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First Canadian Health
CGI migrates health claims system without a hitch
When it comes to migrating a complex information system from one company
to another, there’s no substitute for experience. By skillfully shepherding
First Canadian Health’s claims processing system through this crucial
transition, CGI provided continuity at a time when they needed it most.
The Challenge
Canada’s federal health
department, Health Canada, operates a program to provide
Native Canadians with drug, dental and medical benefits not available
under Canada’s provincial and territorial health insurance plans.
In 1998, Health Canada awarded the contract to administer claims under
this program to First Canadian Health (FCH), a joint venture of the Native-owned
Tribal Councils Investment Group and Aetna Health Management. The system
that FCH used to process and pay these claims consisted of Aetna Canada
software applications customized to FCH’s needs, hosted on an Aetna
Canada mainframe computer, and supported by Aetna Canada.
In 1999, as part of a broader corporate restructuring, Aetna began negotiating
to sell its share of FCH to its partner in this joint venture. But for
the sale to go through, Aetna had to find an IT service provider that
could take over, host, and support FCH’s system, and make this transition
quickly and flawlessly. Aetna called for proposals, and CGI’s response
blew the competition out of the water.
The Strategy
CGI’s strategy called
for migrating FCH’s system from Aetna’s mainframe to CGI’s
Toronto-area data center. Mary Dee-Smylie, FCH’s Executive Director,
explains how CGI and FCH went about this task.
“CGI started by doing something I’d never seen before—they
sent us a team with extensive experience in smoothly transitioning complex
systems like ours. These people knew all the issues to investigate and
all the questions to ask. Instead of our having to show them everything,
they anticipated our problems and helped us work out the best solutions.
“CGI also sent several experts in our Aetna health management applications
to facilitate the transition, plus specialists in other disciplines to
enhance our system’s performance.
“The day we cut over to the CGI environment,” she continues,
“we saw what a difference all this heavy-hitting talent had made.
There was zero downtime. We literally plugged in the new system, unplugged
the old one, and kept on rolling.”
The Technology
- Outsourcing services provided: mainframe and applications support,
telecommunications, client-server support, disaster recovery, help desk
- Application development tool: MS Visual Basic
- Mainframe environment: IBM S/390 running MVS, AS/400
- Client environment: Desktop PCs on a Novell LAN
The Results
Looking back on the transition
and on FCH’s experience working with CGI ever since, Executive Director
Dee-Smylie is delighted at what she sees.
“When we first heard Aetna was pulling up stakes,” she recalls,
“we felt a little lost. They had provided all our users with such
wonderful, close support, and we were scared that no one else could do
the same.
“But CGI has really taken us under their wing, addressed all our
concerns, and made us feel completely secure. Our objective was to get
the same service and certainty from CGI as we had gotten from Aetna, and
we certainly have. However large or small the problem, CGI has always
been just a phone call away with all the support we need.”
As FCH’s IT outsourcer, CGI now hosts and supports a system that
processes over
7 million dental claims per year, while also producing reports for 20
million medical and drug claims processed elsewhere. CGI supports over
100 on-line users of the FCH system, who rely on it for 100% of their
job duties.
Thanks to CGI’s best practices and state-of-the-art facilities,
and the application enhancements developed by CGI, the FCH system now
provides better reliability and performance than ever before, including
99% availability.
Looking forward, Dee-Smylie sees a continued close working relationship
with CGI. “Right now, we’re transitioning to a new core health
management application, and CGI’s expert knowledge of our data architecture
is proving invaluable. We may also eventually partner with CGI to manage
health insurance claims for other clients besides
Health Canada.”
“We view CGI as the ideal partner for future ventures where we need
world-class support for our mission-critical information technology.”
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