Transforming Workman’s Comp Case Management

Overview

Before this project, the organization relied heavily on email to manage its Workman’s Compensation operations. There was no centralized system for case tracking, collaboration, or documentation, which led to inefficiencies, delays, and missed billing opportunities. A leading provider of occupational healthcare services needed a modern, secure, and efficient way to manage Workman’s Compensation cases. Their nursing teams required a tool to diagnose and document patient cases, coordinate care across clinics, and ensure timely communication with patients and employers — all while maintaining a complete, auditable record of every transaction.

The team was engaged to build a web-based application that could unify all workflows into a single interface and integrate seamlessly with healthcare communication tools like e-fax and secure email. The platform had to support case collaboration, dynamic case assignment, and full auditability — all within a HIPAA-compliant environment.

Challenges

The initiative focused on replacing a legacy, email-based workflow with a modern case management platform tailored to meet the complex and diverse requirements of multiple clients. Each client brought its own unique business rules, terminology, reporting hierarchies, and compliance standards. Users were accustomed to the convenience of Outlook for patient correspondence and communication, so the new system needed to maintain that intuitive simplicity. At the same time, it had to intelligently present the correct forms and documentation based on the client and case type—minimizing cognitive load and reducing the risk of human error. The platform also needed to enable real-time collaboration, secure communication, flexible case workflows, and accurate billing and audit logging, all while ensuring full compliance with HIPAA and other regulatory mandates.

Key challenges included:

Managing the complexities of each client’s unique requirements, including variable terms, documentation expectations, and internal reporting structures
Ensuring case workflows were flexible enough to support multiple case types with differing data needs and logic paths
Capturing an accurate, timestamped audit trail that validated the timing of all patient interactions and satisfied strict regulatory compliance
Difficulty in time tracking for case work and ensuring complete billing
Fragmented case tracking and documentation
Asynchronous communication with clinics and patients
Case hand-offs and workload balancing
Employer-specific preferences and documentation
Real-time collaboration among case workers
Strict HIPAA and audit trail requirements

Solution

To address these challenges, the platform was designed with flexibility, automation, and user experience at its core. Each client’s configuration, including terminology, workflow preferences, and documentation requirements, was made dynamic and data-driven, allowing the system to automatically present the correct forms and options based on the case and client context. A unified messaging and audit trail system ensured that all communications were logged and traceable. The user interface was intentionally designed to feel as intuitive as using Outlook, minimizing training needs while ensuring compliance and consistency across the organization.

A scalable, modular platform was developed, featuring a modern Angular frontend and a robust .NET Core backend.

Rich Frontend Experience with Angular

The frontend was designed with performance, maintainability, and flexibility in mind. Angular services were used extensively to manage case state across several modules, allowing different parts of the application to stay in sync without redundant data handling. The application leveraged lazy loading and strong modularization practices to keep bundle sizes small and page loads fast, resulting in a snappy, responsive experience for end users.

Kendo UI + Bootstrap provided a polished, responsive interface
Dynamic Reactive Forms adapted to injury types and client-specific workflows
Reusable Shared Components (e.g., Notes and Email) streamlined communication
Container/Presenter Pattern organized complex pages and separated logic

Real-Time Case Collaboration with SignalR

Live Updates: All case pages and dashboards updated in real time
Dashboard Sync: Changes in assignments or case statuses were reflected instantly
Inbound Communication Visibility: SignalR also ensured that inbound communications such as clinic responses, faxes, or email replies were immediately reflected in the dashboard and associated cases
Enhanced Collaboration: Reduced duplication and improved care coordination

Robust Backend Architecture

.NET Core Web API using CQRS, MediatR, and OData
Entity Framework with SQL Server and versioned database project
RabbitMQ for asynchronous email and fax handling
Mailgun Integration for managing all outbound email and fax communications reliably and at scale
Identity Server for authentication and Role-Based Access Control (RBAC)
SignalR for real-time synchronization

Case Management & Patient Triage

The platform provided robust support for managing the full lifecycle of a case from intake through resolution. Case workers and nurses used the system to triage patient needs, document findings, coordinate care, and manage case ownership.

Case Intake: New cases were initiated based on referrals or incidents and logged with detailed patient and injury information.
Primary Nurse Assignment: A designated nurse was automatically assigned as the case manager, with options for reassignment as workloads shifted.
Case Triage Workflow: Nurses assessed the severity of injuries, identified treatment requirements, and routed patients accordingly.
Ongoing Case Management: All case activities—including notes, emails, faxes, billing entries, and clinic assignments—were tracked in one unified view.
Audit & Handoff: The system supported seamless handoff between staff members and maintained full audit logs of every interaction.

Billing & Time Tracking

Billing was a core component of the application. Nurses were required to log time whenever they worked on a case, ensuring that all case-related activities were properly documented and billable. All entries on a case required corresponding billing time entries, guaranteeing that the organization consistently billed for all nurse-performed work.

Time Logging by Nurses: Every case interaction allowed nurses to create billing entries, capturing the duration of time spent.
Classified Entry Types: Billing entries were categorized by activity type (e.g., documentation, communication, follow-up).
Notes and Timestamps: Each entry included notes and a timestamp, supporting full context and traceability.
Monthly Billing Reports: Logged time data was aggregated and exported for monthly billing purposes, aligned with case history and audit trails.

Administrative Configuration & Client Management

Client Management

Preferences by Client: Terms, documentation templates, and workflows
Dynamic Form Selection: Automatically chosen by case type and client
Organizational Hierarchies: Support for divisions, departments, and managers

Clinic Network Management

A key administrative feature of the application was the ability to manage the clinic network — healthcare facilities that patients could be referred to for services.

Clinic Directory by Region & Location: Administrators managed a centralized directory of clinics, including contact details, services offered, and location metadata.
Client-Based Clinic Preferences: Employers had varying relationships with different clinics. Some were approved, others preferred, and some explicitly excluded. These preferences were configured at the client level and stored in a Clinic Preference Matrix.
Guided Case Routing: Nurses were guided to select appropriate clinics based on the employer’s preference matrix and the patient’s region.
Automated Clinic Communications: Case data was automatically sent to clinics in advance of patient visits.
Clinic Visit Feedback Loop: After appointments, clinics sent visit summaries back to the system for documentation and case updates.

How the System Works (Workflow Summary)

Case Initiation: Nurse logs a new case, system selects appropriate form
Case Triage: Nurse assesses patient needs and determines care plan
Time Logging: Nurses record billing entries for each interaction and task
Clinic Assignment: Based on employer preferences and region
Pre-Visit Communication: Clinic notified ahead of appointment
Visit Follow-up: Clinic sends back results, documented in system
Ongoing Updates: Nurses document notes, send emails, and reassign cases in real time
Audit Trail: Every interaction is timestamped and attributed to a user

Why This Approach?

The architecture and design decisions were driven by the need to deliver a user-friendly, high-performance platform that could scale with business needs and adapt to the complex, variable requirements of occupational healthcare clients. By modularizing services, automating client-specific configurations, and providing real-time visibility into all case activity, the system ensured a seamless experience from intake to billing.

Scalability: Designed to handle growing data volumes and user demand without performance degradation
Auditability: Every action was traceable through detailed logs and timestamped entries
Real-Time Visibility: SignalR enabled immediate updates across dashboards and case views
Client-Specific Customization: Dynamic form and workflow logic adapted to each client’s unique requirements
Integrated Communication: Centralized handling of notes, email, and faxes for streamlined correspondence

Outcome

The platform successfully modernized Workman’s Compensation case management for a high-volume occupational health provider. It replaced inefficient, email-based workflows with a streamlined, auditable system tailored to each client’s requirements. Nurses and administrative users gained a powerful yet intuitive tool for managing cases, coordinating care, and capturing all interactions in a centralized, real-time system. In doing so, the organization increased operational efficiency, improved compliance, and delivered a better experience for patients and employers alike.

Key benefits

Faster patient onboarding and routing
Fewer miscommunications and delays
Dynamic form workflows reduced manual errors
Nurses collaborated more efficiently
Clients received tailored service
Clinics integrated directly into patient journeys

Technologies Used

Frontend: Angular 10, Kendo UI, Bootstrap, Container/Presenter Pattern
Backend: .NET Core Web API, CQRS, MediatR, OData, Entity Framework
Messaging: RabbitMQ
Real-Time: SignalR
Authentication: Identity Server with Role-Based Access Control
Data: Microsoft SQL Server with database project
Deployment: CI-CD Azure App Services