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Healthcare

Healthcare providers are challenged with managing levels of inventory, supporting digitization of patient files, optimizing appointment scheduling, and executing billing and claims processing. 

To help overcome these operational pain points, more and more healthcare providers are embracing Robotic Process Automation to alleviate these challenges and drive enhanced efficiency and growth. Healthcare is predicted to have a 36% automation potential. This means more than a third of healthcare tasks, especially managerial, back-office functions could be automated, allowing healthcare providers to offer more direct, value-based patient care at lower costs and increased efficiency.

The healthcare industry can no longer be complacent regarding embracing technologies to enable better, more effective and efficient process management. We believe such an environment is appropriate for the adoption of Robotic Process Automation within their environment.

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RPA'S IMPACT ON THE HEALTHCARE INDUSTRY CHALLENGES

Healthcare is well-known for using leading edge technologies and embracing new scientific discoveries to enable better cures for diseases and better means to enable early detection of most life-threatening diseases. However, the healthcare industry globally, and in the South Africa specifically, has been extremely slow to adopt technologies that focus on better process management and administrative needs.

1. Streamlined Front- Office Support

Patients are at the forefront of the healthcare industry, and Robotic Process Automation allows service providers to improve the quality of their forward-facing operations. Robotic Process Automation can achieve complex language, named entity recognition, and sentiment analysis capabilities by integrating Google, Microsoft, IBM & ABBYY cognitive and OCR services. When applied to digital help desks or communication platforms, RPA allow software robots to efficiently respond to patient requests.

2. Enhanced Data Confidentiality

The Robotic Process Automation platform does not locally store any process-related data from the software robots. The platform only maintains robot-related activity reports, either locally or on the Orchestrator if using the server option. Patient information accessed during automation of data transfers or claims processing is always confidential.

3. Superior System Compatibility

RPA non-intrusively runs automation through human-like interactions with the user interface using intelligent computer vision. Because the software is a process and is application agnostic, RPA allows automation of existing healthcare systems and applications (both native and web) to be modeled without affecting the underlying code.

4. Better Cost Management

A software robot’s expense is typically one-fifth the cost of a full-time healthcare staff member. RPA can deliver up to 47% overall savings, especially in healthcare payer BPO. With RPA’s intelligent scheduling and multi-tenancy, healthcare providers can leverage a cost-effective workforce and significantly reduce operating costs. Robots can be deployed in Cloud or on-premises from a single central server, making automation possible across multiple independent business units.

THE BENEFITS OF IMPLEMENTING RPA WITHIN THE HEALTHCARE SPACE

The world is reaching a technology inflection point where powerful and accessible emerging technologies give organizations the opportunity to make leaps in productivity and market growth, while creating new products, services, and markets not yet imagined. However, in reflecting the changes around it, Internal Audit soon will not be auditing the way it has in the past by using today’s skills.

1. Admission Processes
Patient admission process often go from desk to desk, taking longer wait time for patients. Automating admission processes can save time, improve the patient experience and generally enhance effective operational procedures. In typical admission process, lot of wait time can be saved if RPA is implemented.
2. Critical care and Emergency Operations
For critical care and emergency room processes, many hospitals go through overwhelming tasks as it is connected to core processes like registration, check-in and availability of physicians and specialists. If these processes are not streamlined, patients may end up waiting too long for treatment. During critical care and emergency, serving the patients in a timely manner is very crucial.
3. Transfers to Other Hospitals
Patients who need to be transferred may end up experiencing delays due to lack of a reliable workflow and collaboration system between hospitals, for inter-hospital referrals and transfers. Adoption of RPA in healthcare can enable hospitals to resolve this and collaborate with other hospital applications seamlessly.
4. Medication Processes
Medication error is a major concern for hospital administrators. Patient safety is often contingent on correct and timely administration of treatment. With several medications at their disposal, health professionals may error in the type and dosage of medication administered.
5. Patient Discharge
Another important RPA use case in healthcare could be overseeing the discharge of patients. Discharge of patients takes lot of time as it involves lot of processes like preparation of discharge summary, approval, creation of pending payment bill, return of unused drugs and stationery and final bill settlement. While bed availability and system capacity can determine patient flow, delays are often caused by process issues which involves lot of human intervention.
6. Claim Settlement
Most of the patients are tied up with medical insurance companies. RPA can help in accelerating the claims settlement of patients by giving the appropriate patient details in a timely manner to third-party insurance companies.

THE RISE OF ROBOTIC PROCESS AUTOMATION

Typically, the natural adoption curve for Healthcare functions has been towards a greater use of long- standing tools and less towards more-advanced ones. For example, certain technologies that have been thought of as revolutionary in the recent past are now considered foundational tools for Healthcare that seek to resolve complex issues and maintain their value in a technology-driven future. This includes technologies from dashboards and self-service data extraction to advanced analytics.

However, some Healthcare providers have started moving across the continuum by leaning right into the technology-driven future. They are already advising in areas such as risks and controls over Robotic Process Automation (RPA) and the application of Artificial Intelligence (AI) in their organization. They are using collaboration tools to increase their levels of organizational alignment and efficiency, data extraction tools and RPA to improve the expediency and coverage of their audits, and analytics, artificial intelligence (AI) and machine learning (ML) to offer innovative and value-added insights to the organization.

THE IMPACT OF ROBOTIC PROCESS AUTOMATION

The Institute of Electrical and Electronics Engineers (IEEE) Standards Association defines RPA as: ‘‘A preconfigured software instance that uses business rules and predefined activity choreography to complete the autonomous execution of a combination of processes, activities, transactions, and tasks in one or more unrelated software systems to deliver a result or service with human exception management’’. These preconfigured software instances known as robots, or software robots, reproduce the work typically performed by humans. In other words, RPA has the capability of automating human tasks. 

Rather than hard-coding automation workflows and Application Programming Interfaces (APIs) into software programs, RPA mimics a person’s actions in conjunction with existing systems. RPA works in the same way that a human worker reads and interprets data from a physical document and transfers this to multiple applications on their computer.

Robots can seamlessly move data across boundaries, from one application to another, mimicking activities such as clicking, typing, and moving between windows. In addition, these robots can use native and add-on Artificial Intelligence (AI) and Machine Learning models (ML) to enhance overall capability and learn from experience over time.

“There is no way to talk about a financial institution without considering technology. Therefore, the internal audit functions of these institutions must know technology and make intense use of it in their work. I believe that in the next five years, technology will make internal audit functions fast, relevant, and timely and offer greater coverage and lower costs.” 

- Fabio Adriano Da Silva, Internal Audit Manager, Banco do Brasil SA

THE BENEFITS OF CREATING A DIGITAL WORKFORCE

There are numerous ways in which Internal Audit can embed automation capabilities throughout the entire audit life cycle. This includes risk assessments, audit planning, fieldwork and reporting. The investment in automation technologies can yield the following positive returns:

1. Better use of scarce resources:

By replacing manual activities, automation can free up capacity for teams, allowing personnel to focus on higher-value activities, such as quality assurance reviews, exception management, process improvement, and interpersonal interactions. In turn, this shift toward value-added activities can improve operating effectiveness, allowing the Internal Audit organisation to keep pace with business changes and the associated impact.

2. Increased efficiency and reduced costs:

RPA can operate and execute audit tasks around the clock at an accelerated pace. As a result, the reduction of time-consuming manual activities can lead to significant cost savings.

3. Higher quality output:

RPA enables tasks to be performed more uniformly and efficiently. In addition, the results are highly traceable and auditable. With inherent process standardisation, fewer manual errors are likely to occur, which improves the accuracy and quality of audits. When mistakes, manual or otherwise, are made, they can be detected more readily and rectified more easily due to the systematic nature of the process.

4. More business value:

Nearly every Healthcare organisation seeks to increase assurance and coverage. RPA furthers this goal by enabling Healthcare to move from statistical sampling to full population testing. These technologies can also enable organisations to increase the frequency of testing and, in many cases, to transition to a continuous auditing model for providing more timely insights to the business. As technologies evolve, business value is expected to increase in tandem, enabling proactive insights and analysis in reporting.

5. Greater coverage:

Having a Robotic Automation manage and drive the full analytics allows Healthcare professionals to get greater coverage across the organization (more data, transactions, etc.) while not increasing the time or resources needed to analyze large data populations. This also removes audit sampling from the equation and helps auditors get closer to complete assurance. Robotic Automation allows teams to find the anomalies in data/transactions and focus on those outliers.

6. Improved on-demand visibility into department performance:

Using automation in reporting and project tracking allows for on-demand visibility into departmental performance. Dashboards and workflow tools anchor and make possible a timely and efficient Healthcare function. Such tools ease Healthcare’s work with those they are auditing or advising, and they simplify the sharing of information and the collaboration with risk functions.

“Automation is not about decreasing head count; it is about moving up the value chain. By freeing up resources, auditors can shift time to proactive activities like business transformations and emerging risks, becoming problem solvers rather than problem finders.”

- Christine Katziff, Corporate General Auditor, Bank of America

THE KEY PROCESSES SUITABLE FOR AUTOMATION

The way to begin an automation road map is to conduct a process scan and opportunity assessment to identify processes and activities with the highest potential return on automation investment. Activities appropriate for RPA generally have certain characteristics.

It must be a highly manual, repetitive and high-volume process
It must be a rule based process
Must have low variation between processes
Inputs must be electronic or machine readable
The process and their application must be stable
The processes are already being performed by large teams

MAKING AUTOMATION A PRIORITY

Innovation is changing the future daily and bringing with it an expansive array of risks and opportunities. That is why Healthcare functions must not only fully understand innovation’s impact on their organizations’ risk profiles but also embrace that impact themselves. Through the acceleration of an existing technology and talent strategy, or building a more revolutionary action plan, all Healthcare functions will have the ability to address the technology- and innovation-related risks facing them. That readiness will continue to increase Healthcare’s relevance and reinforce the function’s role as a trusted adviser. 

Healthcare departments, which have been burdened by manual processes and tedious tasks for years, can now turn the majority of the “grunt work” over to a digital workforce who are able to handle long hours and repetition, and who rarely make mistakes when managed properly. As a result, this has the potential to increase efficiency, effectiveness, and quality throughout the Healthcare life cycle, creating more value for the business and making better use of the most precious resource of all - intelligent, highly skilled human talent. 

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