RPA and Healthcare: An Unlikely Pair?

Editor's note: This post was written and published in 2016. For up-to-date information please visit the UiPath blog healthcare page. We also recommend registering for our healthcare webinar series.

While it might not be one of the first industries talked about when considering the implementation of process automation, the healthcare industry is one where RPA has the potential for great transformation. Healthcare, particularly in emerging or previously underserved markets, is an evolving and growth-oriented field, and as the number of patients increases, the need for more efficient and accurate back offices processes for healthcare providers has seen significant increases in recent years. Advanced automation solutions to assist with tasks like patient scheduling, billing, claims processing and more are crucial to increasing efficiency of these tasks.

Is the healthcare industry a viable candidate for RPA? How so? What would RPA implementation look like in this field? What activities could be automated?

These are important elements to consider when discussing RPA’s place in the healthcare industry, especially when it comes to healthcare providers who, perhaps more than other component of the industry, have to juggle a myriad of back office tasks with direct communication and interaction with patients. Let’s explore how RPA could restore the balance between paperwork and people, allowing providers to focus on caring for and treating their patients.

Implementation In the Industry

As we know, the healthcare industry is a complex field with a number of players across the value chain. The scope of the industry means that automation and process streamlining goes beyond just eliminating paperwork or reducing the amount of time it takes to process, file, or store a form - though those tasks certainly are a large part of the need for RPA technology.

Let’s consider some common processes frequently used by healthcare providers that can be streamlined by using RPA and the potential implications for the industry.

Data entry and migration: The healthcare industry is one that is modernizing rapidly - in part due to technology and in part due to external forces like government regulations and mandates. Instead of being reliant on paper charts, providers are digitizing patient information so that it can be stored electronically accessed online by other doctors and the patients themselves. In order to expedite the process and not be reliant on employees to transfer these records manually, RPA can be used to automate this transfer of data between paper files and legacy systems to the new system. This will also foster increased levels of customer service to the patient through transparency and ease of access to their medical histories.

Patient scheduling: Patients create appointments with their doctors on a regular basis but sometimes have to cancel them as well. Appointment cancellation and no-shows can be costly for health providers. RPA can be used to minimize the involvement of human employees in the scheduling process and can also help optimize appointment turnout by managing appointments with patients. Not only a benefit for the healthcare provider, appointment optimization will also positively impact patients who will now be able to schedule appointments sooner.

Billing and claims processing: Billing and claims processing are of particular importance for the healthcare sector. A patient visits the doctor, an insurance claim is filed, a patient is billed for the remaining amount, and accounts receivables are monitored to ensure the patient makes the payment. These processes can be very time consuming and prone to errors. The importance of RPA for both health providers and also health insurance companies is quite clear - reduction in human error, increase in efficiency and time-management, and better control or custody of billings and claims as these tasks progress across the value chain.

Benefits of RPA in Healthcare

How are healthcare providers improving their services due to RPA? What are likely benefits of RPA within the realm of healthcare?

A recent publication by Alsbridge argues the cost reduction alone by implementing RPA solutions is reason enough for the healthcare industry to take notice of process automation: “A claim requiring human intervention costs approximately $4 to process, while an auto-adjudicated claim costs approximately $1...Considering that more than 3 billion healthcare claims are filed each year, applying RPA to extend auto-adjudication rates by an additional 10 to 12 percent can generate savings well in excess of $1 billion.”

Even though this statistic specifically targets health insurance companies, it can be argued the benefits of more efficient claims processing can trickle down to the healthcare providers and eventually the patients themselves. Reductions in the time and resources devoted to these menial tasks - as well as reductions in costs to the insurance companies themselves - could mean more resources, time, and coverage for patients. The money saved might also mean more money for the healthcare providers and office staff to use for other services, allowing them to devote more time to patient care.

Other possible outcomes and value propositions of RPA implementation include:

Increased appointment turnout and fewer cancelled appointments: Many healthcare providers suffer financially when appointments are missed due to last minute no-shows or cancellations. With the use of RPA to automate scheduling and send appointment reminders to patients, doctors will be maximizing the number of patients they see each day, increasing productivity and efficiency.

Automated monitoring of accounts payable/receivable: By careful monitoring of accounts payable and receivable, software robots are able to lead to an improvement of billing efficiency and a reduction in write-offs. Payments will be made and received in a quicker and more effective manner than if monitored by a human employee. As a result of debt reduction, this use of RPA is another boost to the financial performance of healthcare providers.

Elimination of human error in digitization of patient records: RPA software robots drastically reduce the amount of error in data migration and copying tasks and the digitization of paper records is no exception. The increased accuracy from the use of RPA will allow healthcare providers to maintain up-to-date and accurate records, which is especially important when considering a patient’s medical information and history consulted during the course of treatment.

Improvement in patient experience: A positive patient experience is essential to the success of healthcare providers. By automating time-consuming and repetitive processes, such as appointment scheduling, data digitization, and inventory tracking, doctors will have more time to provide value-based care for their patients. In addition, patients will benefit from having shorter wait time for appointments and will have the ability to easily access their health records and bills online.

Potential Obstacles to an RPA Implementation

Implementing change into any company can be a difficult task as it often involves changes in the day-to-day tasks for the employees of the organization. Clarity about the objectives and benefits of an RPA deployment is crucial from the very beginning - from the changes in process to the benefits and advantages provided.

Existing technology environments might require upgrades of technology and investment in technology resources and support and training of staff.

The Future of RPA in Healthcare

While potential obstacles in implementing change need to be addressed, they are greatly outnumbered and outweighed by the benefits. RPA will help healthcare providers not only reduce costs and streamline activities, but also increase the quality of patient care. Doctors will be able to spend more time focusing on their patients. Patients will be happier with the care they are receiving and will be able to receive their diagnoses and treatment more timely.