Robotic Process Automation(RPA) Use Cases in Healthcare Industry

Do you agree that today’s customers are tech-savvy and digitally driven? Well, it’s not different when it comes to healthcare patients. At least you might have one health-related app in your phone, am I right? That’s the world we live in today.

If the front-end stuff is changing, it’s obvious that the behind-the-scenes stuff must also change to make this digital shift smooth. Let’s not beat around the bush; RPA – Robotic Process Automation is one of the key automation technologies that plays an integral part in healthcare digital transformation.

Understanding the Role of RPA in Healthcare

First let’s see what made RPA an eligible candidate for healthcare digital transformation.

Healthcare workers are stretched thin, facing intense pressure from compliance requirements and cost constraints amidst uncertain times. That’s when healthcare stakeholders realized RPA – Robotic Process Automation can bring a significant change in healthcare industry. And they weren’t wrong about it.

33% of work performed by healthcare providers may be automated.

Integrating RPA into healthcare enables organizations to achieve greater efficiency by automating tasks using predefined rules, structured data, and logic. Whether it’s managing data, patient care, scheduling, or IT helpdesks, RPA tools enhance productivity, boost patient outcomes, and enhance employee satisfaction.

Benefits of RPA in Healthcare

• Reduce healthcare administrative costs, as RPA bots take over mundane, repetitive administrative tasks potentially reducing the need for administrative staff to some extent.

• Achieves data accuracy by replacing erroneous hands of humans with process automation bots, which ensure data consistency in all the organization’s systems.

• Powers up staff productivity since healthcare staff are no longer tied up with mundane tasks, allowing them to focus on tackling complex issues that demand human judgment. This maximizes staff capacity and elevates overall efficiency in healthcare delivery.

• Improves patient experience, as healthcare staff can dedicate their valuable time to patients, offering them more personalized attention and addressing their needs more effectively.

Effective Healthcare RPA Use Cases

1. Revenue Cycle Management

Revenue cycle management is a tedious task for both payers and providers with slow and inefficient processes impacting productivity, cash flow, and critically, patient experience. RCM encompasses the entire payment and claims adjudication process for revenue generation, based on fee-for-service billing. Let’s see how RPA deals with it.

•  Claim processing

How long can a receptionist go through piles of paper to check patient details, medical history converts the diagnosis medical codes and sometimes calls with their respective insurance companies for verifying eligibility.

“72% Claims denied in 2020 likely due to administrative or paperwork errors.” – Kaiser Family Foundation

 However, RPA makes this long chain process simple. It autonomously populates insurance fields with the help of tools extract data from electronic health records (EHRs), patient management systems, or insurance portals. The RPA tools use data extraction techniques to identify, and capture required data elements accurately, reducing manual data entry errors and speeding up the claim creation process.

•  Billing and invoicing

In continuation to claim processing, the same principle works here. One need not worry about billing activities. Trust me, nobody wants to be near that area. RPA bots validates payment received from insurance companies, patients or third-party payers. They can match incoming payments with corresponding claims, update patient accounts with payment details, and reconcile payments against outstanding balances.

2. Front office operations

• Appointment scheduling:

Receptionist single handily dealing appointment scheduling either through phones calls or manually taking done consumes so much time and energy of patient and the receptionist. On top of that, sometimes the receptionist needs to send reminders, reschedule or even cancel.

Instead of this time-consuming method, healthcare providers can create self-scheduling options for patients with bots where a patient can autonomously book their appointment through bots and connect with healthcare professionals for early diagnosis and treatment. To make it more effective, healthcare providers can use these bots for sharing healthcare records and data directly to patient IDs for easy knowledge sharing.

“More than 60 percent of consumers expect to be able to change or schedule a healthcare appointment online.” – MacKinsey

•  Patient Eligibility & Registration:

Patient eligibility is a key factor in revenue cycle management. It’s not just a pre-registration activity but checking eligibility all along the way helps cut down on denied claims, missed payments, and long waits for payment. In fact, stays at hospitals are not cheaper in these days, therefore failing to verify eligibility can quickly raise costs to unacceptable levels.

Using RPA bots for patient registration can zip through the whole process, automating tasks like pre-registration and insurance checks in no time, with no mistakes. Yay, now teams can focus on more productive, satisfying work.

3. Clinical Data Management

•  Data entry & validation:

Here, it’s not just RPA but comes other players like AI, machine learning and OCR. RPA levied on top of these technologies can create an ecosystem of intelligent document processing that can easily collect information from any system, in any format and enable easier data access.

•  Data entry & validation:

Having accurate data on your plate is a big responsibility, especially in the healthcare industry. Imagine manually entering data into umpty number of columns for a new patient. This task consumes a lot of time and is burdensome for the staff doing repetitively all alone.

This is exactly what RPA is looking forward to taking up – mundane, repetitive, rule-based tasks. RPA bots can complete the task swiftly and accurately without ferocious typing hands.

•  Medical Coding:

In medical coding, manual coders meticulously review patient records to determine coding requirements, then manually assign codes using either handbooks or coding software, a time-consuming and error-prone process.

All these step-by-step processes can be done single handedly with RPA bots. Let’s see how?

Using predefined rules and algorithms, RPA bots analyze medical documentation to identify diagnoses, procedures, and treatments, and automatically assign appropriate codes from standardized code sets. There’s more to it…

RPA bots can perform automated checks to validate coded information against coding guidelines, flag potential errors or discrepancies for review by human coders and ensure accuracy and compliance.

Explore how our RPA services can revolutionize your workflow and productivity

4. Pharmacy Operations

•  Medication dispensing:

Medical dispensing can involve a lot of tasks such as taking medication orders from prescribers and healthcare providers, and packaging medications according to prescription specifications.

RPA streamlines these processes efficiently. The process automation bots verify prescription details and generate orders. Additionally, RPA automates the dispensing process, ensuring accurate labeling and compliance with regulations.

•  Medication reconciliation:

RPA bots automatically collect medication data from various sources like EHRs, pharmacy records, and patient lists. They then compare this with the patient’s history to spot any differences in names, dosages, or administration. Alerts are generated for healthcare providers to address any discrepancies and prevent errors.

5. Supply Chain and Management

• Inventory tracking:

Traditional inventory management involves manual data entry, paperwork and spreadsheets. To top if off, healthcare facilities deal with medical supplies, drugs, and equipment, and each of them needs specific storage, expiration dates, and how often they’re used. Trying to keep track of all that by hand is a big headache and makes mistakes more likely.

RPA makes sure data updates are spot-on and happen in real-time by eliminating manual data entry errors. Plus, it can integrate with existing systems, such as electronic health records (EHRs) and supply chain management software, to ensure seamless data flow and maintain data integrity.

Well, the benefits list continues as it can predict demand, optimize reorder points, monitor and track expiry dates of medical supplies and pharmaceuticals, send timely notifications to prevent the use of expired products and generate automated alerts for low stock levels.

• Order Management:

It is similar in terms of medication processing, but here it involves a lot of interaction between suppliers, vendors, and internal departments. Rest follows similar pattern seen in medication processing – order placement, verification, routing, tracking, and fulfillment.

Therefore, RPA bots can retrieve order information from electronic systems or emails, validate orders against predefined criteria, and route orders to the appropriate departments or suppliers for fulfillment. They can also generate automated order confirmations, status updates, and delivery notifications to keep stakeholders informed throughout the order lifecycle.

6. Human Resources

• Employee onboarding and offboarding:

For employee onboarding, RPA bots can automate tasks such as generating and distributing welcome emails to new healthcare staffs, collecting and organizing new hire paperwork, and setting up accounts, giving access permissions in various systems and provisioning of new equipment.

Similarly, for employee offboarding, RPA can automate tasks such as revoking system access, collecting company property, initiating exit interviews, and updating HR records.

7. Finance and Accounting

• Expense management:

In the healthcare industry, employees deal with huge piles of bills covering various charges like consultation fees, medical bills, prescription costs etc. As you know, finance is a risky realm where a simple mistake can make a huge mess. Despite the inevitability of human errors, we simply cannot afford to overlook or tolerate such mistakes.

RPA streamlines tasks like data entry, invoice processing, and expense tracking for improved accuracy and efficiency. Bots automate expense capture, categorization, and receipt verification, reducing errors and ensuring financial compliance. RPA also facilitates proactive expense monitoring and analysis, helping healthcare organizations find cost-saving opportunities and enhance financial performance.

8. Compliance and Reporting

• Regulatory compliance:

We have come across compliance in many other areas too, these intentional emphasizes are to pinpoint the importance of compliance when it comes to healthcare. For healthcare organizations, sticking to the rules of the Health Insurance Portability and Accountability Act (HIPAA) is a big deal.

Let’s talk about how RPA plays a crucial role in keeping us compliant. RPA automates repetitive compliance tasks and ensures consistent adherence to regulatory requirements. It enhances efficiency in compliance-related processes, such as data validation, risk assessments, and audit preparations.

•  Quality reporting:

You must know by now that RPA bots can extract data from different sources which will be very helpful for providing quality reporting. It ensures accuracy, efficiency, and compliance with regulatory standards, facilitating real-time monitoring and timely identification of improvement areas. This empowers healthcare professionals to focus on analyzing data and implementing interventions to enhance patient care outcomes.

Wrapping Up:

By now it is very clear that RPA is a feasible technology partner for your healthcare organization as it won’t disrupt your entire system ecosystem and churn out quantifiable results in your hands. The world is getting into “Intelligence” era, here RPA can be your first step towards the next level. We can help you to roadmap your automation journey hassle free.

Talk to our automation experts, who has more than ~ 25,000 hours experience under their belt.