Pain: it’s a part of every injury. But when the injury is workplace-related, the discomfort often goes beyond physical distress.
Imagine, for a second, that you fall at work and injure your back. Your treatment will likely be covered by workers’ compensation insurance, but the journey toward healing—and navigating the confusing road of workers’ compensation—is likely just beginning.
You’ll need to see a doctor, and maybe a specialist or two. You might need medications to treat the pain, coupled with physical therapy. If you can’t get around, you’ll also need a wheelchair, and maybe a van or bus to shuttle you between all these different businesses, appointments and anywhere else you need to go. It can be a challenging situation for both patients and the claims adjusters managing this often complex care.
Brett Luna, chief information officer of Healthesystems, says his company can ease some of the anguish.
Most basically, it helps insurance carriers manage the cost and use of pharmacy and medical services provided through workers’ compensation benefits.
It has developed technology for this purpose, so clients can, for instance, instantly access reports, alerts, prior authorization requests, tools, publications, clinical guidance and more, through a user-friendly web portal, Verticē.
“We also use analytics to point out the trouble areas and discrepancies associated with a workers’ comp claim,” Luna adds, which can include instances of fraud, misuse of services, overcharging and even the prescribing of inappropriate medications.
Healthy inside and out
Luna joined Healthesystems in 2016, following 25 years of providing enterprise business solutions internationally for multiple industries, including brand names like Hewlett-Packard, Boeing, Cisco Systems and Blue Cross Blue Shield.
Upon his arrival at the Tampa, Florida-based company, Luna was excited to enhance its IT organization.
“We needed to be more engaged with our business partners, get involved earlier and be part of the strategic planning process so that we have early visibility into what the organization needs,” he says.
In response, Luna and his team crafted a three-pronged IT strategy to better align the IT department with the business objectives. This involved simplifying and standardizing business intelligence (BI) and analytics capabilities, modernizing the mission-critical platforms and reducing the overall cost, risk and complexity of Healthesystem’s services.
Scoring a hat trick
Since the company’s founding in 2002, it had amassed several BI and analytics solutions, which, when combined, could be cumbersome, costly and time-consuming to maintain.
Luna and his information management team aim to improve their customers’ analytics experience by defining clear goals and improving the analytics, as well as deploying a single standard BI and analytics tool. He says the mission-critical platforms must also keep pace with constant change in the healthcare and IT industries.
The “next-generation” platforms will be even more flexible, scalable, reliable and secure, in order to meet the evolving needs of the healthcare industry, Luna says, and will be offered in a “componentized” structure as opposed to a traditional, monolithic one.
Healthesystems’ business units require the company to address current customer demand while staying out in front of needed change. Luna explains that this modernization effort is “like changing out the engine of a car while it’s moving down the road at a hundred miles per hour.”
The final goal of cost-containment—doing things better, while spending less—is common in any company, Luna says, adding that if the other goals are achieved, this part should come naturally. However, Luna’s team has also reviewed all of Healthesystems’ internal IT assets to identify which systems will continue to be invested in and which will be retired.
“As we continue to achieve these key goals throughout 2018, we expect that the outcomes will support our company’s mission: to simplify complexities for each of our customers,” Luna says. “And ultimately help expedite getting injured workers the right care, so they can get back to their normal lives sooner.”
Leadership: It’s not about you
During his time in the United States Marine Corps, and as an IT leader at companies across several industries, Luna says he has learned a lot about leadership.
When asked about his leadership experiences at Healthesystems, he enthusiastically responds that, “It’s an open, transparent, and friendly culture and work environment; when you look to your left or right, it’s reassuring to know your fellow employees are working toward common goals.”
It’s not just about being in charge, Luna says. It’s more about communicating a vision and providing your team with what it needs to be successful—being a true “servant-leader.”
It also helps to keep the end game in mind: Getting the injured worker back to work.
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