Robotic Process Automation In Healthcare: How Robotic Process Automation Is Improving Healthcare Operations And Delivery

Robotic Process Automation In Healthcare

Robotic process automation (RPA) is the use of software with artificial intelligence (AI) and machine learning capabilities to handle high-volume, repetitive tasks that traditionally require human intervention. Across many industries, RPA is being adopted to improve efficiency, reduce costs, mitigate risks, and refocus human workers on more engaging and meaningful job responsibilities. In recent years, the healthcare sector has been a prime candidate for greater RPA integration due to the administrative complexity of the industry and need to optimize resources.

Automating Patient Admissions and Billing

One of the most common applications of Robotic Process Automation In Healthcare is streamlining patient admissions and billing procedures. When patients receive treatment at a hospital, clinic, or doctor's office, there are extensive administrative tasks involved in registering new patients into electronic health record (EHR) systems, verifying insurance coverage, collecting demographic and medical history data, billing for services rendered, and following up on payments and outstanding balances.

Rather than relying solely on human registration clerks and billing specialists to manually input and process this high-volume transactional data, healthcare providers are deploying RPAs that can retrieve, input, and manage patient records and financial exchanges more quickly and accurately. The bots have access to APIs that allow them to automatically populate EHRs and billing software by pulling relevant data from various sources like medical history databases, insurance provider portals, and payment processing platforms. This eliminates mundane data entry work for humans.

One 300-bed non-profit hospital in Massachusetts deployed an RPA to digitally register and collect insurance information from over 32,000 patients annually within their EHR system. This allowed clinical staff to focus on direct patient care instead of administrative paperwork. The RPA also streamlined insurance authorizations and claims submissions, reducing average billing processing time from 10 days to just 2 days. This resulted in $1 million in annual savings and improved cash flow.

Streamlining Prescription Management and Refills

Another prime healthcare workflow ripe for RPA is prescription management and medication refills. When patients are prescribed ongoing regimens of drugs to treat chronic conditions, it entails ongoing manual labor and follow up by pharmacists and pharmacy technicians. RPAs can take over much of this process through a combination of intelligent OCR reading skills to interpret prescription labels, data processing ability to track refill schedules, and communications capabilities to notify doctors and patients of upcoming refills.

Leading pharmacy chains like CVS Health have deployed RPAs that can scan new and bottle label images to extract medication details like drug names, dosages, quantities, and patient information. This allows RPA bots to automatically place refill orders with wholesalers on a preset recurring schedule and notify patients and prescribers of upcoming due dates. The bots also monitor prescription expiration dates to trigger renewals as needed and warn customers of potential lapses in treatment. This level of perpetual refill monitoring saves pharmacy staff countless administrative hours each month.

Assisting Clinical Documentation and Coding

In healthcare facilities, clinical documentation specialists play a vital role by inputting detailed billing codes for all medical procedures, diagnoses, tests, and treatments administered to patients during their care. However, the process of reviewing lengthy clinician notes and provider documentation, identifying all relevant billing details, researching appropriate codes, and applying charges is highly labor-intensive. This is an area where RPA not only improves productivity but also enhances billing compliance and revenue capture.

One large medical group deployed an RPA that could automatically extract key text from electronic clinical notes using natural language processing techniques. It would recognize billing-relevant concepts like procedure names, diagnostic results, medications prescribed, physician specialties involved, and more. The RPA then cross-referenced this extracted data against insurance billing rulesets to suggest the most applicable billing codes independently—helping specialists code two to three times faster on average. This additional coding capacity unlocked an extra $2 million in annual reimbursements.

Automating General Workflow and Communications

Beyond transactional healthcare processes, robotic process automation in healthcare can bring robotic assistive support to a variety of general administrative and clinical workflows as well. For instance, hospital concierge bots can direct incoming phone calls, answer common patient questions, schedule appointments electronically, send appointment reminders via SMS text or voice calls, and provide updates to staff. In pharmacies, RPAs are capable of digital document processing like handling prescription images, collecting customer intake forms, and processing insurance paperwork.

Laboratories are also automating mundane data entry. One lab implemented an RPA that retrieves test order information directly from EHR interfaces to populate lab requisition forms digitally on behalf of clinicians. This eliminates the need for physical form transport and manual requisition entry by lab technicians. Elsewhere, RPAs are surfacing real-time patient data on clinicians’ mobile devices through AI-enabled clinical decision support and guided workflows. As healthcare robots develop increasingly sophisticated perceptual and conversational abilities matching human skills, there remains enormous potential for optimized RPA use-cases across the entire care continuum.

As the healthcare industry grapples with rising costs, staffing pressures, and the need for higher patient volumes, robotic process automation is poised to become an invaluable operational ally in the years ahead. The repetitive, rules-based workflows inherent to clinical, billing, and back-office processes are prime targets for digital labor that is faster, more reliable, and free of human limitations like compliance fatigue. By infusing healthcare operations and clinical delivery with new levels of digitization, data transparency, and efficiency through RPAs, providers can enhance financial performance while redirecting precious human capital to areas needing creativity, clinical judgement, and compassion that cannot be replaced by technology alone. Though still in its relative infancy in this sector, RPA promises great potential to elevate both the business and patient experience of healthcare worldwide.

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