Blog | Aug 11, 2020

Where To Next for Automation Healthcare?

Single payer post image

Where is automation making the biggest impact in healthcare – and where should the use case hunters look next?

Automation is already proven and recognized for the value it delivers in the back office, across industries. Repetitive processes which consume the time of skilled resources are a natural fit, and in most mature organizations the automation of low hanging fruit – finance, HR and IT processes – is well underway.

As the impact of the global pandemic shakes the healthcare sector, how will existing automation programs need to adapt or evolve in order to help healthcare payers and providers respond? And how does the future look, in a changed world?

Many of the workflows in healthcare share these common characteristics: repetitive, cumbersome, time consuming and manual. The most mature use cases for automation have tackled these issues in intake processes. Automation has been managing check in and triage for over a decade. In addition, finance processes around billing, validation and collections have been automated, but often in islands.

The initial shock of the pandemic led to a laser focus on ensuring business continuity and creating resilience in response to dramatic changes in demand and capacity. Those core requirements have now been mostly met and the industry is looking ahead.

As Gillie McCreath, IBM Automation’s Healthcare lead puts it, ‘As the dust begins to settle, we are now seeing the real implications.’ He identifies extended grace periods, layoffs driving lower member bases, and a new raft of fraud concerns, as exposing issues – and opportunities – across the payer value chain. And for healthcare providers, there are many ramifications including a significant impact on revenue.

The pandemic has created a burning platform, then, for transformation – and that’s where automation comes in. This is no longer about improving the efficiency of tasks, through a technology-lead approach. As Gillie McCreath puts it, ‘Automation used to be a conversation led by IT – it’s now top of mind for CFOs and COOs. This is a wake-up call for automation.’

The use of automation for those intake and triage processes mentioned above will continue to be expanded, with added intelligence. Optical character recognition and other smart data capture capabilities are key to ensure that the benefits of automating at intake are felt right through the value chain.

The value delivered by automation will then follow the movement of users – downstream. Engagement, assessment, analysis – leveraging some existing capabilities but will also require greater intelligence and further integration.

Healthcare providers and payers are awash with spreadsheets and multiple systems – even a highly integrated single payer system, like the UK’s NHS, has over 300 systems of record. As Blue Prism’s Josh Noble points out, particularly in the US, ‘a lack of interoperability between systems and between providers has led to higher costs without necessarily funding quality of care impacts.’

Automation of intake enables improved integration downstream. Digital workers can traverse multiple and various systems – independent of APIs – and the scope of their activities is massively expanded if intake and triage is digitized from the outset. With digitized, structured data being captured from the beginning, the possibilities for automation to co-ordinate the transmission of prescription data, to schedule follow-up appointments, manage billing and payment – are more easily within reach.

Where to next for automation in healthcare? My advice to those in search of their next use case: follow the value chain, follow the patient, and continue to integrate. For more information, please view our on-demand webinar.