Applications of RPA in Healthcare

Health care institutions strive to continuously counterbalance the patient experience, compliance with regulations and the desire to cut expenses. Many repetitive operations and decisions in healthcare organizations, like patient onboarding, billing, physician reporting and prescription administration, rely on the availability of correct data. It is helpful to examine what robotic process automation is and how it offers a solution for increasing efficiency, lowering costs and improving the patient experience by handling repetitive tasks.

What Does RPA Stand For in Healthcare?

Robotic process automation (RPA) is software that automates back-office processes, such as data extraction and paperwork. It integrates and executes repetitive operations across enterprise and productivity applications via APIs and user interface (UI) interactions. RPA technologies automate the execution of a wide range of tasks and transactions between disparate software systems by deploying scripts that mimic human operations.

RPA's Importance

In the healthcare industry, there is no room for slack. Tasks that are time-consuming and error-prone slow down operations and impact cost structures, patient experience and regulation compliance. RPA software improves data collection and reporting quality and speeds up decision-making by automating tasks while cutting costs and freeing resources.

RPA systems use a business rules engine to make automated decisions based on established rules and conditions for tasks that involve structured data and logic. For large, unstructured data sets, RPA can also help, but only after a bot obtains the data and afterward processes it using tools like natural language processing (NLP) and optical character recognition (OCR).

When organizations combine RPA solutions with AI, intelligent automation (IA) tries to mimic human skills and actions as accurately as possible, primarily by using bots.

Use Cases of RPA in Healthcare

There are a lot of sensitive interactions with patients in the healthcare industry, but there are also a lot of administrative, time-consuming, and monotonous tasks that don't require expertise. RPA can automate tasks across the enterprise, including front desk tasks, operational tasks, patient interactions and payments.

50% of US healthcare providers will invest in RPA during the next three years, according to Gartner. It also follows that healthcare providers are stuck in a toxic combination of lowering payments, enhancing outcomes, improving the experience and strengthening credentials. Any technology that helps these providers improve their service delivery and facilitate their operations must also reduce costs.

The following are examples of healthcare challenges that RPA can address:


● Administrative data entry: Administrative data entry rarely requires specialist expertise, although it can be a tedious activity. Using natural language processing (NLP), speech processing and picture recognition, RPA can take data inputs from various sources and use bots to structure large data sets. Subsequently, a user must enter this information into a database or other repository for the organization's usage.
● Document digitization: RPA can prepare and put documents into a more extensive archive for storage or use, including health records and insurance claims.
● Patient appointments: Organizations can automate patient appointment management and scheduling using RPA bots to interact with customers. Appointments can also be scheduled, changed, canceled or updated as needed.
● Billing and processing: These processes are typically repetitive. Providers can automate these tasks using RPA, with bots managing claims, including initial inquiries and follow-ups.
● Managing Records: The healthcare business is highly regulated, necessitating strict processes and reporting on patient records, health records, and other sensitive information. RPA can help ensure regulatory compliance by ensuring records' security, consistency, and accuracy.
● Infection control: RPA can assist healthcare practitioners in implementing infection control measures, including managing diagnostic tasks, monitoring screening processes, inventory and patient flow management and monitoring care plans for patients.
● Correspondence: RPA can automate communications in the healthcare industry, including responses to online questions, calls to customer service, administrator inquiries and email campaigns.
● Customer support and remote care: RPA and bots can automate customer service and remote care tasks that are repetitive. Machine learning and intelligent automation (IA) make it possible to answer identical questions consistently and instantaneously. As part of the patient care plan, RPA can be used for remote care to deliver particular communications at critical points in the patient's treatment.

Why Use RPA in the Healthcare Industry?

Healthcare organizations can get a lot out of RPA because there is a need to cut costs, speed up operations, streamline tasks, make business processes more efficient and enhance the patient experience.

RPA implementation can reduce healthcare administration costs, increase the speed of processes such as triage and improve the accuracy of data, tasks and reporting. It can benefit the patient experience by enhancing the productivity of healthcare staff by automating tasks that do not require human intelligence and providing consistent care.

Healthcare providers must consider several factors when implementing RPA, such as where automation can be beneficial, the available resources and if a partnership can help speed the process by providing expertise or resources.

Situations Where RPA Could Help Reduce Costs, Raise Efficiency and Improve Patient Experience

RPA has so many applications in healthcare. Any firm would be well-advised to begin by concentrating on a select few opportunities that could result in financial rewards.

Below, we will examine how RPA tools can increase the operational efficiency of a hospital.

Nearly three-quarters of Hospital Y's administrative resources resolve errors and delays in manual procedures. The hospital must optimize its expenses and resources to accommodate the rapidly increasing number of patients from the COVID-19 outbreak.

Prior insurance authorization, processes such as cost estimates, insurance verification and benefits denials, and claims management and accounts receivable cost hospital Y more money than other operations. These processes entail several manual actions that are time-consuming and require precision to provide effective patient care.

Hospital Y may reduce the manual reliance on each process by using RPA, which reduces the risk of error and improves accuracy, thus lowering expenses. The hospital automated each of the following processes using RPA:


● Prior insurance authorization: RPA and AI submit and track requests for prior authorization for procedures, communicate routinely with the patient and other stakeholders, and schedule the procedure. Since submissions for insurance authorization depend on accurate coding, AI technology can detect and fix anomalies in submissions caused by human error. Approval of coverage for special tests or treatment authorization is obtained online, along with the patient's fee, and the response is provided automatically via email.
● Insurance verification and benefits denial: As the facility arranges, attends or cancels appointments, RPA keeps track of the details and requests approval for patients. The system offers information about how much the patient will have to pay, deductibles and other coverage details so that everything is clear and consistent from the start.
● Cost estimates: Patients can know, in advance, the costs of procedures and treatments, and payment plans and collection efforts are also automated.
● Claims management and accounts receivable: RPA manages claims processing operations utilizing AI and bots, including denials communication and resubmission and income and expense forecasts based on historical data. Additionally, the system automates revenue collection and facilitates the recovery of funds without requiring repetitive manual intervention.

These activities are a few examples that can take advantage of the use of RPA to eliminate manual input, repetitive tasks and human mistakes, hence lowering costs and enhancing patient care and the patient experience.

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