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Bots can make businesses healthier

Robotic process automation is improving performance and saving money

INSIGHT ARTICLE  | 

Health care is the ultimate people business. The products and services of health care are literally designed to optimize a person’s physical well-being. Unfortunately, many of the processes and systems commonly utilized in the health care industry are not designed to support the organization’s health. As the industry grapples with improving care outcomes while removing costs, many organizations are succeeding by employing automation technology to enhance their human workforce with assistance from digital robots often referred to as bots.

Robotic process automation, known as RPA, delivers the ability to automate processes across the health care industry. Processes that are highly manual yet low in complexity can generally be fully automated by unattended bots which results in improved accuracy and speed with lower costs.  More complex processes can also be optimized by leveraging attended bots to alleviate tasks in the workflow that are time consuming or error prone as they work side by side with their human counterparts.

Alice Khosravy, a principal and health care technology leader with RSM US LLP, frequently collaborates with industry leaders in the RSM Healthcare Innovation Center located in Nashville to blueprint lean processes that capitalize on RPA advancements, “Organizations are highly focused on the areas of supply chain, pharmacy, patient engagement and revenue cycle.”

Richard Kes, a health care partner and industry senior analyst at RSM US, uses an example of RPA application involving eligibility checking, which is both time consuming and repetitive throughout the patient’s care journey. Inaccurate insurance information is one of the leading causes of denials. By leveraging the bots to conduct the website lookups, organizations can strengthen their denials prevention processes and increase revenue while decreasing days in accounts receivable.”

How a general partner dramatically reduced labor

“We had a health care company that was reviewing medical records, taking inbound medical records and having nurses and physicians review them. It turns out that the vast majority of those didn't actually need to be reviewed by a human. So we applied some machine learning technology to filter out the low-hanging fruit, and we were able to automate almost 40% of the cases that flowed through their system. That reduced labor dramatically, and it was expensive labor. It was physicians and nurses. Automation allowed them to focus on the cases that they really needed to focus on.”

- Cory Eaves, Operating Partner, General Atlantic

Kes also warns against a common misconception of RPA; it should not be viewed as an employee headcount reduction tool. “We advise clients to leverage bots to redeploy humans into more strategic roles. We advise our clients on how to digitally upscale their workforce so that they can use technology to make better decisions more quickly,” says Kes. “That enables organizations to better serve their patients and communities.”

Khosravy stresses that among the processes that can be improved and automated are those that have an impact on patient safety, using the pharmacy business as an example. Pill counts and medication refills done by bots are consistently more accurate, so long as the underlying safety processes are sound.

The opportunities to automate business processes across health care are so many that determining where to begin can be both exciting and daunting. Khosravy advises her clients that it’s wise for businesses to start with a pilot program for a single process; however, business leaders and their private equity sponsors should really be thinking big from the start. Long term, the real power of RPA is the fact that it can cross systems.

RPA can be a particularly appealing strategy for a private equity sponsor that is executing a buy-and-build within health care, and doing the heavy lifting of merging many different entities. One of the more difficult aspects of all this merging is trying to get disparate systems to work together. One common approach is to force standardization across companies, but Khosravy says with bots, this laborious and often costly process can be streamlined. “All the organizations in your portfolio aren’t required to switch systems. RPA would be a cost effective tool to minimize organizational disruption and standardize operations.”

Khosravy also cautions her clients not to view the implementation of bots as a job for the IT department. RPA must be embraced and championed by the business unit leaders, as they are ones who desperately need a digital workforce to augment their current teams.

Instead, integrating automation into a business needs to be viewed as a business initiative, embraced by top management and supported by IT. It is also important to carefully track the results of the initial RPA initiatives, thereby helping to increase team buy-in as more and bigger automations are rolled out.

In preparing for the initial RPA rollouts, many health care organizations learn valuable lessons about processes that may have been consigned to the back office and neglected while management focused more on growth. “During the RPA testing phase, a company might identify an issue with an existing process. This provides a chance to understand and rectify that failed process before automating. This ensures the most efficient and accurate outcome,” says Kes.

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