Semi-structured processes arise extensively in various industries such as government, insurance, banking and healthcare and are characterized by their flexibility and data-driven nature. Case management systems are evolving to handle the growing demand for providing operational support to knowledge workers involved in these processes. While enabling flexibility in human actions is an integral part of these systems, this capability increases the potential for errors in case handling. We propose a new paradigm of case health aimed at providing knowledge workers and supervisors a case health service to continuously and objectively assess both the current state of a case instance and provide a prognosis for the future state of the instance. The case health service is composed of constituent services each of which provide case health indicators and can be combined in flexible ways to determine the overall health of an instance. We have implemented case health with respect to a simulated credit card dispute scenario modeled in IBM Case Manager and evaluated the utility of computing the case health of running instances of the credit card dispute scenario. Results indicate the utility of incorporating case health in a case management system in terms of early detection of undesired outcomes and abnormal execution patterns in running case instances. © 2012 IEEE.