New ITSM implementation increases first response time for healthcare provider

Published: June 6, 2023

By leveraging modern service management, ITIL best practices and Jira Service Management, the Brazilian insurance company Seguros Unimed optimized processes and ensured the delivery of high-quality services to customers.

Seguros Unimed, a Brazilian health insurance provider, operates a highly complex IT ecosystem. Seven technology areas within the company manage systems that support the five companies of the group. However, the lack of governance in IT management led to issues impacting the quality of service to both internal and external customers. These issues include cumbersome processes, delayed response times, lack of reliable KPIs, and customer dissatisfaction.

To elevate IT to a strategic role in the insurance company’s services, the Shared Services Center area started a project with e-Core to evolve its ITSM.

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Through the implementation of processes following the ITIL methodology in Jira Service Management, the company successfully addressed service quality problems and fostered a new culture of IT services. Both internal and external customers recognized the positive impact of these changes.

Fernando Herculin, The IT and Infrastructure coordinator at Seguros Unimed, emphasizes the significant impact of these improvements. He points out that even an hour of waiting caused by an IT service failure can worsen a patient’s health status. “These are lives that can be at risk,” says Herculin.

What we delivered

  • Implementation of modern process and service management following ITIL best practices in Jira Service Management
  • Development of automation solutions to optimize processes and services
  • Support in reviewing the product catalog line

The results

  • Better healthcare experience for end users
  • Improved quality of IT service
  • Strategic decision-making based on reliable data
    Increased efficiency and optimization of processes

“When customers use the Seguros Unimed provider network, such as a hospital, clinic, or laboratory, they use our systems to process authorization requests. If the system malfunctions or is unavailable, this may lead to an increase in the patient’s waiting time until approval is granted by the Seguros Unimed team responsible for that request.

Previously, when system issues occurred, the call center would contact the teams by phone without opening a ticket. There was no proper management since incident tickets were not generated. Now, with the ITSM tool (Jira Service Management), the call center generates an incident ticket handled by the Shared Services Center team that is available round-the-clock to analyze the tickets. If the incident is considered critical, with a massive impact, the SLA (Service Level Agreement) sets a 15-minute timeframe for reclassification as a crisis. From then on, the crisis management team is involved, and a war room will automatically be opened with notifications sent via SMS to the relevant teams. After identifying and solving the problem, the ticket is then sent to problem management so that the root cause can be identified.”

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Fernando Herculin

IT and Infrastructure Coordinator at Seguros Unimed

Check out the details of this ITSM case!

Seguros Unimed is the insurance and financial arm of the Unimed system, which is the largest health cooperative system in the world. Focused on increasing transparency, integrity and improving risk management, the insurance company adopted a series of measures that significantly improved its governance in 2022.

One of the key projects that contributed to this achievement was the evolution of ITSM based on the ITIL methodology. The project started in February 2022, led by the Shared Services Center area, which relied on e-Core’s vast experience in ITSM to support it in implementing best practices and a new culture of IT services among the company’s seven technology areas, enabling modern IT process management.

“Coordinators who had already worked with Jira at other companies praised the tool a lot, emphasizing its configuration and integration with our systems. This achievement was only possible because e-Core leveraged the lessons learned from previous experiences. We wanted to implement the tool based on ITIL principles. But how do you do that? e-Core proposed the best way to deliver it. Their experience had a huge impact, even influencing discussions with other managers.”

Fernando Herculin

IT and Infrastructure Coordinator at Seguros Unimed

ITSM deployment in stages

The Services Center embarked on a process of centralizing a significant portion of IT tickets and functioning as a vital link between the business and technology divisions. With the help of e-Core, all processes designed based on the ITIL methodology were revised and implemented following the best practices in Jira Service Management.

Following a successful pilot with Infrastructure, Technology Governance, and the Shared Services Center, all other departments transitioned to Jira. Today, business areas such as marketing, communications, processes, and quality control are also being incorporated into the tool.

Challenges Encountered

Cumbersome and manual processes, which made it difficult to manage IT services

  • The IT area used a system that wasn’t flexible, preventing the creation of subtasks, for example. Thus, users often had to open several tickets across different areas to have their requests resolved;
  • Automation was not feasible in the previous system, resulting in slow and bureaucratic change management.

Low-quality customer service negatively impacted customers

  • There were no standards in the service level agreement between the business and technology divisions, which led to dissatisfaction regarding compliance with established deadlines;
  • As there was no Shared Services Center, developers often focused on resolving low-complexity incidents instead of solving complex problems that could improve the customer experience.
  • The request queue lacked prioritization, which could lead to delays in resolving more critical incidents;
  • The service lines were very technical and not user-friendly;
  • Customers could not track request status;

Lack of real-time monitoring of KPIs, which hindered the visibility of the root of problems

  • The previous tool did not allow real-time monitoring of KPIs, such as SLA delays, number of incidents, resource allocation, etc.;
  • Reports were exported in CSV format, which could lead to data inconsistency;
  • The satisfaction survey was mandatory for the customer to open another ticket, which made many conduct their evaluation without proper criteria.

Benefits of ITSM at Seguros Unimed

Modern management of processes, which are more efficient and optimized, resulting in better response time and better IT governance

  • All IT processes were included in Jira Service Management following ITIL practices;
  • Automated processes to better serve customers;
  • Automations were created for critical situations to streamline and improve service delivery to end customers.

“Previously, we had many more crises. However, with the implementation of the ITSM tool and the help of e-Core, we use KPIs to assess our success in meeting Seguros Unimed’s goals. This led to significant gains in process optimization throughout the company.”

Fernando Herculin

IT and Infrastructure Coordinator at Seguros Unimed

Improved quality of IT service, acknowledged by customers inside and outside the organization

  • SLA standardization was implemented for all areas;
  • Users gained increased visibility into their tickets, enabling real-time tracking of service progress.
  • The integration with other company systems brought greater convenience to users and problem-solvers.

Making strategic management decisions based on reliable data, enabling continuous improvement in service provision

  • Team performance indicators are automatically generated by the tool and can be shared in real-time;
  • Automations were created to signal recurring incidents and other service problems, such as overdue tickets.

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