Robotic Process Automation: The Upgrade Healthcare Providers Deserve
Humanity has been through many difficult times during its course of existence. These events that threaten our survival have ranged from wars to epidemics. One would think, with an improvement in our knowledge of the universe, humanity would have mastered endurance and survival. But the COVID-19 pandemic, which stopped life as we know it dead in its tracks at its peak, questioned our preparedness to fight for our survival.
Despite being a globally local, modern, digitized, well-connected and highly intelligent society, we have been rattled to the bone by a pandemic.
Our first line of defense against the COVID-19 virus is our team of clinicians. Unfortunately, they were already overworked when the pandemic struck. Imagine asking Iron Man to save the world with a failing power source in his suit. In retrospect, this is akin to what our heroes, dressed in a lab coats have done for us since late 2019. The least we could do is, to make their work easy.
The efficiency, quality, sustainability, and affordability of care depend on clinicians’ ability to function well in the continuum of care. Unfortunately, most of them are burdened with cumbersome administrative functions such as quality reporting, medical billing management and claims processing. Perennial federal healthcare regulations are to blame.
However, there is a respite for care providers that can overcome the burden of administrative tasks when used effectively. It comes in the form of healthcare Robotic Process Automation.
Understanding Robotic Process Automation
All the burdensome tasks that require a significant amount of labor and resource allocation in the healthcare industry are routed through software applications. From the EHR to the PMS and appointment management portals, healthcare facilities utilize dedicated software systems to record and manage patient healthcare data. What if there were software bots that could emulate human action and navigate these critical applications to ease care providers’ administrative burden?
Say Hello to RPA!
It sounds like the stuff of science fiction at the outset, but RPA offers endless possibilities to care providers by easing paperwork and data entry intensive tasks. By releasing care providers from the mundane tasks like organizing documents to ensure a smooth claims process, it serves as an effective tool to unclutter their desk. At the far end of the spectrum, it also enables payer organizations to speed up their operations and prevent revenue leakage for care providers by automating time consuming processes such as data logging, adjudication and payment processing.
Evaluating the Important RPA Use Cases in Healthcare
The following are the core areas for care providers to explore to tap into the power of RPA bots.
Claims processing: Data logging and validation are the two pillars of claims processing. The accuracy of medical codes, spelling, date, charge information, etc., and validation steps to determine ‘in-out’ network status are vital when filing claims. They are also tedious processes. Since they are all ‘rule-based’ processes that require a precondition to be fulfilled, they form the ideal use case for both care providers and payer organizations. RPA can vastly reduce down operational costs and reduce errors in data input while they are at it.
Operational Analytics: RPA bots are highly capable of gathering data that enables healthcare and payer organizations to analyze and decipher performance metrics. For example, metrics such as the time utilized to complete an activity and exceptions in completing the process (if any) can unlock hidden performance by running administrative procedures in ‘auto-pilot mode. As a result, immense opportunities exist for healthcare organizations already using RPA bots to enhance their capabilities through efficient employee utilization further and increased process efficiency.
Medical Record and Data Management: Healthcare records are updated daily. The number of patients who utilize healthcare services and the updates associated with their electronic health information inflates healthcare data volume into petabytes quickly. Whether it is appointment management or discharge, hundreds of changes accompany a patient throughout their journey. The accuracy and meticulousness of RPA bots can vastly reduce the propensity for error in medical data management.
Patient Pre-authorization: Patient health data management has been a rocky road mainly because of the pre-authorization steps associated with ensuring patient safety. To comply with numerous patient privacy laws such as HIPAA, care providers and payers are jostled around an array of approval requirements. However, prior authorization requests, as they are called, can enable providers to reduce cost and processing time through RPA.
The continuum of care is set to change, becoming more patient-centric with every new CMS and ONC regulation. Technology is the driving force catalyzing this change, and healthcare engineering services are the conduits to equip provider and payer organizations with it. RPA is among future healthcare technologies set to become an elementary component of the healthcare technology ecosystem in the years to come.
Interested to learn more about RPA in healthcare and how you can tap into its immense possibilities? Connect with us at info@nalashaa.com for a chat.
