Role of RPA in Healthcare Industry – Benefits and Top Use Cases

by | Last updated Aug 3, 2022 | Published on Aug 3, 2022 | RPA

Today, the healthcare industry is facing huge challenges when it comes to high volume costs and stringent regulations. This in turn puts immense pressure on the industry, challenging the quality of healthcare and urgency of patient care. Robotic Process Automation (RPA) is the current trend. Right from individual practitioners to healthcare clinics, RPA is being utilized to tackle such challenges using strategic and profitable automation. According to a McKinsey study, robotic process automation in healthcare will generate $350 billion and $410 billion in annual value by 2025.

In the post-COVID-19 era, automation in healthcare has already accelerated operations in various healthcare organizations. In fact, key technology applications like – artificial intelligence and machine learning incorporated by a robotic process automation company can help automate and streamline healthcare operations and improve patient care.

In the healthcare sector, many repetitive processes and decisions solely rely on the accuracy of patient data. For instance, patient onboarding and follow-ups, medical billing and claims processing, report generation for physicians and prescription management are some of the repetitive tasks that are common across all healthcare organizations. In fact, these areas in healthcare create a perfect environment for RPA to increase efficiency, reduce costs and better patient experience.

Significant Role of RPA and Its Benefits in Healthcare

In simple terms, robotic process automation refers to an automation technology that mimics back-office tasks like extracting data, filling in forms, and moving files with the help of software. Reports suggest that RPA in the healthcare industry is expected to rise, with the global market size to top $10.7Bn, at an average CAGR rate of 33.6% over the next seven years. The COVID – 19 pandemic didn’t create new problems in healthcare, rather, it exposed the broken system. Healthcare providers are continuously working to tackle these pitfalls and create an environment where patient care is given due priority.

According to a WHO report, there is a global shortage of physicians, with 2.5 healthcare practitioners to 1000 patients in the United States. Furthermore, the lack of healthcare providers and systems results in more significant problems such as physician burnout. The RPA solutions prevalent in the healthcare industry can be described as software that organizes other applications and performs tedious back-office tasks on its own. This gives healthcare workers time for diagnostic work and meaningful physician-patient interactions. The algorithmic nature of RPA bots are the best fit for taking over the tedious, mundane tasks and healthcare automation. RPA in healthcare leverages software robots to execute high-volume functions in a digital environment. By utilizing the power of automation and RPA in healthcare, providers can address these issues, making the system processes more efficient and faster.

Top Benefits of RPA in Healthcare

Here discussed are some of the top benefits of RPA in healthcare –

  • Improves Efficiency – As per reports, health plans spend about $2.1 billion annually on inefficiently performed manual tasks. RPA software robots streamline processes by completing these tasks faster and with more accuracy.
  • Increased Appointment Turnover – Healthcare providers suffer financially when patients don’t turn up or cancel the scheduled appointment at the last minute. Implementing RPA in healthcare with a telemedicine solution would help physicians send out appointment reminders to patients. They can even ask patients for follow-ups — increasing appointment turnover, productivity, and efficiency.
  • Improving Cost Management – By employing software bots to handle various repetitive day-to-day tasks, RPA offers significant cost savings that can be invested in enhancing patient care.
  • Effective Patient Scheduling – RPA smart bots help stream online appointments. They help identify and record vital factors received in an appointment request like location, physician, claim carrier, time, and date. These bots then log these factors in a report and send it to the representative/system assigned to confirm the appointments.
  • Enhanced Patient Care Cycle – A positive patient experience is crucial for the growth and well-being of the patient. RPA releases healthcare staff from repetitive tasks and allows them to focus on patient-centered activities and areas that require human connection. Implementation of RPA offers additional benefits like data digitization and patient tracking. These factors ultimately add to the patient benefits and enhance the value-based care experience.
  • Streamlined Workflow – Healthcare providers and patients share several similar critical tasks including population wellness, case utilization management, and remote monitoring. The common factor in these tasks is that they are time-consuming and involve repetitive processes – a core area for RPA in healthcare.
  • Improving Healthcare Facilities and Analytics – Through automated data collection, patients are served in a better manner as accurate and timely healthcare decisions are taken to provide the right treatment and improve patient care and recovery.
  • Increased Employee Satisfaction – RPA bots allow healthcare workers to focus on high-priority tasks by eliminating and automating mundane and repetitive tasks. As high-priority tasks involve creative inputs and add to authority, implementing RPA often increases employee satisfaction.

Top Use Cases of RPA in Healthcare

The healthcare industry is a complex field involving a system of interconnected procedures, repetitive tasks and multiple players across the value chain. In fact, the use of RPA in healthcare accounts for almost 30 percent of the total RPA usage. Generally, RPA scenarios in healthcare can range from no-brainer tasks such as auto-generating replies to emails to supporting single-click installations of complex software systems. It offers excellent potential for improving and streamlining the efficiency of operational and organizational processes.

Top Use Cases of RPA in Healthcare Settings

Here discussed are some of the top use cases of RPA in healthcare settings –

  • Fast-paced Claims Management – Proper claims management is important for the proper functioning of healthcare institutions. According to the United States Census Bureau, more than 90 percent or almost 294 million people in the United States are insured. However, processing these health insurance claims is a fastidious job that involves clerical errors that could result in financial pitfalls. According to McKinsey, the use of robotic process automation in medical insurance promises a 30 percent reduction in claims processing costs for companies that automate 60-70 percent of actions associated with claims administration. With RPA implementation, software bots can be programmed to identify compliance and non-compliance-related exceptions and regulations, streamlining the entire process of managing insurance claims.
  • Payment Processing – RPA solutions in healthcare can typically work in tandem with claims management and medical coding systems. In order to receive reimbursement from insurance companies, healthcare providers need to source miscellaneous data (including drug and disease codes and entries from patients’ medical history). Apart from automating data aggregation and entry processes, RPA medical tools can improve pricing transparency for patients. For instance, Baylor Scott and White Health (BSWH) — a health system that serves 52 hospitals across the USA — introduced a claims evaluation mechanism driven by RPA and AI. Typically, in healthcare settings, it usually takes revenue cycle employees five to seven minutes to work out how much patients are likely to pay for services before they actually receive care. With intelligent bots, BSWH now manages to produce 70 percent of estimates without the least human involvement. Bots can precisely calculate the bill amount at a faster rate, thereby improving billing efficiency and avoiding payment delays and miscalculated bills.
  • Workflow Management – Healthcare institutions handle several day-to-day operations like – case management, discharge, creating and allocating prescriptions, patient admission and claims processing. Implementing RPA helps automate day-to-day business processes. This enables medical practitioners (including physicians and nurses) to focus their attention more on patients.
  • Appointment Scheduling – Scheduling and seeing through a complete medical appointment often involves several complicated tasks such as collecting patient’s basic information (including previous medical history), checking for valid insurance policy number, aligning patient appointments with the physician’s on-board schedule and informing patients/physicians about specific changes. Before the COVID-19 pandemic, about 88 percent of appointments were booked manually, extending the gap between an initial referral and actual visit by up to two months. In fact, missed appointments cost US healthcare providers an astounding $150 billion annually. By infusing RPA medical bots into appointment scheduling and patient engagement software, hospitals could eliminate manual data entry. An RPA bot can carry out the above-mentioned processes in a more efficient and quicker manner thereby reducing operational costs and promoting efficiency.
  • Regulatory Compliance – Ensuring compliance with legislative acts and standards and regulating patient health information management is important. For instance, the penalties for HIPAA violations can vary from $1,000 per mild accident to $100,000 for serious breaches. RPA bots ensure that everything they do is tracked traced, or the document is logged and systematically stored in well-structured logs. Therefore, any specific report that is required during a healthcare audit for regulatory compliance can be easily sent to the concerned parties. This in turn prepares healthcare enterprises to deal with and handle unprepared and sudden external audits (if any).
  • Patient Remote Monitoring – RPA in healthcare offers several benefits like higher accuracy and faster processes. In addition, these benefits improve patient record management. This enables healthcare providers in creating a standardized prognosis plan toward achieving the desired patient health objectives.

Robotic process automation (RPA) is revolutionizing the healthcare sector, thanks to its many benefits such as improved efficiency, reduced cost, improved patient care and reduced errors. Implementing new technology does pose certain potential obstacles, but the benefits far exceed the associated challenges. RPA for healthcare is a win-win situation, as it streamlines the workflow at the physicians’ end while offering superior care to the patients. However, integrating RPA into your organization is not easy. Therefore, working with an experienced business process outsourcing company can help guide through the process and drive RPA.

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