RPA overcomes three major problems: lack of APIs, data/system integration, and interoperability sandbox

Interoperability for value-based programs, like care management and population health management, won’t happen overnight despite additional legislation. However, intelligent automation solves three problems standing in the way of streamlined, interoperable value-based care programs.

Technologies, like robotics process automation, can help healthcare organizations overcome lack of data/system integration, lack of APIs, and lack of an interoperability sandbox.

Now is the time for providers to prepare, and automation provides a robust and flexible path to be ready for what’s coming.

Forces Moving Towards Interoperability Fall Short

Earlier this year, CMS published Interoperability rules that give patients in certain federal programs access to their health information on their smart devices, as well as the ability to request that their medical records follow them from one health plan to another. While patient access to data could become much easier, transferring patient information from hospitals to nursing homes, from nursing homes to primary care, remains a challenge.

Separately, the Condition of Participation (CoP) requirement, as part of the interoperability ruling, asks hospitals to send electronic notifications to another healthcare facility, community provider, or practitioner when a patient is admitted, discharged, or transferred.

The ruling does not talk about sharing patient information across providers to streamline value-based care programs like care management/coordination and other population health initiatives and care settings as shown in Figure 1. If providers cannot share patient records seamlessly, we cannot expect interoperability to achieve its full potential.

COVID-19 has further exposed healthcare’s need for sharing data easily. According to a study published in the Journal of Informatics in Health and Biomedicine, over 40 percent of hospitals reported that public health agencies are unable to effectively receive and act on patient data. This is no surprise because health systems, typically, use 18 different electronic medical records systems.

Build Towards Interoperatibility Chart
Figure 1: Sample use cases where RPA streamlines interoperability across healthcare settings.
(Click image for large view)

Leverage Robotic Process Automation to Solve Three Interoperability Challenges

Robotics process automation (RPA) is a type of business process automation technology that mimics human interactions with IT systems, but with much greater efficiency, accuracy, and at much higher volumes. Compared with traditional IT solutions, RPA solutions are easy to implement and can be implemented at fraction of cost compared to traditional solutions.

Specifically related to healthcare’s quandary to achieve required interoperability and enable dispersed, virtual, and value-based care delivery, there are three challenges that providers face and RPA solves:

Challenge #1: Lack of data and system integration

An average health system uses 18 different EMR vendors. These canned technologies aren’t interoperable and create huge barriers to enabling care coordination. While an ideal solution, providing a unilateral patient view, remains the ultimate goal, physician burnout and its consequences on patient experience makes the waiting intolerable. RPA, however, enables providers to supplement with a digital workforce that can bridge the gap and create a unilateral patient record now. Providers can use bots to input information into EMR systems, and other IT applications, across the care setting, aiding consistent, secure data entry and exchange. 

Challenge #2: Lack of Future API Requirement

While regulatory bodies aren’t clear on future revisions of the interoperability rule, health systems should expect future revisions that support value-based care and data interoperability requirements. Investing time in preparation will ensure that that provider organizations are prepared for changes in VBC needs and new regulations.

View RPA as a strategic tool and not as a bandage that solves temporary capacity problems. RPA provides robust and proven technologies to bridge the current state of healthcare technologies, increasing care management and coordination needs for data now, and the future vision of interoperability requirements.

Consider these actions to start using RPA strategically:

  • Perform data and process assessments to identify patient interactions throughout the care journey and, mapping these interactions across care settings (referrals, authorizations, transition of care, etc.)
  • Create a detailed data dictionary and master data inventory of all provider-patient interactions
  • Complete a paper mapping exercise, illustrating your master data inventory and existing FHIR resources
  • Identify all manual data transfer points among systems that automation could streamline
  • Automate those interactions that require manual data transfer between systems
  • Use RPA bots to map interactions against FHIR standards

These steps give you an actionable map of all provider interactions against FHIR standards while identifying areas where automation can streamline care management and coordination activities in your workflow and data exchanges.

Challenge #3: Lack of Integration Sandbox

RPA allows you to quickly and easily test new interoperability options without making a large, upfront investment of time or budget. RPA provides a sandbox where your technology team can experiment and try new integrations and tools.

Rather than assume how one of your existing systems will work post-integration, RPA allows you to pilot integrations across systems – like a new clinical decision tool — or test onboarding a new provider network. Here, RPA gives you the tools to innovate and experiment without costly and time-intensive legacy system upgrades.

RPA Expedites Interoperability

Interoperability is becoming the standard for all forms of whole-person, value-based, and modern population health programs. Robotics process automation can help healthcare organizations overcome lack of data/system integration, lack of APIs, and lack of an interoperability sandbox. If preparing for future requirements while empowering your current PHM and VBC programs with greater interoperability is a goal, we can bridge that gap sooner with intelligent automation.

  • Shrey Sekhar
    Delivery Executive
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  • Ryan King
    Vice President of Services
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