Crawford & Company

Crawford & Company is the world’s largest independent provider of claims management solutions to insurance companies and self-insured entities. Crawford’s major service lines include workers' compensation claims administration and healthcare management services, property and casualty claims management, class action services and risk management information services.

In the workers’ compensation area, when a covered individual is injured on the job, Crawford’s mission is to assess the situation and facilitate the process required to return the employee safely to work.

For complex Workers’ Compensation claims, Crawford assigns case managers to manage and coordinate the medical process to ensure the best possible outcome for the patient, and the optimal efficiency and cost-effectiveness for the insurer or self-insured employer.

Traditionally, case management has been a paper-based process in which case managers generally nurses and counselors working from remote locations collected information from claimants and healthcare providers primarily as notes on paper that later had to be keyed into Crawford’s AS/400 claims management system.

There were a number of problems with this paper-based method. Because the information was gathered in a narrative manner, it was difficult to translate into the type of quantitative data Crawford’s clients were requesting. Additionally, every case manager gathered data a bit differently, resulting in a lack of consistency in the type and amount of information gathered. This created delays in producing reports for clients on the progress of various cases and made it difficult to enumerate Crawford’s value to its clients beyond reports of ‘soft savings.’

To improve the efficiency and consistency of the case management process, and enable it to analyze case management data and report progress and outcomes to its clients, Crawford created the CareTech Case Management Application, powered by SQL Anywhere.

“We faced internal and external challenges,” explains Nick Coussoule, Crawford’s Senior Vice President and Chief Information Officer. “We had many case managers based in locations across the United States. We needed to provide them with information in a timely fashion, and to allow them to share information in order to improve our productivity. We also needed to synchronize data between multiple databases. Beyond that, we wanted the ability to analyze data and create reports rapidly to demonstrate our value to our clients and to measure our performance against our own quality standards.

“CareTech has enabled us to not only meet these objectives, but to exceed them.”

Making Mobile Users Less Remote
The CareTech application was written in C++ and consists of a consolidated application, used by employees at Crawford headquarters in Atlanta as well as a remote application used by the case managers.

There are approximately 350 full time mobile users.  A mobile user may directly access the consolidated system, while a consolidated user may be defined as a mobile user at anytime. The mobile users have the CareTech application running on standard Windows XP-based notebook PCs. Their case management information the information sent to them for new cases and the information they collect on those cases from claimants and healthcare providers is stored in the SQL Anywhere database on their notebooks. They typically synchronize their local databases twice a day with Crawford’s centralized Oracle database using SQL Anywhere Studio’s MobiLink synchronization technology.

“We’ve developed the application with multiple MobiLink instances,” explains James Petty, Information Architect at Crawford, “so that it’s possible for all of our remote users to synchronize concurrently. Typically, however, we have 50 to 150 users synching simultaneously on anything from dial-up to cable modems and DSL. The users actually synchronize with our centralized MobiLink servers, running on Windows 2000 machines with four processors and 4GB of RAM. That information is then moved into our Oracle system.

The application is designed to ensure consistency of data collection by walking users through a series of standard data collection screens. Case Managers can still enter text notes, but not to the exclusion of the specified data. CareTech also includes an enforcement function that requires users to synchronize their databases with a specified frequency.

MobiLink Synchronization Key to Selection of SQL Anywhere
In developing the remote CareTech application, Crawford evaluated a number of mobile data management technologies from vendors including Microsoft and IBM. “We needed a reliable, robust database,” explains Petty. “Plus, we needed a secure, bi-directional, synchronization capability between our remote users and our back-end Oracle database. SQL Anywhere met all of our criteria. Its MobiLink synchronization technology, in particular, was key to our selection.”

MobiLink also provided a solution to an internal support challenge. “Thanks to MobiLink,” says Petty, “upgrading the application or the database is a simple synchronization process. It eliminates the need for us to send out upgrades on CDs or direct users to a Web site to download executables. Instead, we simply notify our users that an upgrade is coming and the bottom line is that the usual synchronization just takes a bit longer.”

CareTech Gives Crawford Competitive Edge
By making the case management process more efficient and by enabling the company to meet its clients’ demands for information more quickly and precisely, the SQL Anywhere-powered CareTech application has made Crawford a more competitive company.

“Back in the days when we were operating in a paper environment,” says CIO Coussoule, “our ability to collect and share information with our clients either about the status of particular cases or the overall savings we were producing for them was pretty seriously encumbered. That’s no longer an issue, thanks to this application.”

Geoffrey Griffin, a National Account Executive for Crawford, provides a concrete example of the competitive edge Crawford has gained with the implementation of CareTech.

“We recently received a contract from one of the top ten workers’ compensation carriers in the United States. The key to winning this contract was our ability to provide the carrier with specific data, compiled the way they wanted to see it and delivered on a contractually defined schedule. The carrier wanted information on everything from our triaging of claims to determine which would benefit most from case management intervention, to the outcomes of cases and the savings we produced for the carrier. If we were still operating in a paper-based environment, we would never have won this business. CareTech made it possible.”

Companies that have been Crawford clients since its pre-CareTech days are also very pleased by the greater availability of information and the improved integration between claims management and healthcare management. “As a national provider of services in the case management arena, we believe Crawford, is highly integrated,” says Coussoule.

A Technology Foundation for the Future
Extending its innovative leadership even further, Crawford will soon provide its clients with Web-based access to information, allowing them to view their information whenever they like and to create customized outcome reports as they desire. Crawford is also considering deploying CareTech on handheld devices to further improve case management productivity and cost-effectiveness.

Coussoule gives SQL Anywhere a great deal of credit for the success of CareTech.

“When I look at technology, there are two pieces to it. It has to help us solve a problem we’ve got and we have to be able to depend on it doing its job without an enormous amount of care and feeding. When I look at some of the technology related problems we were trying to solve including worker mobility, consistent data movement, and reliability of the application SQL Anywhere has delivered on all fronts. It has allowed us to solve those problems with a high degree of reliability.

“As we look to the future in terms of handheld support, for example we are comfortable that the technical infrastructure we’ve put together will support us in that evolution as well.”

James Petty adds: “I would say that our experience with iAnywhere has been excellent. Between the quality of their products and the quality of their professional services and support, you can successfully address virtually any challenge.”