7 Use Cases of RPA in the Healthcare Industry

7 Use Cases of RPA in the Healthcare Industry

Naveen Joshi 09/06/2019 3

The advent of RPA in healthcare services will automate various complex tasks for medical professionals and administrators in hospitals and clinics. With the help of RPA, healthcare institutions can improve their efficiency and offer better medical care for their patients.

Healthcare providers across the globe carry out multiple procedures and tasks such as billing and claims management, patient onboarding, delegating medical professionals, collecting patient reports and data, and providing prescriptions. Traditionally, these tasks are managed or monitored manually or with the help of off-the-shelf software. With this approach, executing and tracking these procedures along with core tasks can be tedious, time-consuming, and error-prone. Additionally, healthcare institutions must ensure compliance for various rules and regulations. Also, healthcare regulations are constantly changing. Hence, healthcare institutions have to be updated with the latest changes and take suitable measures for regulatory compliance. Non-compliance of regulations can result in hefty fines or in some cases, the shutdown of hospitals. Such incidents affect the reputation of healthcare institutions.

The advent of robotic process automation has transformed various industry sectors such as manufacturing, construction, and telecommunication. Likewise, the introduction of RPA in healthcare will revolutionize the healthcare sector. Leveraging RPA in healthcare will present a feasible solution for several concerns related to healthcare. RPA bots will automate rule-based tasks in high volumes. Such bots can store and manipulate data, processes transactions, communicate with other digital systems, and trigger responses. RPA bots have the ability to generate accurate results and avoid errors.

Use Cases of RPA in Healthcare

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1. Simplifying Patient Appointment Scheduling

Patients often schedule appointments online. Healthcare institutions have to collect personal information, diagnosis, and insurance details in the registration process. Scheduling appointments based on patient data can be a tedious process. Also, patient appointments have to be aligned with different doctors’ schedules and their availability in hospitals. For instance, if a patient needs to be diagnosed by a neurologist, then their appointment must be fixed according to the neurologist’s timings in the hospital. Also, in case any doctor is unable to attend to their patients, then the hospital staff needs to inform the patients beforehand. Hence, scheduling patient appointments can be a complicated task.

Implementing RPA in healthcare can resolve all concerns related to scheduling patient appointments. RPA bots can automate patient data collection and processing. With this approach, RPA bots can optimally schedule patient appointments according to diagnosis, location, doctor availability, and other criteria. RPA systems can scan patient data to create a report that can be sent to a referral management representative to fix the appointment. Additionally, RPA bots can notify patients when doctors are unavailable for their appointment. For instance, a cardiologist is caught up with a time-consuming operation might be unable to attend their patients. The RPA software can track the cardiologist’s schedule to help alert patients in case of unavailability.

2. Speeding up Account Settlements

Healthcare institutions have to monitor, calculate, and evaluate bills accumulated during the diagnosis and treatment of each patient. Manually processing of such data can be time-consuming and introduce multiple errors. Also, maintaining records of several tests, prescriptions, doctor fees, wardroom cost, and other facilities are essential for accurate calculation of every patient’s bill. Therefore, the entire process can become very complicated for the hospital staff.

RPA bots can accurately calculate the bill amount considering the costs for tests, medicines, wardroom, food, and doctor fees. RPA software can notify patients of their bill amount and receive payments. By introducing RPA in healthcare, healthcare providers can reduce payment delays and inaccuracies associated with the calculation of bill amount. Hence, leveraging RPA in healthcare services can effortlessly speed up account settlements.

3. Streamlining Claims Management

According to statistics, almost 91.2% or 294.6 million Americans have health insurance coverage. Managing insurance claims involves processes like data input, processing, evaluation, and dealing with appeals. The entire procedure, if handled manually or using a generic software, can prove to be inefficient and error-prone. Outdated insurance claims procedures can significantly impact the cash flow. Furthermore, around 30-40% health insurance claims can be denied due to non-compliance of regulations. Hence, ensuring regulatory compliance for insurance claims can be another complicated task.

Leveraging RPA in healthcare services can streamline the process of managing insurance claims. RPA bots can speed up data processing for insurance claims and avoid errors. In this manner, RPA bots can avoid delays and monitor the entire process. These bots can also identify compliance-related exceptions and avoid non-compliance of regulations. Therefore, the adoption of RPA in healthcare services can improve the efficiency of complex insurance claims management procedures.

4. Implementing Discharge Instructions

Generally, patients are given prescriptions, medications, and are required to follow post-discharge guidelines to help them with certain symptoms. Checking whether the patients follow discharge instructions is almost impossible for healthcare institutions. For example, after chemotherapy, a patient may suffer from an upset stomach and a loss of appetite. In such cases, doctors may prescribe medications for their condition and suggest follow-up appointments. Healthcare institutions are unable to monitor and ensure compliance of such discharge instructions.

RPA bots can ensure the accuracy of discharge guidelines and send reminders to patients about prescription pick-ups. By leveraging RPA in healthcare, hospitals can also notify their patients about upcoming doctor’s appointments and medical tests. Additionally, RPA bots can alert healthcare providers in case any patient needs further assistance with their condition. RPA software is essential for the improvement of HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores. With this approach, healthcare providers can enhance their patient’s experience, provide better healthcare, and reduce readmissions.

5. Recording Audit Procedures

The auditing procedure involves multiple tasks for risk assessment. Such processes and their results need to be recorded to generate reports. These reports are sent to concerned parties for verification and approval. Such audits can be done for multiple objectives such as patient safety or quality of services. The reports generated during healthcare audits are necessary for regulatory compliance. Hence, collecting and evaluating multiple reports from different auditing tasks and collaborating with several concerned parties can be tedious. Also, errors in these reports can result in non-compliance of regulations.

Audit procedures can be easily optimized by utilizing RPA in healthcare services. RPA bots can record data and generate reports during audits. The reports can be automatically shared with concerned parties for evaluation and approval. With RPA software, hospital staff can monitor the progress of these reports and check which personnel are pending to approve the reports. With this approach, RPA software can help healthcare institutions ensure accountability for different auditing procedures. In case of non-compliance, the person who approved the reports can be quickly identified using an RPA software.

6. Improving the Healthcare Cycle

Healthcare providers collect large volumes of patient data such as their personal information, diagnosis, and treatment cycles. Since all the data is stored in a generic database, extracting and optimizing such data for analysis can be tedious and complicated. Also, the volume of data keeps increasing every day with newer patients and disorders. Hence, healthcare providers may have to extract and optimize data constantly.

RPA software can record and monitor increasingly volumes of data effortlessly. With the help of RPA in healthcare services, hospitals and clinics can optimize and extract their data to generate analytics with the help of other digital systems. Such analytics will offer profound insights into diagnosis methods and different types of treatments. Leveraging such insights, healthcare providers can deliver accurate diagnosis and develop well-tailored treatments. With this approach, healthcare providers can easily track and analyze large volumes of data and spend a majority of their time in attending and assisting their patients.

7. Managing Healthcare Workflows

Running a healthcare institution involves various crucial workflows such as managing and coordinating healthcare, case and utilization management, remote monitoring, and population wellness. These critical workflows contain routine tasks that are essential for healthcare providers and patients. Generally, the workflows are managed manually, which can be an inefficient approach.

The utilization of RPA in healthcare services can centralize and streamline different workflows. Shifting these routine tasks from human agents to bots can result in cost savings for healthcare providers. Also, automating crucial workflows will improve efficiency across the board. With this approach, healthcare professionals can spend the majority of their time on patient care and other critical activities.

A major drawback of leveraging RPA in healthcare is that RPA can only process structured data and work with a rule-based approach. However, the advent of intelligent process automation (IPA) will make RPA smarter. With the help of cognitive technologies and machine learning in healthcare, IPA can process unstructured data and make informed decisions. The applications developed with the help of IPA be even more beneficial than RPA.

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  • Daniel Shaw

    RPA in healthcare will certainly lead to better patient outcomes.

  • Matt Watkins

    These are just partial solutions to solve the healthcare crisis.

  • Zack Bond

    We need more drastic solutions.

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Naveen Joshi

Tech Expert

Naveen is the Founder and CEO of Allerin, a software solutions provider that delivers innovative and agile solutions that enable to automate, inspire and impress. He is a seasoned professional with more than 20 years of experience, with extensive experience in customizing open source products for cost optimizations of large scale IT deployment. He is currently working on Internet of Things solutions with Big Data Analytics. Naveen completed his programming qualifications in various Indian institutes.

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