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RPA in healthcare: The potential use cases

Robotic process automation (RPA) is beginning to appear in many industries, including healthcare. An expert discusses RPA use cases in healthcare.

Experts say robotic process management (RPA), which is software with artificial intelligence and machine learning capabilities that essentially automates other software, can be used across many industries. However, it's mainly being used for rules-driven and repetitive back office work at organizations, including healthcare organizations.

Ascension Health, the largest nonprofit health system in the United States based in St. Louis, Mo., is using RPA for just that: Back office work. However, A.J. Hanna, executive director of the Ascension Ministry Service Center, which provides human resource, supply chain, and finance services to Ascension Health, believes there are other use cases for RPA in healthcare including revenue cycle management and the internet of things (IoT).

Why do you think RPA in healthcare is important and do you think it's going to play a bigger role than it already is? What do you think are the top use cases for RPA in healthcare?

A.J. Hanna: I do think it has tremendous potential to expand within healthcare beyond just the normal back-office functions that we do, and … the primary use case that I see is in revenue cycle. I worked for a third-party claims organization for about 15 years. As you know, there are code changes, ICD-9 code changes, code definitional changes, billing code changes and the like and it could be easier to train a fleet of robots who are doing repetitive activities and similar activities than it may be [to train] a large human staff. And so I see there being tremendous potential not just for the ability to accommodate change, but because there are a lot of rules-based activities within the revenue cycle process as well. I also think that there's some place for the technology to begin to be able to do some comparative looks on medical records. There are technologies that are coming to the fore where there can be some analysis of the differences in the record states and provide some analysis of what those differences were. So I think you'll begin to see more technology applied in EMR, and those are the two primary areas, but in terms of RPA I don't know that anyone has really scratched the surface yet on the clinical operations side of what this technology can do for us, and it's stuff that we're doing right now: Working with the clinical divisions to explore how we might be able to use the technology effectively in those environments as well.

How widely is RPA being used in healthcare today?

Hanna: I do get a lot of requests from all kinds of organizations but certainly healthcare organizations asking about our process … how we went about it and how we chose a vendor, how we implemented … and so … it is a growing trend in industry in general. Any health organizations that are using any kind of business process outsource services are certainly beginning to take a look at this. And then in the clinical settings, I think we're going to begin to see a movement away from -- as you know, there are some use cases for IBM and Watson where they've worked with MD Anderson Cancer Center and some other organizations to do some detailed data mining -- but I think what we'll begin to see is a movement from that not being the primary thing that health organizations are looking at but they're going to be looking at other classes of technology as well to see how they can build in efficiencies and gain better insights into the work that they're doing.

Is a good use case for RPA in healthcare IoT?

Hanna: Absolutely. If you know anything about Moore's law and the idea that our knowledge base and data grows and process and capacity grows exponentially over time, we're really in a shining example of what that means right now. Tools like … RPA are creating new data insights in ways that we, some of us, certainly didn't have access to in the past because of the age of the systems that we're working on or whatever the case may be. So there's actually new data streams being developed out of this automation effort and I think that the organizations that are able to capture that data and use it in a meaningful way are going to have the most success.

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This was last published in September 2016

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Are you using RPA in healthcare? If so, how?
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Provider enrollment is a perfect example. Depending upon the position (doctor, therapist, doctor's assistant, etc.) and state, the processor, in order to set up a provider, has to go to multiple websites. Imagine how much faster and less error prone the activity would be if a robot handled these transactions.

A.J. alluded to claims. On average, a claim takes about 30 days to complete the cycle. Imagine if the robot could shave just 5 days from this average. Not only is it revenue generating, but also 5 days of cash flow improvement! It goes even further, because robots can easily handle a high percentage of the collections process.

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