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How Automated RPA Applications in the Healthcare Sector Can Be A Gamechanger

The healthcare industry stands to gain a lot from investing in Robotic Process Automation (RPA). Successful adoption of RPA leads to improved patient care at reduced cost. Here’s our understanding of how the Healthcare industry can benefit from implementing RPA.

Now more than ever, healthcare organizations face a daunting challenge in sourcing and integrating information from various internal and external sources. The healthcare industry collects and processes vast amounts of data on a daily basis from sources such as: lab information systems, clinical applications, third-party portals, radiology information systems, insurance portals, scheduling applications, HR applications, and ERP systems. 

The data integration and the flow of information across all these sources is complex, multi-layered, and repetitive. Healthcare organizations have historically relied on manpower for these data-driven tasks, leading to a strain on resources and resulting in inherent ineffiencies. In fact, the industry ‘collectively spends $2.1 billion on poorly performed and error-prone manual tasks around provider data management [1]’. The COVID-19 pandemic has exasperated the resource and efficiency problem as hospitals, labs, and insurance companies try to keep up with peaking demand. 

To improve efficiency and realize tangible benefits, Robotic Process Automation (RPA) can automate monotonous, time-consuming and labor-intensive tasks essential to functioning, processing, and providing healthcare. Rules-based RPA bots essentially mimic user interaction at the user interface level and perform the same tasks at an exponentially faster rate with fewer errors. The technology has been proven to deliver significant business value across many industries while having relatively low barriers to adoption. 

The healthcare industry stands to gain from investing in RPA as successful adoption leads to improved patient care at a lower cost. This insight article will review organizational benefits of RPA, as well as highlight specific use cases showcasing RPA impact across the industry.

Did you know that RPA technology can enable the optimal quality of patient care while minimizing cost? This means less Human interaction and more automation.

RPA Automation Means More Organizational Benefits

The core tenet of RPA is that the technology automates routine and mundane tasks to increase employee productivity and shift to higher-value activities. Numerous processes, tasks, and projects across an organization benefit when companies prioritize and invest in RPA. 

Benefits include:
Accelerated Decision Making Improve organizational speed and decision-making capabilities by quickly acquiring, accessing, processing, and analyzing large sets of data with fewer reporting errors. • Robots are exponentially faster than employees in interacting with the various systems used by a process. A natural byproduct of RPA technology is an increase in the speed of decision making. RPA enables faster, more accurate decisions as a result of task automation that would otherwise be delayed due to excessive manual process times [2].
Increased Productivity Enable a more productive workforce by automatically performing repetitive tasks and freeing employee time and attention to higher value-added activities. • Studies have shown that RPA is empowering organizations to execute business processes 5-10 times faster, while expending 35+% fewer resources [3]. This increase in productivity has allowed organizations to redirect workflow where staff can focus on higher-value tasks – leading to increased satisfaction in both staff as well as patients.
Expanded Business Knowledge Implementing RPA leads to superior knowledge management, enabling increased efficiency, collaboration, and productivity via comprehensive business process documentation and mapping. • To implement RPA, organizations need a thorough understanding of their exisiting business processes. In fact, the organizations should consider RPA implementation an opportunity to not only map operations, but more importantly improve them. The implementation of RPA should be combined with value-added changes to business processes.
Increased Cost Savings Bots cost less and operate 24/7/365. Bots typically cost 35% of the cost of an employee. • An augmented, digital workforce that includes RPA bots presents an opportunity for savings – bots work 24/7/365 and cost a fraction of humans. Return on investment can be seen in less than 1 year, with strategic early implementations.
Improved Data Management RPA leads to effective and efficient management of regulatory, financial, and operational data and improves compliance with data related protocols. • Data Management can be enhanced through the application of RPA. Applying RPA to an organization’s central database contributes to increased data quality, reliability, and output consistency.
Streamlined Compliance RPA technology aids in ensuring compliance with data related protocols and regulations such as HIPAA and GDPR. • Regulatory processes are automated leading to increased process accuracy and high levels of compliance. Automated recording of actions and exceptions leads to increased auditability and greater transparancy.

How Successful Applications of RPA in Healthcare can Benefit the Healthcare Industry

There have been several successful applications of RPA across the healthcare industry value chain. Payers, providers, insurers, purchasers, and producers all stand to gain significant value when investing in RPA. Select RPA use-cases across the healthcare sector include:

Administrative Functions of Patient Care 

The Opportunity - Patients typically favor interfacing with a person when considering health matters and symptoms. However, there are not enough healthcare resources. An augmented workforce, with automation solutions, such as RPA, have been used to tackle patient care and ease the burden on providers.

How RPA Helps - Automated scheduling and notifications enable patients to self-schedule, eliminating several steps in the patient intake process. There are also AI-powered platforms that provide tools to help manage care and process payments. Online Avatars interact with patients and ask relevant questions about their history and current condition before guiding them to applicable and effective care centers. Automating routine patient encounters optimizes the end-to-end process and enables greater efficiency. These online platforms have been especially effective during the COVID-19 pandemic. For example, Providence St. Joseph Health deployed an online screening and patient triage tool to keep up with COVID-19 related demand [4]. Also, Mass General Bingham deployed the Partners HealthCare COVID-19 Screener, a tool that presents patients with questions that can automatically differentiate between possible COVID-19 cases and other ailments [5].

Resource Utilization  

The Opportunity - The COVID-19 pandemic has resulted in a dramatic increase in inpatient care. The patient surge has led to an alarming shortage of hospital resources such as staff, PPE, rooms and beds, operating space, ventilators, etc. The optimization of resources has quickly become a matter of utmost priority. 

How RPA Helps - By leveraging technology such as digital sensors combined with RPA, providers have been able to track scarce portable equipment assets such as ventilators, defibrillators, and various kinds of medical pumps.  The locations of these scarce assets are tracked and reported via a cloud-based control panel that graphically displays all tracked assets with color-coded circles to show status alerts [6]

COVID-19 Response: How a hospital utilized RPA to fight the pandemic

Technology and healthcare organizations have been hard at work in implementing RPA to accelerate operations and keep up with peaking demand stemming from the recent pandemic. 

The Opportunity – A hospital in Dublin recognized the value of RPA for automated COVID-19 reporting. Before the pandemic, the disease reporting function was largely manual with nurses and administrators logging into a testing system, obtaining disease codes, logging into another portal via VPN, and manually entering the results into the portal – for each patient. When the pandemic hit, the hospital understood that this process was not feasible, so they wisely decided to invest in RPA to automate the process. 

How RPA Helps - The RPA robot seamlessly logs into the testing system, applies the accurate code, and inputs the results into the correct system. This specific piece of automation alone saved the hospital approximately three hours of work a day, leading to improved patient care and efficiency [7]

The Opportunity - Managing claims can often be time-consuming, repetitive, rules-based, and prone to error. A process ripe for automation. RPA bots ensure faster data processing with minimal errors – increasing claims processing throughput. 

How RPA Helps - Automated health care claims improve compliance with Medicare claims and avoid non-compliance with regulations. Automation can also save resources by automatically checking claim status and managing denials. Managing denials can be costly as 25% of denied claims are due to registration and eligibility issues. One provider implemented an RPA bot that checks patient eligibility from several payors including Medicare and Medicaid. The bot created a report of all self-pay patients and their potential eligibility for coverage under available payors. The bot also identified missing data in the claim once an eligible payor was identified. Through the use of the bot, the provider was able to confirm eligibility information [8].’

Revenue Cycle

The Opportunity - RPA and AI technology can be leveraged to enhance the healthcare revenue cycle, the financial process that facilities use to manage the administrative and clinical functions associated with claims processing, payment, and revenue generation. This is achievable by automating pre-authorizations. 

How RPA Helps - Using RPA, bill details from each department can be automatically collected and organized onto a consolidated bill. This facilitates quicker bill generations as well as conversions to payments – leading to a streamlined revenue cycle process.  

Data Protection  & Cyber-Security

The Opportunity - One of the benefits of RPA technology is that it facilitates role-based access. By leveraging role-based access, RPA bots ensure that the appropriate individuals are accessing confidential information as necessary. This is integral in order to protect data privacy and comply with protocols such as HIPAA. 

How RPA Helps - Automation permits healthcare providers to regulate data access and invoke permission rights. This control is imperative as doctors, administrators, IT, or back office departments all require varying degrees of access. Also, RPA can be leveraged to strengthen a healthcare organization’s Cyber-Security protocol. Automation can reduce detection and response times, automatically deploy security controls, classify risks, and fortify data loss prevention in order to minimize risk exposure for cyber-attacks. 

How Sia Partners Can Help your Organization Acheive its True Automation RPA Journey

Leveraging our experience in automation as well as the Healthcare sector, Sia Partners can provide guidance to providers along the RPA journey. Here are just some of the ways Sia Partners can assist: 

  • Process Identification 

Sia Partners can help you assess the automation potential of your processes through ideation workshops and business case analysis. Our expertise and packaged tools (criteria analysis matrix and heat maps) allow you to identify the right candidates for automation.

  • Roadmap definition

Automation candidates need to be prioritized and a strategic roadmap is critical to progressively implement RPA. We will assist you in creating a process automation roadmap as well as in defining a long-term RPA strategy.

  • Proof of Concept

In order to showcase benefits, gain Physician and other stakeholder buy-in  and identify potential pain points (technical, human, etc.), Sia Partners has developed an accelerator to pilot use cases for your specific needs.

  • Deployment / Roll-out

Once a Proof of Concept and roadmap are defined, Sia Partners will support execution, from single entity or function, to organization scale. We will help you unlock the full potential and return on investment of RPA while maintaining control over automated activities.

  • Center of Excellence Implementation 

As the enterprise matures in its RPA journey, a Center of Excellence (CoE) assures focus on consistency and accelerated value, aggregating leading practices.  Sia Partners can support defining a target operating model and guiding principles, including governance structure.

  • Change Management

As one of the key components of a successful RPA implementation, change management must be anticipated early and at every stage of the RPA journey.  We support change management planning, communication, and capabilities management.

  • RPA Training

Sia Institute, our training platform, comprises a dedicated professional training organization and application that supports training needs, including: event/seminar planning and facilitation, training content creation, system-wide training programs, knowledge transfer, etc. Our RPA experts can provide small- or large-scale skill transfer depending on your precise needs (e.g. process identification, robot development, Robotic Operating Model definition and management, etc.)

  • Automation Tool Selection

Sia Partners can also support RPA provider selection, including RFI, RFP management and provider assessment.