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
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
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
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
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.”