By Patricia Birch
Automation is often thought of as cold, even inhuman, best suited for assembly lines and rote tasks. In healthcare, however, automation applied appropriately can greatly improve member and patient experiences, enhance outcomes and reduce costs. Leading health plans and healthcare systems and their stakeholders already are seeing these benefits. The key to success is carefully choosing the functions to automate and designing automation-supported processes that put the healthcare consumer and clinicians at their center.
Here are areas in which it’s practical and rewarding for healthcare organizations to deploy automation, and the types of automation techniques and tools that complement those deployments.
- Administrative processes. Almost any rules-based and repeatable processes can be made more efficient with robotic process automation (RPA). With RPA, software bots are programmed to make rules-based decisions. Through machine learning and exposure over time to thousands of transactions and processes, software bots can become smarter and more autonomous in their decision making. RPA is especially effective for bridging between two systems, where a human would have to swivel a chair between two monitors or launch separate applications. Using RPA, one large health system easily absorbed the workload of a new business unit without making additional hires. The bots also helped reduce a claims backlog by 65% in a single week, substantially improving provider payment turnaround time.
- Member and patient services. Chatbots deployed in call centers can help consumers get information more easily with a human-like touch. With machine learning and natural language processing, chatbots literally can learn the most common questions and deliver accurate replies, effectively simulating human conversation. These conversations are easily captured and relayed to human agents so they’re fully informed if the member or patient questions are more complex and require a customized response.
At least one large payer is piloting a virtual agent program, enabling providers and patients to get fast responses about routine items such as claims status, enrollment, prior approvals and benefit coverage. In-home assistants, such as Amazon’s Echo and Google Home, eventually could be voice-driven interfaces enabling members and patients to access similar information.
- Patient engagement. Automation coupled with data analytics can help make patient follow up more effective by generating workflows and personalized health coaching tips for care managers. A healthcare provider using an automated platform to support its nurse agents has achieved 100% patient follow-up post-discharge within 48 hours and reduced appointment no-shows by 15%.
- Care delivery. Automated workflows can help caregivers be more efficient by adhering to standardized protocols. An international hospital has increased its ICU nurse efficiency by 45% with devices at the point-of-care that draw on data generated throughout the hospital’s systems to tailor alert messages. A large regional US system has automated its physician consult order process so that its care management platform generates a worklist of patients requiring consults and can automatically connect all the physicians involved via secure text and update the patient record when the consult occurs.
AI developments will create more automation opportunities. Stanford found algorithms and a deep learning network diagnosed skin cancers from images as effectively as board-certified dermatologists did. Radiology and pathology are also natural candidates for automated reading and reviews because algorithms excel at learning patterns. As these algorithms become commercial, healthcare organizations conceivably could create more efficient workflows based on a consumer presenting with a diagnosis in hand.
The automation possibilities are nearly endless, making it critically important for healthcare organizations to develop an overarching automation strategy. The strategy should help align automation projects with clear business objectives. These guide priorities and project implementation. IT should be brought in early, both to help evaluate technologies and to recommend systems and data that automation tools could tap.
The human factor is also key. Studies have shown most corporate organizations implementing automation use it to enable their existing workforce to take on higher value, more complex work. That still calls for change management programs to help stakeholders buy into –and even help design new processes.
Other industries, especially banking and financial services and some retail organizations, have been using RPA, chatbots and other automation solutions for several years, so stable solutions exist. The bottom line: healthcare organizations can realize value from automation relatively quickly, then build a long-term competitive advantage with a well-prioritized and comprehensive automation strategy.
Patricia Birch is SVP and Global Healthcare & Life Sciences Consulting Practice Leader for Cognizant.