By Carole Faig
Today’s health care consumer expects a speedier, more connected experience, and the industry continues to be challenged by the ever-increasing need for value, optimization and efficiency amid a constantly evolving and uncertain regulatory environment.
Organizations have to figure out how to work in a way that is quicker, smarter and more cost-effective. And at the core of this issue, they are being forced to rethink traditional business models and adopt a new, digital approach to talent management. Part of this new approach is the rapid adoption of a virtual workforce, more commonly known as robotic process automation (RPA).
RPA is a customizable software solution that mimics work done by humans, but operates in the background, completely invisible to patients. RPA is not a physical machine; it is software that acts as a virtual co-worker by taking over standard and repetitive activities using existing application screens and desktop applications. It can perform processes like accessing and gathering data from different sources, moving data from one system to another and checking data consistency.
RPA In Action
These “virtual employees” can add value in many ways across the health care industry.
For example, RPA can supplement the administrative work traditionally performed by a claims agent in the revenue cycle, such as claims adjudication and processing, payment integrity, appeals and grievances. It replicates the work of an agent by accessing and gathering data from multiple systems, checking data consistency and making decisions based on that data.
It can also help with data-entry challenges presented by the constantly changing regulatory environment. For example, as the Affordable Care Act continues to redefine coverage areas and providers, RPA can quickly enter or change data, increasing accuracy and significantly reducing the costs associated with this monotonous task.
Clinically, it can be deployed to help review and come to conclusions about data from health monitoring devices. It can help make sense of the waves of data these new tools uncover and more quickly review the impact of the data, as well as helping update electronic health records.
Essentially, RPA allows any type of routine, rule-based work to be performed by a robot that mimics the way a human employee would interact with systems, applications, data and sometimes even people.
The Potential Impact
The ability to automate these tedious jobs leads to countless benefits for health care organizations and their employees.
RPA enables health care companies to keep better pace with patient expectations while solving one of the biggest challenges facing health care organizations: employee disengagement and burnout.
Both are real problems in the health care industry, especially in jobs in which employees are asked to perform repetitive tasks. But the introduction of the virtual colleague frees up human resources to focus on higher-value, more rewarding activities and leaves the data-entry tasks to the computers. This allows employees to be more engaged in their work and less frustrated at the administrative necessities, allocating more time to tasks that require creativity, thought and judgment.
RPI has the ability to sort through thousands of data sets to come to conclusions or solve issues without becoming bored, disengaged or tired. And it doesn’t take sick days. The ability to perform mind-numbing tasks around the clock can create endless savings in the cost of human payroll. And by embracing a virtual workforce to help automate tedious processes, these organizations can conserve their staff’s time and energy to focus on what they do best: taking care of patients.
In addition to freeing up valuable health care employees to take on more strategic activities, RPA can increase efficiencies across health care systems, leading to a reduction in costly errors and improving auditability, consistency and control over error-prone manual activities that elevate risk, noncompliance and financial or reputational harm.
Reducing the potential for errors can be especially impactful in the health care industry, as it significantly decreases the potential for patient harm. For example, when a patient moves from one doctor to another and their systems are incompatible, important medical records such as drug dosage are often entered manually, with great risk for human error. But if the systems could communicate with one another, the potential error would greatly decrease and the new doctor’s office could gain a faster and more accurate understanding of the patient’s history.
The Path Toward Implementation
In further good news for executives, RPA is relatively inexpensive, and organizations often see a swift return on investment.
Since it is a noninvasive technology, RPA can be overlaid on existing systems, allowing the creation of a platform compatible with ongoing developments in sophisticated algorithms and machine-learning tools. Companies often see efficiency savings in relatively short order due to the agile approach to development.
As health care organizations embrace digital to meet the changing needs of their patients, technology, especially RPA, will play a critical role. The benefits are profound: by enabling employees to focus on higher-value and more strategic assignments, organizations can maintain or increase employee engagement, improve interactions with their patients and equip their business for future growth in today’s evolving world of health care.
Carole Faig is the Deputy Leader of the US Health Practice and Southwest Region Market Segment Leader for Ernst & Young LLP, where a recent survey found that 61 percent of health executives cite digital innovation as the most prominent topic on the boardroom agenda. She is based in Houston, Texas, and can be reached at firstname.lastname@example.org.
The views reflected in this article are the views of the author and do not necessarily reflect the views of the global EY organization or its member firms.