post was written by Benjamin Png, previously a Senior Principal MSW at one of the public healthcare clusters.* --- # Agent Instructions: Querying This Documentation If you need additional information that is not directly available in this page, you can query the documentation dynamically by asking a question. Perform an HTTP GET request on the current page URL with the `ask` query parameter: ``` GET https://guide.social360.gov.sg/blog/a-cms-cannot-be-a-crm.md?ask= ``` The question should be specific, self-contained, and written in natural language. The response will contain a direct answer to the question and relevant excerpts and sources from the documentation. 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