The following is a guest article by Pavani Munjuluri, Co-Founder, CognitiveHealth Technologies.
With dramatic change comes significant opportunity. Healthcare changes experienced in 2020 demonstrate the inexorable truth behind this mantra. Never before have healthcare provider organizations pivoted so rapidly to adopt new processes, workflows and technologies. Intelligent process automation (IPA) has emerged as a powerful tool to support these shifts.
IPA is making great strides to improve efficiency and financial outcomes in healthcare. This is especially true in the healthcare revenue cycle.
- IPA automates routine administrative tasks in those cases where complex decision-making, overlapping IT systems and high operational costs coalesce.
- Mundane, high-volume tasks in healthcare’s revenue cycle are also ripe for IPA. The incorporation of intelligent bots for repetitive tasks relieves staff to focus on more cognitive-based work.
However, there are two emerging challenges to consider with IPA in the revenue cycle. The first is how to scale IPA platforms beyond single processes. The need for an integrated, long-term IPA strategy across functions and departments is listed as a top-three challenge in the recent report by Gartner Research. Second, IT leaders must realize the benefits of process automation as quickly as possible to reduce operational costs and subsequently improve organizations’ cash position.
These challenges hit center stage when revenue cycle teams were sent home in the wake of COVID-19. Almost overnight, end users were virtual and access to multiple systems was remote. Revenue cycle staff still needed to access multiple systems and applications, but they were out of touch with management and onsite IT teams.
Crisis or Opportunity?
At CognitiveHealth, we used the COVID crisis to create new opportunities for our health system customers. Workflow assessments already underway were expedited and IPA functionality was quickly wrapped around existing systems to mimic the human interactions that typically occurred. Here is one example of how IPA was applied to a multi-system revenue cycle process that was difficult to support in a remote work environment—incoming documentation.
Staff work between ten to twenty applications to bring information together and do their jobs. Incoming correspondence, such as approvals, denials and explanation of benefits, represent a significant portion of the information that must be identified, read and correctly digitized into the patient’s electronic file for action. These pieces of documentation come from a plethora of payers, a multitude of systems and several formats, including fax.
CognitiveHealth leveraged their IPA platform with applied artificial intelligence to this function to create efficiency with six important outcomes.
- Incoming documents are now electronically read and separated to specify those requiring further action versus those simply needing to be filed.
- Intelligent bots serve as receiving and filing clerks to support everyone on the revenue cycle team. They help staff take necessary action in a timely manner to avoid cash penalties or revenue loss.
- Correspondence requiring human intervention, such as denials, is segregated into individual work queues within their EMR applications based on established rules.
- Meaningful data is extracted throughout the process, such as patient account information, provider details and service-related information.
- High-volume tasks are automated, freeing up staff to focus on more cognitive-based work.
- All the requisite supporting letters for each individual patient are accessed seamlessly and in just two to three clicks instead of a multitude of systems and shared folder locations.
The cost savings for automating this type of mundane, repetitive task can be quite compelling in a relatively short period of time. Yale New Haven Health in Connecticut applied the above workflow to their high volumes of incoming documentation as one step in their IPA journey. Across the larger revenue cycle automation project, the organization reduced revenue cycle full-time employee workload by 14 percent with potential cost savings estimated at 30 to 40 percent of budget.
IT Departments Win Too
On the IT side, systems must be accessible by all staff—remote and onsite—and used at optimum capacity, including the EHR. Since system testing and collaboration are compromised in remote environments, IT departments can use IPA bots to automatically run tests and flag areas of failure. Entire test scripts can be automated with IPA to minimize testing rounds and reduce departmental workload.
One example of test script automation is the use of intelligent bots to create test patient profiles for the integrated testing. They verify to see if the patients are already included in the EHR and even create new patient records if necessary. Exception queues receive errors or misidentified patients for human intervention. This enables the testing team to spend meaningful time on utililzation assessment of workflows. This efficiency of labor savings becomes very critical during system upgrade testing and integrated testing.
Make Smarter IPA Decisions: Ten Points to Consider
It is important to choose the right business processes to automate. Here is a quick checklist for making better IPA decisions.
- Automate repetitive tasks to achieve the greatest impact.
- Embrace digital employees as part of the team.
- Take an enterprise view—leverage IPA platform across departments.
- Dissect and reengineer processes before you automate.
- Track time and cost savings to demonstrate return on investment.
- Don’t take away from the core systems you are already using. Wrap automation around them.
- Extract meaningful information from the IPA tool.
- Remember that IPA bots work around the clock. There are no time constraints or limitations.
- Take a step-by-step approach to minimize staff and workflow disruption.
By choosing the right processes to automate, taking a long-term view of IPA platforms and realizing benefits quickly, healthcare IT leaders can make the most of this supportive tool and be prepared for whatever lies ahead.
About Pavani Munjuluri
With over 20 years of global leadership experience, Pavani is an expert in bringing innovative ideas and solutions together to improve healthcare processes and drive greater efficiency in the healthcare ecosystem. She co-founded CongitiveHealth Technologies in 2018 and currently serves as the company’s chief operating officer.