Healthcare leaders face persistent challenges unlikely to change. With average healthcare organization margins at 1.4%, 54% of healthcare organizations report that their financial health continues to be worse than before COVID-19.
Workforce shortages continue to exacerbate the issues. By the end of 2021, the RN workforce had experienced its largest drop in four decades, falling by 100,000 nurses, according to Health Affairs. Another 610,388 nurses reported an intent to leave by 2027 due to stress, burnout, and retirement. What nurses want to remain in their profession is to spend more time with their patients, participate in professional-growth activities, coach and mentor their fellow nurses, and share in decisions about the work they do.
While capacity will remain constrained, the need for care will only increase as a large portion of the U.S. population – Baby Boomers – grows older and requires more care. Add to that high patient expectations. A recent Bain survey reveals that 65% of healthcare consumers expect a more convenient experience while 70% expect more responsiveness from providers compared with how they felt three years ago.
It’s a conundrum where technology can help. Yet, healthcare has been slow to adopt practices proven in other industries. Other service industries have realized more than 30% productivity increases through workflow automation. Is healthcare finally ready to adopt this technology? Can they use it in a clinical environment? And can they roll it out at scale?
Barriers to automation tech adoption
An area ripe for workflow automation is care coordination. In a recent survey, four in five (80%) clinical and IT leaders/directors agree that care coordination is currently a manual, tedious and expensive process. Healthcare systems already design care coordination processes to improve the patient experience, revenue cycle, and adherence to clinical protocols. However, these processes are often not executed as they were intended, leading to exceptions not handled well, staff bogged down in unnecessary work, and disconnects causing delays and inefficiencies.
In other industries, the idea, intent, and execution are all tightly connected. Yet, in healthcare, we contend with processes siloed in highly specialized clinical areas from cardiology to perioperative to preventive care. While the clinical best-practices are well documented, the ability to execute them in a standardized way, especially across specialties, continues to be a challenge. All these factors widen the chasm between clinical intention and decision-making on one side and administration and operations on the other. Clinical workflow automation can close this gap between clinical intent and clinical action.
What it looks like to cross the chasm
First, technology alone isn’t enough to close the gap. It’s not about throwing software at the problem without collaboration among front-line clinical teams. The focus is not to take away clinical control, but to use automation to augmentwhat clinicians do and help relieve them of unnecessary work.
Perioperative care is a prime example. For a large health system, automation created a highly personalized process for patients while unlocking significant amounts of capacity. When an order is placed for surgery, the patient’s information is often spread across multiple systems, such as provider records, the hospital EHR, and systems and locations. At the point of ordering, automation technology reviews available records and engages the patient to gather information needed for accurate risk stratification. For example, if imaging is required for surgery and the patient’s record shows a recent qualifying result, an unnecessary image is avoided, nurses do not have to track down that information, and costs of care are reduced.
In addition, through automation, the patient’s journey adjusts dynamically to her needs. For example, this health system required every preoperative patient, regardless of overall health or type of surgery, to visit a clinician. This visit typically consisted of vital sign collection, order scheduling, and lab reviews – steps that can be automated. Patients who don’t need in-person visits bypass it and manage those tasks digitally, ensuring that nothing falls through the cracks. And the care team focuses on those patients who need more attention.
The net effect for this health system was transformative. With a goal of gaining a 40% lift in productivity, within 60 days of the system being live, it instead experienced a 60% lift. For its care team of 10 nurses, that translated to 5,340 hours – the equivalent of 2.5 FTEs – of time freed up to focus on those patients who needed more time and other patient care activities. In parallel, 67% of patients bypassed an in-person visit they didn’t need. For both types of patients, the experience is highly personalized, giving them precisely what they need when they need it to prepare for their surgeries.
Thoughtful adoption of technology
Clinical workflow automation has astounding potential given its foundational goal of applying technology that works hand-in-glove to enable best-practice clinical processes at scale. The key to success, however, is to apply the technology through a targeted, progressive path, not all at once. One of the most important outcomes of automation is that it creates the opportunity for measurement. Thus, an organization can implement the technology in a specific area and use it to hone its standardized processes with concrete data.
For example, an organization can start with a specific process, such as perioperative care. By applying automation to the initial standardized protocol, the organization can measure where overrides were activated by care teams. That valuable data helps build consensus to arrive at the best care protocol. The organization benefits from both applying automation to increase productivity while making data-driven decisions that improve standardized care protocols.
Individualizing care
Leading through our industry’s ongoing conundrum won’t be easy, but it’s not impossible. Proven clinical workflow automation technology gives organizations the flexibility to test best practices, measure effectiveness, and use those learnings to overcome today’s challenges.
Once the door is opened, there are numerous ways that automation can deliver concrete benefits. For example, automating the process of screening patients for preventive care, such as colonoscopies, can be done reliably at scale, ensuring patients receive the care needed at the right time and the associated revenue stays in network.
The economic consequences of today’s labor constraints and rising costs necessitate that healthcare organizations embrace enabling technology. Clinical workflow automation is unique in its ability to augment clinical decision-making in ways that expand staff capacity and satisfaction, while improving patient outcomes and experiences.
Cindy Gaines
Cindy Gaines, MSN, RN, is the chief clinical transformation officer at Lumeon.