Care coordination and health services

The client arranges care, equipment, medications, and other ancillary health services for injured workers under a workers’ compensation network, using a high-touch care coordination model to manage patients through the full course of treatment. Constant oversight and stewardship save customers on medical costs while making sure injured workers get the coverage they’re owed.

The organization ran its care coordination operations on a system originally built in Act!, a CRM and marketing automation product pressed into service well beyond its original purpose through years of custom integrations. As the care coordinator role expanded to cover more of a patient’s overall care, and as scheduling, billing, and reporting needs grew alongside it, the system couldn’t keep up: it lacked the workflows the business now needed, and a restrictive billing structure made it impossible to roll out to new staff. The organization was also running the system in-house on individual machines, taking on full responsibility for the availability, performance, and security of HIPAA-sensitive patient data — with no way for remote staff or outside partners to access it.

Gavant worked closely with stakeholders across the organization to rebuild the system as a HIPAA-compliant platform on AWS, realigning it around how care coordinators, schedulers, and managers actually worked. A new mobile-responsive portal gave case managers and adjusters real-time visibility into patient status from anywhere, and departments that had operated in isolation — care, billing, service — were brought onto a single coordinated system. The architecture was built to scale with patient volume, so growth in usage wouldn’t mean a corresponding jump in infrastructure cost or performance strain.

Following the migration, Gavant took on ongoing support for the platform — handling maintenance, monitoring, and day-to-day reliability, with an added allocation for continued enhancement work as the organization’s needs kept evolving.

The new application has transformed internal operating efficiency through visibility, collaboration, and reporting. Users can more easily track services provided to patients, which in turn enables more accurate and streamlined billing. And automations around service activities have completely supplanted weekly recurring processes. With the addition of external-facing mobile access, partners within their network have direct visibility of information that previously required time-consuming phone calls and form requests.

Moving to the cloud cut the organization’s total cost of ownership by more than 50% and reduced the time to roll out new features by over 90%, freeing the team to reinvest in the platform instead of maintaining it.

Weekly manual processes that once ate up staff time were fully automated, and outside partners who’d relied on phone calls and paperwork for basic status updates gained direct, real-time visibility into the information they needed.