Improving efficiency, reducing risk, and improving patient care with Intelligent Automation, RPA, and Intelligent Document Processing
Three automation technologies help healthcare payers and providers provide needed care faster, eliminating redundancies and reducing human errors while cutting cost and elevating consumer experiences. A net gain from all these benefits is enabling healthcare employees to work at the top of their license — at the top of their capabilities — fueling better internal and external experience, quality outcomes, and releasing capacity to invest in growth. Here we highlight healthcare automation trends that demonstrate how organizations are using these technologies.
Robotic Process Automation (RPA)
According to the Institute for Robotic Process Automation (IRPA), RPA in healthcare can improve workflows by automating rule-based tasks and processes. “The bots used for automation can offer storage, data manipulation, process transactions, and system calibration abilities. Above all, automation in healthcare can improve results and reduce system errors caused due to poor functioning and manual processing.”
Gartner defines Robotic Process Automation, “RPA is a noninvasive integration technology used to automate routine, repetitive, and predictable tasks through orchestrated UI interactions that emulate human actions.”
50% of U.S. healthcare providers will invest in RPA in the next three years, up from 5% today.Gartner
Healthcare is riddled with repetitive, high-volume, manual tasks that could be automated across the care continuum. Here are examples of ways healthcare organizations are using RPA now:
- Meridian Medical uses a hybrid RPA solution to address claims denials.
- LifeLabs uses RPA to process prescription intake, translation of handwritten prescriptions, data entry into testing systems, and exception handling.
- Helse Vest uses RPA to populate cancer patient information in three systems – their EMR, a research database, and a cancer registry.
- St. Luke’s Hospital uses RPA to eliminate duplicate patient visit reports, validate and record pre-certification status, and pull together procedure orders, payer authorization, and EMR data with forms.
- Max Healthcare uses RPA to streamline high-volume processes like claims processing, data entry, and reconciliation for government billing.
- Cleveland Clinic uses RPA to cut wait times at drive-through COVID-19 testing facilities, automating registration and printing processes so untrained caregivers could augment staff and scale capabilities.
Intelligent Document Processing (IDP)
Intelligent Document Processing, or Document Understanding technology, combines Robotic Process Automation (RPA) and Artificial Intelligence (AI) technologies to automate document processing. Smart digital bots extract, read, interpret, understand, and process various types of increasingly complex information.
In healthcare, IDP combines automation with AI to streamline document-dependent operations. Trends indicate that IDP is becoming used more widely across functions like physician credentialing, claims and billing, patient intake, risk scoring patients as part of care management planning, and clinical outcome assessment processes.
The IDP industry is expected to grow 70-80% over the next two years.Everest Group
As healthcare follows other document-dependent industries, more high-volume, manual processes that bog down staff and consumer experiences will trend anywhere that the goal is to reduce waste and errors and streamline care.
Intelligent Automation (IA)
By 2023, 20% of all patient interactions will involve some form of AI enablement within clinical or nonclinical processes, up from less than 4% today.
Many functional areas within healthcare organizations use intelligent automation — the combination of automation technologies, like RPA and IDP, with artificial intelligence capabilities like machine learning, Natural Language Processing, and cognitive computing. IDP, as a particular type of intelligent automation, is remaking payer and provider operations to improve efficiency, cut costs, free staff for higher-value activities while enhancing patient communication and satisfaction.
Providers are using IA in various ways, including enhancing the physician’s EHR experience and the patient’s by creating a mobile check-in that uses IA to extract patient data in the EHR and automatically complete fields from data the patient had shared previously.
Health systems and hospitals are using IA heavily in COVID-19-related operations, from check-in to sending results into multiple systems, communicating with patients, and assessing possible symptoms via online COVID checkers. One example is predicting resource allocation needs, which ensures a hospital has enough personal protective equipment for staff. Penn Medicine has a COVID-19 capacity planning tool, and Washington State is using a predictive dashboard and a COVID-19 risk assessment tool.
Beyond helping physicians make better clinical decisions, IA assists business processes like matching patients with physicians and available appointments and appointment management, which helps improve access and meeting patient preferences but optimize clinician schedules.
Payers appear to be adopting various automation solutions at a faster pace and more intensely than providers. Some automate the capture and use of unstructured data to reduce administrative costs, accelerate processing cycles, and improve compliance reporting.
Member services, like pre-enrollment, pre-authorization, and pre-certifications, are trending use cases for health plans. Also, call centers, claims and billing are a typical starting place, as well as physician credentialing.
Other Areas for Healthcare Automation Trends
Throughout healthcare functions in health systems and health plans, automation technologies are picking up speed and proving their value. Here is a list of areas within the HCO to assess and consider for how automation could streamline effort, free staff for higher-value duties, decrease risk from human errors while improving professional and consumer experiences:
- Billing & Claims Management, including Payment Integrity
- Hospital Management
- Appointment Scheduling
- Provider Management, Including Payer-provider Interfaces
- Enrollment, including Eligibility Reconciliation and Dual Eligibility
- Care Management
- Prior Authorizations & Pre-Certifications
- Audit, Compliance & Regulatory Reporting
- Customer Service & Call Centers
- Appeals & Grievance Management
- Data Management & Digitization
- Care Delivery & Order Processing
- Inventory Management & Resource Planning
- Patient/Member Communications
Two Ways We Deliver Automation Value to Healthcare Clients
Healthcare needs to yield the value, efficiency, and consumer benefits of automation. We provide automation value to clients in two ways — automation solutions that are function-specific or by assessing intelligent automation’s potential across broader and deeper swaths of function within the enterprise.
Where should automation streamline your operations, processes, and communication?