RPA in Healthcare: A Path to Intelligent Automation

Back in 2013, the World Healthcare Organization (WHO) predicted that the global healthcare worker shortage could reach 12.9 million professionals by 2035, making in-person medical appointments a luxury few patients can afford. And the COVID-19 pandemic has only aggravated things. While telehealth and remote patient monitoring (RPM) solutions slightly lessen the burden on the US health sector, a 6,000% growth in telemedicine usage has put a strain on medical personnel who manually process claims, enter data into electronic health records, and interact with patients through digital channels. Wide-scale adoption of robotic process automation (RPA) solutions in healthcare may cure medical system inefficiencies. Here’s how.

The whats and hows of RPA in healthcare

What is RPA in the medical field?

Robotic process automation in healthcare is nothing like BostonDynamics’ dog robot or meal-carrying drones. Instead, we’re talking about ingenious bots — or pre-programmed software agents — that inhabit accounting, insurance, laboratory information, and patient engagement systems to name a few. Feeding off structured data, which is stored in databases and may span patient demographics, names, addresses, and financial information, such bots execute rule-based, repetitive tasks the way human workers would. In other words, the RPA solutions prevalent in the healthcare industry can be described as software that orchestrates other applications and performs tedious back-office tasks on its own, thus freeing healthcare workers’ time for diagnostic work and meaningful doctor-patient interactions. In particular, intelligent software agents are good at processing transactions, manipulating data, triggering responses, and conversing with internal and external IT systems.

An overview of RPA software capabilities in healthcare

How RPA medical solutions work under the hood

To better grasp the concept of RPA in healthcare, let’s find out what technologies lie in the heart of robotic process automation and how intelligent bots operate:

Technology stack. Robotic process automation relies on such programming languages and frameworks as Python, .Net, and Java, as well as relational databases and front-end technologies like JavaScript.
Business logic. Prior to deploying RPA medical solutions, a skilled business analyst contemplates a healthcare organization’s workflows and collects stakeholder feedback. Based on this information, inefficient processes and automation opportunities are identified. In the next step, process developers document and program rules or event-triggered instructions for RPA bots.
Components. RPA healthcare solutions are multi-layered systems that feature recorders, extensions, bots, a robot control unit, and a development studio. Thanks to recorders, bots can watch human workers interact with application UI elements and certain types of data, remember object properties, and mimic user actions, such as scrolling, hovering, or copying data when faced with similar tasks. A development studio is where automation workflows are designed. With the help of extensions, bots can extract and manipulate data kept in other systems. Finally, a robot control unit serves as an admin panel for setting up, executing, and managing intelligent software agents.

RPA applications in healthcare

RPA scenarios in healthcare can range from no-brainer tasks like auto-generating replies to emails to supporting single-click installations of complex software systems. Here’s a rundown of the most potent RPA use cases in healthcare settings:

Claims processing. Processing health insurance claims is a fastidious job that is prone to errors. What’s more, it takes a healthcare worker 85 seconds to simply check the status of a claim! Multiply that number by the amount of claims lingering in the queue, and you’ll come to realize why US patients and healthcare providers pay a whopping $496 billion in billing and insurance-related (BIR) costs every year. By integrating robotic process automation into healthcare claims administration workflows, Care1st Health Plan Arizona reduced the time needed to process one claim from 20 seconds to just 3 seconds. Another example of RPA in healthcare comes from Avera Health, a regional health system operating in five states. The organization implemented RPA bots to check user account status and notify Avera managers about pending and incomplete claims. By doing so, Avera Health saved $260,000 in employee costs. According to McKinsey, the use of robotic process automation in medical insurance promises a 30% reduction in claims processing costs for companies that automate 60-70% of actions associated with claims administration.
Payment processing. Robotic process automation solutions in healthcare billing typically work in tandem with claims management and medical coding systems. To receive reimbursement from insurance companies, healthcare providers have to source miscellaneous data, including drug and disease codes and entries from patients’ medical history, from disperate technology systems. In addition to automating data aggregation and entry processes, RPA medical tools can improve pricing transparency for patients. Baylor Scott & White Health (BSWH), a health system that serves 52 hospitals across the USA, introduced a claims evaluation mechanism driven by RPA and AI. In healthcare settings, it usually takes revenue cycle employees five to seven minutes to figure out how much patients are likely to pay for services before they actually receive care. With intelligent bots, BSWH now manages to produce 70% of estimates without human involvement.
Appointment scheduling. Before the pandemic, close to 88% of appointments were booked manually, extending the gap between an initial referral and actual visit by up to two months. Missed appointments, meanwhile, 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 and improve their no-show rates, which range from 5% to 39% depending on a healthcare specialty.
Compliance management. Ensuring compliance with legislative acts and standards regulating patient health information management is a matter of reputation and profitability. The penalties for HIPAA violations, for instance, vary from $1,000 per mild accident to $100,000 for serious breaches. Compliance checks and role-based access controls can be hard-coded into RPA medical tools’ business logic, preventing intentional and unintentional data breaches and maintaining a detailed activity log for fast and accurate security audits.

Other promising RPA use cases in healthcare span efficient medical coding, doctor-to-patient communication enhanced by auto-replies and reminders, centralized electronic medical record management, and inventory tracking.

Benefits of robotic process automation in healthcare

Robotic process automation is a viable solution for healthcare organizations looking to serve more patients and improve patient outcomes without significant expenditures or friction on workers’ part. Below you will find a summary of RPA benefits in healthcare as reported by early adopters:

With RPA solutions, medical organizations can facilitate processes without increasing labor costs, which account for 60% of hospital operating expenses
By assigning monotonous tasks to robots, healthcare organizations can reduce human errors stemming from manual data entry
RPA bots are low-cost and easy to implement, requiring no extensive software customization
Robotic process automation healthcare tools improve knowledge sharing and collaboration between organizations involved in medical care delivery
By leveraging RPA in healthcare, medical organizations could perform labor-intensive tasks 60% faster while reducing the associated costs by up to 80%.

Things to consider when implementing RPA in healthcare

RPA implementation costs and ROI opportunities. The decision to implement RPA in healthcare environments is often driven by cost savings. As Mina Pekkala, Head of Robotics at Helsinki University Hospital, put it, “When we choose potential processes to automate we put weight on cost savings: how much is the work going to cost and what is the actual return on investment?” While the cost of RPA tools in healthcare fluctuates around $5,000-15,000 per intelligent agent, a company might need dozens of bots to facilitate their workflows. The good news is, most organizations that implement and scale their RPA medical system achieve payback in just 12 months.
Alarming RPA project failure rates. Initial RPA projects hit multiple roadblocks and fail in 30-50% of the cases. This can be attributed to the fact that healthcare providers tend to automate the wrong processes, overlook IT infrastructure limitations, make use of traditional software delivery methodologies, or skip the minimum viable product (MVP) stage of RPA development, trying to cover too many business cases at once. Many of these pitfalls can be avoided by partnering with an experienced RPA solution provider and taking a granular approach to automation.
Desired level of intelligence. Experts consider RPA an exploratory step towards truly intelligent automation, which relies on computer vision, natural language processing, and fuzzy logic AI. By integrating AI capabilities into robotic process automation solutions, healthcare providers can derive insights from both structured and unstructured operational data — and act on it. Unstructured data comes in the form of handwritten notes, PDF files, videos, social media posts, medical images, and sensor readings gathered from connected equipment. Up to 80% of all information produced by healthcare organizations can be classified as unstructured, and its volumes are growing as more data is being collected and used for patient care. When planning a pilot RPA project, organizations should weigh in on healthcare AI integration opportunities and discuss available options with their vendor.

RPA in healthcare: what comes next

Although RPA remains one of the fastest-growing enterprise technologies, only 5% of US healthcare providers are currently using intelligent bots to automate mundane work and boost efficiency. According to Gartner, however, the percentage of RPA adopters in the healthcare industry could jump to 50% in just three years, while 20% of all doctor-patient interactions will soon involve some form of artificial intelligence (up from 3% today). A smarter, younger version of traditional hospital software, robotic process automation helps medical organizations improve care delivery and patient experience while keeping administrative costs (which comprise 34.2% of all US healthcare expenditures!) down.

In case your medical organization is ripe for a robotic overhaul, do not hesitate to contact our RPA experts! Together, we’ll enhance every process that needs improvement and automate what can be automated.

RPA in healthcare: a crucial step towards intelligent automation