International SOS Improves Alarm Center Efficiency with SOA-Based Medical Assistance and Financial System

International SOS provides clients, which make up 83 percent of the Fortune Global 100 companies, with a portfolio of medical and security services to ensure that people traveling and working internationally have access to immediate help. Within the organization, more than 70 languages and dialects are spoken. International SOS, whose headquarters are in Singapore and London, provides services that range from 24-hour medical advice, referrals to qualified doctors and hospitals as well as provision of emergency medical and security evacuations when there is a critical illness, accident or civil unrest. In 2005, it handled over 780,000 assistance cases, including more than 14,000 medical evacuations.

With global operations in 65 countries, more than 4,500 employees -- a third of them medical professionals spread across 27 alarm centers spanning five continents -- it is important for International SOS to have relevant information in a 24x7 environment to facilitate successful evacuations. Its reputation is built on its ability to respond flexibly and rapidly to widely varied and developing situations anywhere in the world. Thus, it needed appropriate systems to support its team in delivering quality services in demanding situations where all inputs may not be available.

Ensuring service quality

Mark Crawford, International SOS' Group General Manager of Assistance Services in the medical services and operations division, remembered the second Bali bombing in October 2005 well. His global IT infrastructure project Magellan, a new assistance and financial application, had gone live on the same day.

Immediately after the incident, International SOS experienced an increase in case load, particularly in its project pilot site in Singapore. However, with the support of NewCase, one of two components of the Magellan application, the medical assistance team was able to maintain its usual high quality of service.

The NewCase front-end application was developed in Singapore by the Avanade Asia team, while the other Magellan element BiGGeR (billings and accounting journals generation) was developed by International SOS' in-house team. Both elements have been integrated to provide International SOS with a better view of its operations and aid in more accurate decision making. Crawford recalled that the go-live day of the system was rather anti-climatic as the development phase had focused on getting at least 95 percent of the work done before that day. And that, he reflected in hindsight, was the key to coping with the increased activity brought about by the terrorist attacks the same day.

Distributed systems

International SOS has been providing assistance to its clients using three key assistance applications - CASE, developed in the US; JUPITER, developed in Australia; and NIKKO, also developed in Australia and used for handling International SOS's Japanese clients. The company had been using CASE for seven years, while the other two systems have been around for five years.

While these disparate systems have served the company well in day to day operations, the existing systems have only provided partial integration. For the Sales and Marketing team this meant there were some limitations in the timeliness of the data available to them.

While replication of data has been part of the operating landscape of International SOS for many years, the technology and expertise brought by Avanade has allowed the company to provide a single integrated, replicating environment across its entire assistance structure, further enhancing its ability to provide a single, "virtual" alarm center for doctors and customer service executives working "live" from the same information globally.

According to Crawford, the company's business processes are made up of global standards and local requirements. Magellan was conceived to enhance that process to one that is made up of global standards, and supplemented by client specific requirements. That, he believed, is what the company needed to become location independent, particularly for a business like International SOS.

"When processes become location independent," Crawford explained, "creating a virtual operating environment will enable business and medical assistance to be more rapidly delivered from one or more alarm centers."

Change in mindset and workflow

One important consideration Crawford believes is crucial to ensuring the success of such a large scale project is to make sure sufficient time and focus is put into training the users as early as possible. The user training and testing put in place has been successful in minimizing the impact that the switchover to NewCase has had on International SOS' daily life-saving operations.

With NewCase, International SOS employees now have the support of centrally integrated email, scanning and fax services. They can also share case information between centers, whilst still maintaining a distributed environment. NewCase allows International SOS to have consolidated, more accurate and timely reporting for clients and internal management.

With the consolidated case management system, International SOS expects to improve efficiency across alarm centers by at least 10 percent, while its global nature will help disseminate best practices observed in each alarm center. That, Crawford believes, not only improves staff morale, it helps deliver even better service to its clients with improved monitoring of tasks and providing better communication and efficiency tools.

"Think of NewCase as the core system that combines our clients' records and all related medical and services information in the International SOS alarm centers into one integrated application. This single global repository of client incident and service information enables our service coordinators to have convenient and fast access to more detailed client history, allowing them to focus on providing even more consistently excellent service to our clients," said Crawford.

"NewCase also further improves everyone's understanding of their roles in each case," added Crawford. "With the new system, users can find out what has been sent or received from a service provider at any point in time, and in any of the centers involved for a specific case."

The other tricky bit was replicating information and sorting out how the team could work virtually. Fortunately, NewCase is smart enough to broadcast information to only those relevant to that particular case.

Consolidating resources and planning for the future

Avanade, in consultation with International SOS, proposed a Service-Oriented Architecture (SOA) and web-services based Microsoft .NET platform which is versatile enough to support the evolving business requirements.

The system gives International SOS the ability to more effectively share relevant case information, task processing, notes and documents; integrate workflow between operations and finance including possible future use of e-invoicing and claims management; have a shared front-end look and feel; integrate the sales and marketing system; and integrate with the systems of the company's service providers.

NewCase also has a distributed architecture with replication technology. That enabled International SOS to cope successfully with infrastructure and bandwidth challenges in developing countries such as Vietnam, while catering for traffic to major data centers such as Singapore, the United Kingdom and the United States.

"The distributed architecture will allow all alarm centers to have key operational data available 24x7 including during catastrophic communication failures, while maintaining a high degree of integration with the central data repository," said Crawford.

NewCase is able to integrate the latest call center technology, including CTI, in later phases too. With the new system, International SOS will be able to better monitor alarm center operations and costs, resulting in improved delivery of services and consolidation of uniform service standards.

For example, when opening a case in NewCase today, users have to key in the patient's particulars. The difference here is that this information will be replicated in the appropriate fields in NewCase and need not be re-keyed. That not only saves time but also reduces data entry errors.

When it comes to using the email function in NewCase, the user only had to create the email content, select the appropriate email address from the recipient list and then send the email. The From and Sent timings are automatically captured in the email notes, thereby simplifying the case logging process. With NewCase, this function could be done in as much as a quarter of the time compared to the old system.

Embracing clients' needs

Crawford highlights that "no other system in the world compares to NewCase". Its implementation cost is close to US$6 million over three years including hardware and software.

At the height of the project, the International SOS Singapore office was packed with an implementation team of 30 in house software developers and Avanade Asia members from countries like Singapore, Malaysia, Thailand, and another 15 IT professionals from both companies working closely together on project management and implementation planning.

"The Avanade Asia team shared our problems and helped to resolve them with us. During the intensive project development period, the team showed flexibility and a cooperative approach in dealing with any issues relating to scope that emerged," said Crawford, who has more than 10 years' experience in call centers and medical assistance operations management and is managing a global assistance team that attends to over 700,000 cases and 10,000 air evacuations per year.

When the system experienced performance issues earlier in the project, the Avanade Asia Pacific CTO stepped in to help the developers resolve them. It was important for Avanade to help its clients meet their project objectives and it was committed to do all it could to resolve any issues. Avanade successfully met International SOS's development milestones by completing the Singapore and Thailand pilot application in 13 months from November 2004 through October 2005.