A significant change in the healthcare industry’s approach to providing healthcare is underway- with the patient at the center of it all- patient satisfaction and quality scores. With the constant concern for the hospital CEO around the financial organization, both clinicians and administrative staff are hungry for data to aid decision making and guide their planning.

As we move ahead, the healthcare industry is striving to make for a better system that achieves higher quality at a lower cost. The effort required, though, isn’t simple. The need to move to automation RPA/IA in Healthcare is urgent. The longer the wait, the more difficult it will be to make changes that will enable the health systems to survive the challenges. And the more will be the cost.

In today’s age, as patients exercise their right to choose how and whom they would like to engage in their healthcare needs. When doctors are overwhelmed by the number of patients, primary office accomplishments start to take a back seat.

The lack of focus on the patient journey/ customer experience starts to surface. Simple things like these can be easily managed through Intelligent automation.

Patient Access- Smart Scheduling & Personalization

RPA enabled scheduling tools can facilitate appointments, right from pre-registration all the way to verifying insurance and validating benefits included.

Intelligent Automation or IA in Healthcare can help hospitals understand preferences and personalize treatment based on medical history across systems, early diagnosis, procedures, and medical services. Integrating the traditional system with the CRM system to provide initial documentation for the doctors who are taking care of the patient.

In several cases, all this information is present in isolated systems however, it has not been seamlessly connected and presented in this manner.

Patient Treatment- Using IA in Healthcare

In the past doctors have relied on disparate sources of information from various departments to put records together to come up with a nursing plan. This tends to be more time consuming and far less efficient to judge the best course of action.

Doctors can now capitalize on having more information at their fingertips. This gives them a full picture of the patient journey so they can have the right nursing plan with all the basic medical documentation in order.

The doctor can be in an emergency room, performing an operation and have a plethora of data at their disposal while operating on the patient.

There can also be an optimal utilization of existing staff as a result of increased automation.

Patient Remote Care:

Intelligent Automation or IA in Healthcare can support remote monitoring of patients within the healthcare system. When patients follow the care as prescribed by the doctors, supported by Digital Workforce, the patient health outcomes can be monitored and improved. In case patients deviate from the prescribed care, automation can intervene as necessary. It can provide continuous monitoring of patients and provide high quality care.

Revenue Cycle Management: Charge Management Using Intelligent Automation

RPA is a solution that automates rule-based manual tasks. Administrative and clinical tasks that contribute to the collection of capture, management, and collection of patient revenue systems, “Transaction Processing” can easily be accomplished by RPA or Intelligent Automation.

What activities can IA or RPA offer under Transaction Processing:

– Provider Enrollment

– Eligibility

– Charge Capture

– Payment Processing

– Claims Management.

– Credit Bank Resolution

Back-Office opportunities with RPA/ IA in Healthcare

The earliest use cases for RPA have come at the back office where the tasks are rule-based. E.g. billing and insurance

The Digital Worker is going to do the same thing every time, based on a set of defined rules. Hence, based on compliance needs, the Digital Workforce can automate and standardize tasks with efficiency.

Examples:

Pre-authorization with commercial insurance payers:

From submitting the authorization request through the Website, to pass on the approval to the staff to complete clinical work based on the requests can completely be handled by such automation.

Secondary Billing:

Submit a secondary claim if necessary, post calculation of the fee schedule versus actual payment. And automate contractual adjustments.

Reconciliation:

The Digital Worker can access the remittances that are coming from the payer, pull the bank data, reconcile this, split the payment if needed and post the payment to the payment account in an automated style.

Case Study for Robotics in Healthcare:

In 2009, a National Diabetic Retinopathy Screening service rolled out a new automated grading system which helped to analyze retinal eye images for a specific eye pathology associated with retinopathy. Before this system could go live, they needed to interface the current screening IT system to an automated-grader

They originally looked at the more traditional IT interfaces to link the 2 systems and decided instead to try RPA/ IA in Healthcare as it enabled them to quickly develop a flexible and scalable solution

How has it worked out?

They have been able to steadily increase daily throughput. The robot can now process up to 600 patient episodes per day / over a 7day working week.

The RPA/ IA solution gives them the flexibility to quickly deploy an additional RPA as their patient numbers increase, to help manage the workload – at a minimal cost.

The system is now more resilient and it has provided them with the operational capability and agility that they require in order to deliver their service

The processes that can be done repeatedly, rule-based tasks. Mainly they are:

– Highly Manual

– High Mass Volume

– Rule-Based- No human judgment

– Multiple disparate systems

– Not frequent changes.

For these kinds of processes, RPA delivers accuracy and speed. It also delivers a 100% return. Successful RPA implementations take costs and risks out of business.

How do you Get Started with RPA?

Identify how do you want to consume this technology, go at your own pace and achieve your goals. What is the automation potential and what are the opportunities inside of the organization?

Think of what could be an automation journey based on these goals. Bring in the IT team, talk about the people aspect. Build a Use Case- Not, for example, how do you reduce headcount, but how do you capitalize on free resources

Moving ahead, once you get the digital worker trained, how do you then leverage them to accelerate your output, now that the digital workforce has matured. You can go back to the blackboard and think of other processes that you can feed into the software robot.

How do you mature with RPA and Intelligent Automation?

The key is to understand that you have to automate small processes first. Get them to function efficiently, get a human resource to control and monitor the implementation. Once you have that up and running, you can look at larger more complex processes and Artificial Intelligence. Once the organization has matured with analytics, digitization of data and as these technologies get more involved and accepted inside your infrastructure, go ahead and add more judgment-based tasks. Build a layer by layer approach on top of what you start.

Intelligent Automation is an essential tool for healthcare as it helps to streamline processes, saves labor costs, builds efficiency and increases the quality of patient care.

To Summarize, a large part of the doctor’s busy hours can be attributed to paperwork, administrative processes, manually intensive tasks. RPA and Intelligent Automation can adapt and accommodate multiple changes in the billing cycle that may occur. It can manage accounts payable leading to an improvement of billing efficiency and a reduction in write-offs thus improving the revenue cycle.

RPA and Intelligent Automation can also provide a wealth of information that can be used to optimize patient care. It can collect data on how well the recommended program is working and use that information for further improvisation. The answers for Whom to treat, when to treat and how to treat- answers can be there in your data.