RPA in healthcare: 7 use cases

RPA in healthcare: 7 use cases

May 27, 2021

RPA Business Analyst

While the healthcare sector in general heavily relies on humans’ cognitive input and emotional intelligence to provide quality patient care, its underlying back-office processes are ripe for automation. Administrative workers have to deal with the endless paperwork, transfer data between systems, and often find themselves lost in monotonous yet essential tasks. 

With the help of robotic process automation services healthcare providers can alleviate this administrative load and significantly increase operational efficiencies. In this article, we look at RPA use cases in healthcare and provide the future outlook for the technology.

Appointment scheduling

Although appointment scheduling might seem like a pretty straightforward process, it has proven to be tedious and error-prone when done on a bigger scale. While many clinics have moved from call-based to online appointment scheduling, the process still calls for human intervention.

For example, in many cases, an appointment can go far longer than expected, forcing all later appointments to be postponed and hospital staff to spend time notifying patients about schedule changes. Moreover, based on the appointment subject, administrators still need to ensure that a doctor will have enough time to take care of the patient. For this, most hospitals have a specialized team that handles online booking portal requests and issues.

RPA in healthcare can streamline appointment scheduling by automating the majority of associated tasks. Based on a patient’s data, doctors’ availability, and location, the bot can offer time with the relevant doctor, estimate appointment duration, remove the appointment slot in case of change, and notify both the patient and the doctor. If a doctor realizes that a particular appointment will take longer than planned, he or she can input this data into the system and the bot will inform all the relevant patients about appointment rescheduling via preferred channels such as the clinic’s mobile app, making yet another use of mobile in healthcare.  

In many cases, doctors also have to manually enter appointment information into multiple patient administration systems. Swiftqueue, the scheduling platform designed specifically for automation in healthcare, utilizes unattended RPA bots to tackle exactly this issue. The platform can be integrated with any PAS system a clinic uses, relieving doctors and administrators from manual data entry.

Such RPA-based schedule appointment systems have proven to be especially useful during the COVID-19 pandemic. Apart from being able to effectively handle an avalanche of appointment requests, RPA-powered chatbots can also help with quick online screening. For example, Mass General Brigham Hospital integrated an online screening RPA tool, which can automatically tell if a patient has COVID-19-related symptoms, identify case urgency, and schedule an appointment if needed

Claims administration 

One of the essential processes that hospitals have to deal with on a daily basis is insurance claims management. As the number of patients grows, hospital staff often struggle to handle hundreds of claims in time.

In this case, the employees’ job usually revolves around transferring information between the insurer’s website and revenue cycle management system. This tedious, entirely rule-based process is a perfect candidate for RPA in healthcare. An unattended bot can automatically access any external system, process claim data, and update the hospital’s RCM or any other applicable system.

The ability to update any system is likely the most attractive feature as interoperability in healthcare remains a significant issue. On average, hospitals have about 30 unintegrated electronic systems storing patient data. The disparity of these systems is what really slows the insurance approval process, and, consequentially, the revenue cycle.

The most commonly deployed automation solutions

For example, Max Healthcare, a chain of 14 hospitals in North India, has implemented RPA to streamline its claim administration across all units. By teaming up with UiPath, Max Healthcare has designed a robot that now captures customer information from emails and PDF files, and then inputs this data in the CSV format. The bot can now also log into the Ex-Servicemen Contributory Health Scheme (ECHS) and Central Government Health Scheme (CGHS) portals via different URLs related to each hospital, capture patient transaction records, and verify entry statuses. Upon completion, the robot automatically informs relevant departments via email. As a result, the healthcare provider has managed to save 65-75% of the time on ECHS and CGHS processing, in addition to achieving a 50% decrease in the turnaround time.

On the other side of claims management is the healthcare insurer, which has to handle even more complex and error-prone processes. In the insurers’ world, correcting code contingencies and data errors is what often brings the biggest economical damage to their companies. This involves employees spending an inordinate amount of time sourcing data from other systems and manually correcting any present errors. Fortunately, manual correction of errors is entirely an ‘if-then’ process. Similarly to other applications of RPA in insurance, this task can be automated with the help of bots.

Manual vs RPA-enabled claims processing

Post-discharge management 

Upon discharge, patients need to fill in prescriptions and follow discharge instructions. Ensuring that a patient follows post-discharge guidelines is a critical yet cumbersome task for healthcare providers. For example, patients often suffer from various surgery side-effects ranging from headaches to nausea, calling for the prescription of specific medications and follow-up appointments. RPA robots can ensure that discharge guidelines are followed as intended, remind patients about upcoming appointments and prescription pick-ups. Such approaches to post-discharge management have proven to be useful for the HCAHPS score improvement and an overall enhanced patient experience.

Regulatory compliance 

RPA in healthcare is also useful for carrying out compliance-related tasks. For example, AstraZeneca, a multinational pharmaceutical and biotechnology company, has a dedicated team of professionals who follow up with healthcare professionals to understand how exactly the medicines they produce impact different patients. For pharmaceutical companies, this is not just a matter of continuous product improvement, but also a mandatory legal responsibility to track and manage adverse events (AEs).

Commonly, employees have to manually sift through piles of paper documents to create reports and reach every physician via email, spending countless hours to close the event. Considering that regulatory authorities keep a close eye on this highly important process, the automation appears challenging in this scenario. However, with Deloitte’s support, AstraZeneca has managed to overcome this barrier and deliver a fully functional RPA-based solution for AE management. Apart from a 20x increase in productivity, the company also enhanced employee satisfaction and improved response rates from healthcare professionals.

One of the greatest effects of RPA in healthcare is that it facilitates better audit. Every action of a bot is automatically recorded, providing the necessary transparency for auditors and leaving structured data for further analysis. RPA bots can be configured to automatically create reports, which can be routed to appropriate managers and departments.

Self-kiosk check-in 

Not all appointments can be scheduled in advance. Whether it’s about a physical inability to use an online booking system, an urgent matter, or simply reluctance to do so, in-hospital check-in is still essential to many healthcare providers.

This is why some hospitals turn to RPA-enabled self-service kiosks. Upon arrival, patients can input their information into a self-service kiosk for further triage by front-desk employees. With a more sophisticated RPA software, the basic triage based on patients’ conditions and statuses can also be done by bots. This way, front-desk employees would receive a list of patients organized by priority, significantly reducing check-in times. Apart from reducing friction and improving patient experience, self-service kiosk integration is one step further towards more optimized data collection.

For example, Blue Prism has developed a self-service solution designed specifically for the healthcare sector. One of its clients, University Hospitals Birmingham (UHB), which provides healthcare services to more than 2.2 million people in the UK every year, has installed self-service kiosks in its multiple facilities. With these kiosks in place, UHB has managed to achieve a 50% increase in front-desk staff efficiency and double its patient flow.

Streamlined data management

Since the pandemic outbreak, every minute spent on patient care rather than on administrative tasks has become much more valuable. This is why the Mater Misericordiae University Hospital in Dublin, Ireland, deployed RPA-based software to speed up processing of COVID-19 test results. Previously, nurses had to manually put test results into spreadsheets. With RPA in place, the results are now quickly distributed and sorted, enabling personnel to prevent disease escalation and spend more time on patient care.

In general, clinicians heavily rely on access to medical records. Moving from physical to digital record-keeping was a huge step forward for the industry as a whole. However, hospitals often struggle to keep data updated across every system and department. Employees have to manually transfer data between a myriad of different applications, leaving room for mistakes and data breaches.

Average total cost of a data breach by industry

Given that hospitals deal with extremely sensitive personal data, the above-mentioned statistics shouldn’t be surprising. At the same time, RPA implementation helps strengthen healthcare data security as the software stores only bot-related activity reports while keeping patent information confidential.

For example, after conducting medical tests, lab employees need to manually transfer results from the lab’s system to a patient’s profile. Once test results are ready, they can be automatically put into any relevant system by an RPA bot. This ensures a 100% information accuracy, decreases data breach risks, frees employees from doing mundane work, and keeps medical records synced and updated at all times.

Proactive staffing

Achieving appropriate staffing levels every day is a rather complex process for the majority of hospitals. Ensuring that employees have just enough work for the day is a matter of avoiding burnout because of understaffing and cost-cutting.

Quite often, hospital administrators have to juggle between different systems to coordinate schedules, manage attendance, and monitor performance. Moreover, all of these systems need to be synchronized with each other as performance, payroll, FTE and other metrics are interconnected.

The University of Texas MD Anderson Cancer Center faced exactly this problem. Its HR, attendance and staffing systems have different interfaces, data formats, and credentials. In this case, the RPA solution based on HelpSystems’ Automate product acts as an orchestrator, which securely transfers data between systems, generates reports, updates and backs up critical data.

Juan Garcia, System Analyst at the Center, remarks how easy it was to configure the software. With the drag-and-drop interface, exactly those employees who have done this work manually initiated more than 80 automations. Additionally, instead of the staff being constantly on the lookout for mistakes, the RPA solution sends detailed error logs in case of failure. Apart from ensuring optimal staffing levels, reducing administrative burden, and enhancing customer care, Garcia estimates that the RPA integration saves around $150,000 yearly.

A bright future for RPA in healthcare 

RPA in healthcare is poised to optimize a plethora of administrative tasks that hinder optimal care delivery. Unlike other automation solutions, RPA is comparatively easy to implement and can bring quick returns. Instead of thinking about RPA as a technology that replaces humans, it should be considered as the one that frees employees to use their cognitive skills in more intellectually intensive tasks rather than copy-pasting.