RPA in Healthcare: Benefits, Use Cases & Case Studies in 2024

Healthcare systems contain multiple burdensome tasks and strict regulations that require a substantial amount of resource allocation, such as claims management and patient scheduling. This leads to inefficiencies, high costs of operations, and slow processes.

By leveraging the power of automation and RPA, healthcare providers can address these issues and make healthcare systems more efficient, healthcare processes faster, and improve the overall levels of patient satisfaction.

With automation and fast implementation projects, enabled by RPA and intelligent automation, healthcare providers can avoid costly, long-running digital transformation implementation projects and reap fast rewards, enabling them to channel more resources to healthcare delivery.

Analysis of Use Cases

1. Patient Scheduling

With the involvement of RPA technology, patients can schedule their appointments without intervention from hospital employees. Along with eliminating the need for resource allocation for scheduling, this application can also improve customer relations, since patients can arrange an appointment faster.

Business benefits:

• Increased appointment turnout: Through automation of patient scheduling and appointment reminders sent by the RPA bot, patients are less likely to forget their appointments. This will optimize patient admission and discharge.
• Better patient experience: The RPA bots streamline front-office support and make it easy for the patient support team to manage patient queries. RPA solution in the front and the back office allows healthcare providers to offer a higher quality of customer service.

2. Claims Management

After a healthcare service is provided, billing could take some time to be processed because of the manual and repetitive tasks in the claims management process, such as inputting, processing, and evaluating documents and data.

Along with automating time-intensive tasks, an RPA-led claims management system can also eliminate human errors during claims processing. That is beneficial to healthcare providers, given that according to the US Center for Elder Justice, medicare loses ~$60B annually due to fraud, errors, and abuse.

Business benefits:

• Minimized human error: Most healthcare data processes are repetitive and rule-based. Leveraging bots to automate these processes minimizes human intervention and the consequent, inevitable errors of manual processing. If the bot developer writes an accurate code, chances are high that your rule-based processes will be consistent across the board, and error-free. 
• Increased employee satisfaction: Assigning your workforce to tedious tasks may harm employee satisfaction which can lead to higher employee turnover. This leads to more recruiting and onboarding during which employees are considerably less productive.

3. Regulatory Compliance

RPA enables healthcare providers to track and document each process step in structured logs files so that the company can comply with external audits. Since these processes will be handled by bots, RPA could improve data confidentiality as well.

Business benefits:

Achieve higher transparency: Bots generate event logs of each performed step in the process, creating a transparent audit trail. This helps healthcare audit teams have a highly visible and transparent source for ensuring compliance.

4. Data Entry/Migration/Extraction

The healthcare industry is reliant on paper documents. A survey in 2021 found that 67% of respondents had said that their healthcare organizations have departments that heavily rely on paper documents.

The heavy reliance on paper makes the healthcare industry a good candidate for digital transformation. Healthcare providers today are increasingly digitizing patient information so that it can be stored electronically and accessible online by other doctors, and even the patients themselves.

The process of extracting data from legacy systems, and entering those into digital systems, can be automated by RPA bots. And then, when there is a need for the migration of data for a different purpose, such as medical research, another RPA bot can handle this migration process.

Check our article on the use of RPA in legacy system integration for a more comprehensive account.

Business benefits:

Reducing costs: Price of RPA software is just a small fraction of what healthcare providers pay to employees for manual tasks. According to CAQH’s study, the healthcare industry could save $13.3 billion if administrative tasks are automated in the revenue cycle.

Examples of RPA case studies in healthcare

1. GAM Pharmaceuticals

Sponsored:

Problem: GAM, a distributor of medicine and perfumery¹ , wanted to automate repetitive tasks because they struggled with data errors caused by manual data entry, and delayed customer quotes.

Solution: GAM leveraged IBM’s RPA solution to automate 22 rule-based processes across different business platforms (e.g. company website, spreadsheets, ERP).

Result:

Automating these tasks using IBM’s RPA enabled GAM to:

• Save BR$120k per year on manual tasks
• Increase the speed of responding to customer requests

2. Max Healthcare Institute

Problem: Max Healthcare Institute is one of the largest healthcare chains based in New Delhi, India. They deal with the process of patient transaction data on a daily basis. Some manual processes they need to streamline every day are customer detail recording, claims processing, and reconciliation of data for government health schemes. The main priority was to improve the efficiency of existing processes to ensure greater accuracy and reduction in turnaround time, yet, the institute wanted to start small and scale up as and when required.

Solution: They partnered with an RPA consulting firm to identify areas where robotic automation could be implemented and where the maximum impact could be achieved. The institute adopted an RPA platform to handle the following processes more efficiently:

• Claims Processing
• Data Reconciliation for Central Government Health Scheme (CGHS)
• Data Reconciliation for Ex-servicemen Contributory Health Scheme (ECHS)

Results:

With this solution, Max Healthcare was able to reduce turnaround time (TAT). For claims processing, the TAT was reduced by at least 50% while CGHS & ECHS have achieved time savings in the range of 65%-75%¹.

3. Major U.S. Healthcare coverage administrator automates appeal processing

Problem: The company must review cases when members submit a policy complaint or want to appeal a decision, yet, members request appeals through different channels such as email, fax, phone, or a web form. Information regarding member names and complaint types was manually entered from different channels to start the appeal process. These manual steps were time-consuming. Errors and delays in the appeal were costly for the company.

Solution: The company adopted an RPA solution to solve this problem. The software is able to extract data from emails using robotics and OCR, then uses machine learning models to classify and route requests into queues

Results:

• Manual work is reduced by 85% across the process end-to-end, from data extraction to policy decisions.
• Timestamp and other data were extracted at a 99% accuracy rate, up from 62%.
• Average routing time cut from 15 minutes to 3 minutes².

Other automation technologies relevant to healthcare

Healthcare facilities can also leverage workload automation (WLA) tools for data-related tasks, such as ETLs, FTPs, and data warehouse management. WLA tools can automate the initiation, triggering, and execution of these processes on different business platforms from a centralized point to provide an overview of data transfers and migrations, and log these actions.

For more on RPA

To explore RPA benefits, challenges, use cases, and best practices in detail read our in-depth whitepaper on the topic:

For more RPA case studies, feel free to check our RPA case studies article.

And if you still have questions about deploying RPA, don’t hesitate to ask us. And if you believe your business will benefit from investing in an off-the-shelf RPA solution, feel free to scroll down our data-driven list of RPA software and other automation solutions. 

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This article was originally written by former AIMultiple industry analyst Atakan Kantarci and has been reviewed by Cem Dilmegani

Sources

1, 2

• 1. “Enhancing workforce efficiencies with Robotic Process Automation.” IBM. Retrieved on February, 28, 2022.