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Robotic process automation in healthcare

Dan Housman, Chief Technology Officer, ConvergeHEALTH by Deloitte

Robotic Process Automation (RPA) provides an opportunity to streamline the administrative process in healthcare, by replacing tedious tasks that inhibit information flow and delegate them back to computers to free resources, time and capital. When most people think of robots they imagine an android form with metal joints connecting arms and a face, or an industrial tool that picks pills or welds metal. People are not talking about that kind of robot when referring to Robotic Process Automation. Instead the robot or ‘bot’ is operating as a recording of human interaction when typing, checking for errors, and cutting and pasting between applications. Think about a player piano, where a pianist records each key stroke and the piano plays automatically from the recording, to make identical music. RPA is similar, but does not work the same way. In RPA, once the basic recordings have been established, they can be extended to add logic as needed.

The idea behind moving administrative work in healthcare from a human to a bot is worth thinking about. While some administrative work requires significant thought, there are a number of tasks, such as cutting and pasting from a document that involves little conceptual thinking. If a human looks like they are acting like a robot, cutting and pasting line after line from a spreadsheet into a software application, then this is a good place to replace that human with RPA.

For instance, think about a large health system updating a catalog of medical product SKUs that need to be purchased and tracked within an enterprise resource planning (ERP) system. These products do not come from a single source, and are generally entered into the system in a process where the user enters new items/SKUs into a spreadsheet. The user then goes through a complex system to copy and paste the data from that spread sheet into the ERP system. It takes about 15-20 minutes to enter each item/SKU. This instance is a perfect candidate for RPA. A bot can be created in 3 weeks that could replace the 15 minutes of work per item and reduce the manual work to compiling the spreadsheet.

RPA is an efficient tool that is able to benefit multiple areas of the health system by taking the same approach to reducing labor intensive tasks. One example would be timekeeping. Each time an employee’s time is captured, there are often exceptions or mistakes. Human time keepers go through a process to confirm reflected hours in the time keeping application. In this case, the health system can establish a bot to make some simple decisions and answer very structured questions to confirm reflected hours and resolve the problems that arise. At times, a human is not needed to make time correction and, at other times, the RPA may need to extend to a human.

These instances appear to be back office and shared services functions, but business issues can also be automated. With strong incentives in the Affordable Care Act and general pressure to reduce the data processing involved in patient care, RPA is becoming an attractive approach for finding increased resources to spend on value-based care. Because RPA uses a recording approach to low complexity issues, it creates many solutions to quickly scope problems that can have a cumulative big impact, such as revenue cycle management. There are a number of administrative tasks that happen in revenue cycle management such as reviewing claims and denials that can be streamlined. Through RPA, you are able to automate the process and send the relevant content relating to the claim in a more efficient manner. When looking at the ROI and business case for a process it is a simple equation: If a process can eliminate the work and generate a pay back in an acceptable time period, the investment is justified.

In thinking about how to get started with RPA, the groups we have worked with generally start with back office processes like shared services, revenue cycle management, and building spreadsheets. Once a single use case can be proved, the use of bots can spread quickly into multiple concurrent areas of the organization. As RPA gets increasingly implemented at sites, groups can catalog processes or work with consulting teams that have implemented RPA at other organizations.

Among the things we have learned at Deloitte is that deploying RPA solutions can be appropriate across multiple industries. There is a natural need to transition slowly and effectively. The human and the bot have to work in sync to check for quality. All too often, organizations choose to redesign the administrative process with almost no focus on the humans doing the actual work. Training bots can be easier than looking to change how humans work. Groups like human resources should always be included on the discussion of implementing RPA because the focus can be too narrowly cast around cost savings vs. worker well-being. If done correctly, using bots can lead to creating better jobs for humans that are highly productive and fulfilling as long as bots can be established as a worker’s assistant rather than as their competitor.

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Affordable Care Act, enterprise resource planning, ERP, Revenue Cycle Management, Robotic Process Automation, RPA