Case Study

Our customer CRICO/RMF of Harvard medical community is an internationally renowned leader in evidence-based risk management. They had built a comprehensive application suite using Microsoft Technologies (Visual Basic, ASP and SQL Server) and a Data Warehousing and Analytics Solution using Business Objects and SQL Server Analysis Services.

Over the years, ongoing functional enhancements were made to meet business needs and improve operational efficiencies within their departments. As is natural with software systems, maintenance costs of these applications have exceeded industry standards. Our customer was looking for a partner with deep medical malpractice and patient safety expertise with proven track record of innovation and software delivery. They expected their partner to possess rich Research & Development (R&D) experience in architecting and delivering Data Analytics and Service Oriented Architecture (SOA) based solutions to help conceptualize and deliver a multi-year information solution strategy. ZANEC played a key role in defining overall IS strategy. Some of the key contributions of ZANEC to the success of CRICO/RMF are:

ZANEC Solutions
Technology Strategy and Enterprise Architecture
Technology Strategy and Enterprise Architecture

After assessing the existing applications with the current business needs, ZANEC has defined a strategy to regenerate tools based on a service oriented architecture platform that enhances capabilities to achieve its goals in providing a superior malpractice insurance program to their members.

Clinical Coding solution

Based on the defined SOA platform, ZANEC has built Clinical Coding solution for capturing clinical elements embedded in the professional liability cases to accurately identify the root of the alleged medical error based on the customer's proprietary taxonomy. The insight gained through this taxonomy provides clear evidence to drive patient safety initiatives.

Underwriting and Claims solution

Current Underwriting and Claims applications provide basic operations management and reporting capabilities but some of the current‐state operations are largely manual, time‐intensive and require the maintenance of paper‐based or electronic tools to guide management decisions. After careful consideration of the future processes and subsequent to the completion of the high‐level Underwriting and Claims requirements, our customer is pursuing the development of Underwriting and Claims platform modernization. In order to achieve the goal of modernizing its systems and underlying processes, ZANEC is assisting customer with several critical activities necessary to support an Underwriting and claims solution upgrade.

Risk Intelligence and Analytics

Our customer's Risk Intelligence tools provide interactive, drill-down capabilities built on customer's proprietary taxonomy, identifies / prioritizes the clinical areas of vulnerabilities. ZANEC's security model for the analytics platform ensured data protection via an access control that was based on role, organization. The underlying platform was MS-SQL Server / Reporting Services / Analysis Services / ProClarity and Windows Active Directory. ZANEC designed the cubes that were based on the customer's taxonomy and managed the QA and the Release Management till 'Go-Live'.

Master Data Management

Our customer has multiple entry points of non-transactional data or Key business data (E.g. add/update Person/Party information), and because a person can have multiple roles and relationships (E.g. Board member can be a physician), ZANEC worked with the customer in defining Master Data Management (MDM) processes and tools that consistently define, cleanse and manage the non-transactional data / key business entities. MDM delivers a "Single source of Truth" by providing the processes for collecting, aggregating, matching, consolidating, quality assuring, persisting, and distributing to ensure consistency.

Single Sign On

Our customer's applications used custom built login modules and security model. Users of our customer's applications had different user names and passwords for each application. In addition, there were a few users that needed multiple user names for the same application, to access different Client databases. To achieve SSO, ZANEC defined an enterprise-wide security model based on Active Directory and integrated the login modules of these applications with an Active Directory based Authentication model.

Taxonomy Based Knowledge Management

To enable the customer search for key information from large volumes of files/ documents spread across the enterprise network stored on File Servers, Microsoft SharePoint Document Libraries, and Emails, ZANEC built a comprehensive Search solution using Microsoft Office SharePoint Server (MOSS) 2007, Microsoft Search Server with innovative features such as creating a mind map(taxonomy) based on the content of the document (crawler), ability to search the content inside(body) the documents, document preview etc.

Clinicians & Risk Managers' Portal

To enhance the customer's brand for its primary audience groups and be the presentation layer for the audiences (clinicians and Risk Managers) that access or connect with customer, a portal is being created to support clinicians/organizations coverage, obtain Policy documents and support enrolment and tracking of Risk Reduction programs. ZANEC helped customer in defining the overall Enterprise content strategy and providing software testing services.

Collaboration Platform

Our Customer maintained many departmental and project portals in SharePoint 2007 for their team to collaborate and manage the knowledge content. ZANEC re-skinned portals based on defined Enterprise Content Management strategy as well as the Enterprise branding standards and migrated all the SharePoint 2007 sites to SharePoint 2010.

Root Cause Analysis Submission Tool

Root cause analysis data from care organizations can provide real time insights into events that may later become malpractice cases and support the development of best practices to improve patient safety. ZANEC has designed the web based solution for our customer's member organizations to submit complete RCAs with all attachments and enable comparative analysis across organizations and the identification and dissemination of sharing of best practices. ZANEC also has been providing independent software testing services for this application.

Feature enhancement and Application maintenance

Maintained and supported Claims Apps, Underwriting Apps while the apps were being migrated to the SOA architecture.

Independent Software Testing and Quality Assurance

ZANEC with its deep domain understanding, expertise on Data management and testing practices, has provided testing services to independently validate the solutions.

Summary

Ongoing work of modernisation of CRICO/RMF's platform and additional tools and solutions built as above, are enabling CRICO/RMF to embrace the data-driven analytics based approach to claims management and patient safety and allow them to provide a unique outcome based service to their members and stakeholders. CRICO/RMF is also reaching beyond the borders of their own Harvard medical community to create new partnerships among physicians, healthcare systems and their medical malpractice insurers, using what works: comparative analysis of claims data, shared effective patient safety practices, and dialogue among a national community of peers.

WHY ZANEC

ZANEC, as a specialist provider of innovative solutions and services, understands the importance of innovation and technology in addressing the challenges of MPL Industry. ZANEC has years of experience in building technology tools to analyze medical professional liability claim data and mine the information to identify root causes of patient safety issues to provide actionable information leading to improved patient safety and risk mitigation.