We live in a world where computer time is eclipsing face-time. Where technology, tools and regulations that were supposed to make us more efficient at times seem to bog us down. Where the use of our “human” brain isn’t always saved for the more complex or personal tasks required of us.
The benefits of using robotic process automation (RPA) in healthcare to streamline processes isn’t anything new, however it can help healthcare organizations make a significant contribution to cutting costs, improving processes, and providing better care. A KPMG study showed that robotic process automation can increase savings up to 50 percent. More and more CIOs are turning to RPA to eliminate tedious tasks, freeing up their staff to focus on higher value work. In healthcare, research from Gartner shows that over half of “healthcare provider executives say that their organization has currently deployed at least one GenAI use case.”
What is Robotic Process Automation?
Robotic process automation enables organizations to effectively automate tasks, streamline processes and increase employee productivity. RPA is computer coded software that replaces repetitive or rule-based tasks across multiple systems and/or applications. It’s not walking/talking robots or a virtual assistant. Rosie from the Jetson’s won’t be entering the workforce or taking your job anytime soon.
Using RPA tools, an organization can configure software, or a “robot,” to capture and interpret applications for processing a transaction, manipulating data, triggering responses and communicating with other digital systems. Robotic process automation is capable of automating activities that once required human judgment, reducing the administrative burden.
It is an autonomic, self-learning and self-healing system and should be viewed as a competitive advantage. It’s not replacing humans but enabling them. It’s the evolution of automation: the automation of automation.
And What About Gen AI? Is That the Same as RPA?
Not quite. Robotic Process Automation (RPA) and Generative AI (Gen AI) are both automation technologies, but they’re not the same.
RPA primarily focuses on automating repetitive, rule-based tasks across applications. It’s ideal for processes like data entry, invoice processing, or claims management, making it perfect for applications in healthcare.
RPA “bots” follow predefined instructions without understanding the content or context.
Gen AI is capable of understanding, processing and generating data such as language and images. It can analyze complex inputs, generate human-like text, and create new content.
But that doesn’t mean it’s truly “intelligent”.
While GenAI can appear to interpret information, make decisions and act creatively, in reality it’s essentially an incredibly advanced data prediction model (with many invaluable applications in healthcare!)
So, What’s Best for Healthcare? RPA or Gen AI?
Both! RPA is ideal for automating structured, repetitive tasks that involve clear rules and workflows. Think claims processing and billing, invoicing, data entry and administration.
Gen AI on the other hand is useful for tasks that require interpretation of data and language. It can automate tasks like analyzing patient data and summarizing patient interactions, and creating medical reports and treatment plans.
Use Cases in for RPA Healthcare
Healthcare organizations can use RPA to streamline manual, transactional tasks, benefiting internal personnel and the patients they serve. There are many areas where RPA can be applied to healthcare operations including account management, claims processing, underwriter support, customer support, billing, collections, reconciliation and reporting and analytics consolidation. According to data published by Precedence Research, the resulting market will be worth around $50 million by 2026, and $90 million by 2032.
- Claims Processing: We can estimate that on average, processing claims takes about 30 days. Imagine if RPA could shave just five days from the cycle – not only would it generate revenue but it would improve cash flow by five days.
- Provider Enrollment: Depending upon the position (doctor, therapist, doctor’s assistant, etc.) and state, the processor, in order to set up a provider, has to go to multiple websites. Imagine how much faster and less error prone the activity would be if RPA handled these transactions.
- Appointment Scheduling and Management: RPA can automate patient appointment scheduling, as well as send reminders and manage follow-up notifications.
Peter B. Nichol also makes the point that “the conversation has expanded beyond cost reduction to quality, engagement and innovation”. The surface hasn’t even been scratched yet on the clinical operations side of what this technology can do for the healthcare industry.
RPA in Action – Examples of RPA in Healthcare
There’s no one-size-fits-all approach for implementing RPA. Each organization must consider their unique needs, existing technologies, data, processes and ability to drive and adopt change. At Emids we’ve worked with several organizations to implement an RPA solution designed to their specific needs.
RPA for a Leading Patient Care Solution Provider
Challenge: A leading patient care solution provider was looking to replace manual processes with automation to submit CMS records on their Healthcare Application.
Solution: Emids implemented a one-click solution to complete the manual process within a three-week timeframe. A bot was created to submit CMS records including all permutations to satisfy the client’s requirements. The bot was able to read data from a spreadsheet, access healthcare web applications and submit the records by validating the data based on various conditions like data mismatch, records not available in spreadsheet and duplicate records.
Business Impact:
- Productivity increase of 75 percent as compared to manual efforts per record
- Huge reduction in time to complete the process from 15-person days to 2 hours
- Improved process with 100 percent accuracy and efficiency
- Annualized saving of about $250,000
RPA to Improve Invoice Processing for Finance
Challenge: A Finance Department wanted to replace manual process with automation to process about 80 percent of invoices to their SAP system.
Solution: Emids created an RPA bot to process invoices and send emails for approvals in a 13-week end-to-end implementation timeline. The bot was able to read invoices from emails with PDF, spreadsheet and Word attachments and automatically process invoices to the SAP system.
Business Impact:
- Improved process with 100 percent accuracy, 80 percent efficiency and compliance
- RPA implementation and utilization had an incredible impact on the rate at which invoices could be processed. It took around 84 days to process 4000 invoices with manual data entry. With RPA bots, this was reduced to an average of just 6 days.
RPA for Medicaid Edit Research
Challenge: A team was spending a significant amount of time manually comparing medical records, annotating key words and searching the medical dictionary for definitions.
Solution: In just 4 weeks from brief to implementation, Emids developed an RPA bot that could automate these time-consuming research tasks. The bot was able to compare documents using UiPath, look up keywords in the medical dictionary, and annotate with its meaning.
Business Impact:
- Solution significantly improved process with 100 percent accuracy, 70 percent efficiency
RPA for Claims Entry
Challenge: Claims management is a manual, intense, and error-prone process which can cause claim rejections mainly due to human error when converting claims from paper to electronic format.
Solution: Emids implemented RPA in a two-step solution, using an RPA bot that leveraged the payer claims processing validation rules. The bot had the capability to decipher the CMS1500 & UB04 paper format, which enabled seamless data entry operation accurately to the relevant fields in the claims entry application.
Business Impact:
- Automating the most time-consuming, manually intensive, and error-prone processes enabled the client to achieve an increase in operational efficiency by 90 percent
- Quality improved reaching 99.97 percentage by eliminating data entry errors and claim rejections
- Reduced operational cost by 40 percent
- Created quicker turnaround processing time
RPA requires proper design, planning and governance to bolster your business. Emids has a deep understanding of the healthcare industry, and how RPA can be used to streamline processes, improve the patient experience, and reduce costs. Contact us today to see how we can help you take the most important first step to figure out which use cases could be best solved by RPA.