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In Hawaii, the Department of Labor and Industrial Relations (DLIR) handles tens of thousands of claims and status reports are made each year for disability compensation. Those claims go through a complex process of intake filing, review and reconciliation. The agency's tasks include monitoring the payment of Worker's Compensation Benefits and Claims, adjudicating disputes between claimants, insurance carriers and employers and collecting data for work-related injury statistics.
With the intake process being manually based, submittals were time-consuming and exhaustive. Paper documents forced linear workflow review, statistics and data coding entry. Moreover, rigorous system edits force a considerable effort to prepare documents before data entry. In addition, the system was exacerbated by added costs due to onerous process and the need to outsource the keypunch process.
Another inefficiency centered on the hearing process. DLIR hearings at five offices on four different islands require the scheduling of participants and the transfer of case-related paper documents. Moreover, the manual calculation of benefit awards was time-consuming and open to possible errors.
Lastly, DLIR processed their large volume of claims and status reports onto an IBM mainframe and stores the submittals in LekTriever files. Done by hand, the creation of these reports were difficult and their retrieval was time-consuming.
DataHouse re-engineered the DLIR's system and business process to dramatically improve productivity and reduce costs.
For claim submittals, DataHouse created an electronic method of filing, either via diskette or through the Internet. Having claims made in electronic format made research much easier, eliminating the keypunch process.
For scheduling hearings, DataHouse created an efficient scheduling and e-mail system, aimed at consolidating all hearings statewide including postponements and cancellations. The scheduling is based on Notes Free Time Scheduling and notifies key participants via Notes mail and its calendaring function. The centralized calendar system eliminates conflicting schedules. This application also speeds hearing readiness by tracking required documents on-line and generating electronic case jackets.
To speed the hearing process, DataHouse created a series of multi-purpose electronic forms that allow for collection, validation and calculation of the benefit awards. These cleanly interfaced Lotus Notes forms calculate awards automatically, based on data entered during hearings and data currently on the system. The application computes benefit awards according to Hawaii statutes and DCD (Disability Compensation Division) Administrative Rules. The results are incorporated into the legal decision for the case. Hearing officers interpret decisions, researching previous cases before rendering a decision, based on pre-existing decisions and the law. The Lotus Notes application automates this interpretation process and provides for a more efficient means of rendering accurate decisions. When research is required, a DLIR officer can now gather the information on-line.
Business processes were addressed with several recommendations. One recommendation was to stop building "case jackets" for cases that do not get adjudicated. These bulky files make up about 80 percent of cases, taking up considerable production time and storage space. This alone would free up the staff's time, lower production costs and eliminate the need to pay for costly storage. DataHouse also reviewed data intake practices for weaknesses and found that manual collection and calculations resulted in wrong information as well as slow processing.
DataHouse enhanced DLIR's technology infrastructure by integrating a relational database into the system and housing it on the Division's statewide WAN. Claim, claimant, employer, and carrier/adjuster information were stored in SQL Server and displayed real-time using the Realtime Notes function in LEI. SQL Server data is also accessible for queries using SQL Query and Microsoft Access via ODBC and Microsoft's Office Suite. DataHouse extended the usefulness of the DLIR's IBM mainframe, which handles claims tracking, payment and queries/statistics by providing needed enhancements in support of these changes.
The total project environment was comprised of:
Application
- Lotus Notes/Domino on Windows NT
- Lotus Enterprise Integrator
- Microsoft SQL Server
- Microsoft Office
- Software AG ADABAS/Natural
Platform - (installed by State of Hawaii and IBM)
- IBM TSO
- IBM MVS / OS390
- Mixed environment of Thin Clients based on Microsoft Metaframe and Standard PC's connected to IBM Netfinity Application/File/Print Servers
- LAN/WAN - Ethernet with CISCO routers / Switches
- WAN - Frame relay on Fiber backbone to Neighbor Islands and offices
- 3270 Emulation SNA over WAN to Thin Clients/PC's
- Category 5 copper within offices
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