Occupational Health Case Management Platforms on Salesforce

Summary

An occupational health case is a work-related injury, exposure or fitness-for-duty question that moves through examination, classification, restriction, treatment and return to work. We build case management platforms for that work on Salesforce, covering the clinical record, employer and worker links, medical surveillance programmes, correspondence, controlled documents and external access. This kind of engagement covers the data model, the sharing and security design, regulated surveillance workflows, portal access for employers and referrers, and migration off spreadsheets and shared drives.

The Challenge

The record has to hold clinical findings, the employer and job role, the disposition, work restrictions with effective dates, surveillance results, and every communication about the case. Several parties touch it - physicians, nurses, case managers, employers and safety officers - and each is entitled to a different slice. Spreadsheets, shared drives and paper forms fail here not because they are slow, but because they cannot enforce who sees what and cannot prove afterwards who did. Medical surveillance is the part most implementations underestimate, because schedules, thresholds and escalation paths are easy to encode as one-off logic and expensive to change. Free-text classification quietly destroys reporting, protected health information leaks through portal-visible fields, and permission design is costly to retrofit.

The Solution

Core data model

Salesforce is a reasonable foundation because the domain is relational, workflow-heavy and access-control-heavy. The model normally centres on custom objects for the case, the encounter, the exposure event, the restriction, the surveillance result, the employer account and the worker record, with junction objects where the employer of record differs from the site of work. Classifications, dispositions and restriction types belong in governed picklists rather than free text: every downstream report, compliance check and trend analysis depends on closed vocabularies. Restrictions need start and end dates and a review owner, or they silently persist past their clinical basis.

Regulated surveillance and compliance

Blood lead level monitoring is a representative example: the platform has to know which workers are enrolled, at what testing frequency, which thresholds trigger action, and what notification, retest or medical removal follows a given result, with periodic reporting generated from the same records rather than reassembled by hand each cycle. Modelling schedules, thresholds and escalation paths as data rather than as code means a regulatory threshold change is a configuration edit, not a release.

Communications, documents and access control

• Integrated fax and email - inbound and outbound messages logged as activities against the case, so the correspondence history is part of the record instead of living in individual mailboxes.
• Document management with an audit trail - files held against the case with version history, structured classification and retention rules, since ad hoc cloud folders provide storage but no defensible chain of custody.
• Role-based security - sharing rules, field-level security and record types so an employer sees fitness and restriction outcomes while the underlying clinical detail stays with clinical roles.
• An external portal - an Experience Cloud community with granular permissions gives employers and referrers real-time visibility without provisioning them into the internal organisation, with licensing model and sharing set design settled before build.

How we build it

We model objects and sharing before automation, since permission design is far more expensive to retrofit than any workflow. Automation is declarative first - flows, validation rules, approval processes - with Apex reserved for volume and logic that declarative tools cannot express, always written bulk-safe. Reports and dashboards are built on the object model, not on exported extracts. Migration from spreadsheets is treated as work in its own right: deduplication, mapping legacy free-text classifications onto the new vocabularies, and validating historical caseloads in a full sandbox before cutover.

What This Delivers

Every party works from one record and sees only the slice it is entitled to, and that entitlement is enforced by the platform rather than by convention. Surveillance cycles run from enrolment data, thresholds and schedules held as configuration, so a regulatory threshold change does not require a release. Correspondence and documents live with the case, making the history defensible. Reporting becomes possible because classifications are closed vocabularies, and an audit question is answered from the system.

Technologies and Tools

• Salesforce with custom objects, record types and junction objects
• Sharing rules, field-level security and role hierarchy
• Flows, validation rules and approvals, with bulk-safe Apex where needed
• Experience Cloud communities for employer and referrer access
• Integrated fax and email logged as case activities
• Native reports and dashboards, and full sandboxes for migration rehearsal