Case Database 2 Case Study

Evermore Enterprises developed Case Database 2 (CDB2) for R&G Medical Legal Solutions LLC to help them manage their workflow, stay organized, bypass geographical limitations and provide excellent and cost-effective services to their clients. CDB2 has helped R&G leave their competitors behind.

About R&G

R&G Medical Legal Solutions LLC has been providing litigation support services to legal counsel working on cases involving medical issues for over two decades. Among other things, they provide document retrieval, management and medical record summary services. That is, they collect medical records from doctors and hospitals, scan them, code them and, produce reports that explain them in clear legal terms. Their projects may involve a few small cases or, mass tort for drug or medical device recalls involving thousands of plaintiffs.

CDB2

The Case Database 2 (CDB2) “Bigfoot” system was designed and developed by Evermore Enterprises in collaboration with R&G to simplify, streamline and organize their workflow.

CDB2 is the third incarnation of this system. CDB1 and CDB1.5 were custom-built applications that served well in their day. As R&G's practice evolved, new needs became clear. CDB2, built on top of the stalwart ECMS1 system, was written from the ground up to meet those new business needs.

CDB2 is key to R&G’s current business. It helps R&G provide efficient, organized and consistent service to its customers. Without CDB2, their workflow would be unmanageable, labor-intensive and difficult to scale. CDB2 is a smart use of technology that has allowed R&G to far outpace its competition.

Business Needs

As R&G expanded and started to take on larger and larger projects, organization became increasingly critical to success. In court, factual errors and lost document can be disastrous.

As R&G sought to recruit the brightest and best Legal Nurse Consultants (LNCs), their operation took on an increasingly national scope, with numerous professionals working from home offices around the country. Workflow organization, accuracy and agility became critical to success in every aspect.

Of course, R&G’s business has continued to evolve and change. CDB2 has continued to evolve and change with it. A cycle of continuous deployment allows us to deliver new functionality within hours or days of discovering the need.

As in any business, R&G pays close attention to the bottom line. Evermore has reliably and repeatedly produced the software R&G needs at a fraction of the cost estimated by other software development companies, all without sacrificing a strong dedication to excellence.

About Time

The first functionality of the new CDB2 system was time tracking.

At the time, R&G was processing hand-written time-sheets FAXed in from remote workers in diverse locations. Expert LNCs were often less expert at understanding billing codes. Self-employed consultants were often less timely in filing time sheets than was ideal. So, R&G employed multiple HR professionals to keep the process flowing.

CDB2‘s time tracking module provided a means for local and remote workers to submit their time sheets, properly coded by project and billing code, with a minimum of supervision. The system was able to enforce business rules, obviating the need for tedious phone reconciliation by HR staff.

The CDB2 time tracking system integrates with existing billing and payroll systems, sending clean, vetted data where it belongs.

Multiple full-time HR positions were reduced to a few hours every Friday afternoon by one HR staff person. The rest were freed up for more interesting and productive work.

This savings alone paid for the initial development of the entire CDB2 system.

R & G Case Database 2 in use — R & G CDB2 2 in use

So Much More

After deploying CDB2‘s time tracking features, we went on to build a full workflow and document management system.

Case Managers receive jobs from clients and enter the details into CDB2. They assign the cases to Document Specialists and LNCs. The Document Specialists retrieve records from medical providers, scan them and upload them to CDB2. When records sets are complete, the assigned LNC is notified, they download the records, review them and produce the desired report. The LNC uploads the report back to CDB2 for review by the Case Manager. Once approved, the client can use CDB2 to retrieve work products.

Safe Data Handling

CDB2 restricts employee access to sensitive information. Different types of employees are granted different access levels, with most employees restricted to only being able to see information on jobs to which they are assigned. Detailed access logging provides an audit trail showing who has seen what. Administrative staff are alerted immediately and automatically when unauthorized access attempts are made.

All communications between users and CDB2 are encrypted and, sensitive data is stored encrypted. Automated monitoring systems watch for potential problems and, alert administrative users to take corrective action.

Reporting

CDB2 collects a lot of data in the process of tracking and monitoring R&G’s workflow, including a history of each job and a history of each employee’s work. We quickly realized that CDB2 could provide excellent productivity metrics. R&G has used CDB2 reports summarizing this data to improve its overall workflow efficiency and to identify specific issues with its workforce.

The Technology

CDB2 is a LAMP stack application: servers using the Linux operating system run the Apache web server software with the MySQL database on the back end, the custom portions of CDB2 being written in the PHP programming language, HTML and JavaScript.

Changes to CDB2 are done in a dedicated development environment on separate, isolated servers. Once new code is working, passes automated testing and, is properly tagged and check in to our source control system, we push it to the testing environment. R&G staff review changes in the testing environment to ensure they work as expected. The changes then are pushed to the live production environment.

The primary CDB2 servers are located in a high-security NOC (with biometric authentication and live security) with redundant connections to multiple Internet backbone providers. Additional servers are spun up as needed, either on traditional hardware or on cloud infrastructure.

The database and all production files are regularly (and automatically) backed up to two different off-site locations over encrypted connections.

By using professional-grade infrastructure combined with attentive operational management, the CDB2 systems runs with the much-desired “five nines” of reliability (99.999% uptime). Evermore’s proactive approach to maintenance, careful planning and monitoring has made this level of service in running CDB2 very cost-effective.