RPA in healthcare:
use cases, benefits, and challenges

RPA in healthcare: use cases, benefits, and challenges

March 3, 2023

RPA in healthcare market statistics

of all healthcare provider tasks can be automated

McKinsey

of US healthcare providers will invest in RPA in the next three years

Gartner

RPA in healthcare market CAGR from 2022 to 2030

Precedence Research

Chart title: Robotic process automation in the healthcare market size, 2021 to 2030

Data source: Precedence Research

11 RPA use cases in healthcare

Appointment scheduling

Appointment scheduling is a tedious and error-prone activity when done on a bigger scale. Even with online booking instead of call-based scheduling, the process still calls for human supervision.

RPA can facilitate appointment scheduling by automating the majority of associated tasks. Based on the request, doctors’ availability, and clinic location, the bot can offer the patient time slots with the relevant doctor, estimate appointment duration, remove the appointment slot in case of cancellation, and notify both the patient and the doctor.

Claims management

Insurance claims management is a process that hospitals have to deal with daily, and as the number of patients grows, the staff often struggles to handle hundreds of claims in time.

Instead of manually transferring information between the insurer’s website and a revenue cycle management system, RPA bots can streamline this tedious, rule-based process, automatically accessing external systems, processing claim data, and updating the hospital’s RCM solution or any other applicable system. Empowering most of the claim processing steps with RPA, healthcare organizations can save up to 30%, according to McKinsey.

Post-discharge management

Upon discharge, patients need to fill prescriptions and follow discharge instructions. Ensuring that the patient follows post-discharge guidelines is a critical yet cumbersome task for healthcare providers. For example, people often suffer from various surgery side-effects ranging from headaches to nausea, which calls for the prescription of specific medications and follow-up appointments. 

RPA robots can ensure that discharge guidelines are followed as intended and remind patients about upcoming appointments and prescription pick-ups. Such approaches to post-discharge management have proven to be useful for HCAHPS score improvement and an overall enhanced patient experience.

Regulatory compliance

RPA in healthcare is also useful for carrying out compliance-related tasks. For example, at AstraZeneca, a dedicated team follows up with healthcare professionals to understand how the medicines they produce impact patient care. To substitute manual handling of paper documents for adverse event (AE) report creation, AstraZeneca delivered an RPA-based solution for AE management. As a result, the company increased its productivity 20 times, enhanced employee satisfaction, and improved response rates from healthcare professionals.

RPA can also be used for compliance audits. Every action of a bot is recorded, providing transparency for auditors and leaving structured data for further analysis. RPA bots can also be configured to automatically create reports and route them to appropriate managers and departments.

Self-service kiosk check-in

Since in-hospital check-in is still essential to many healthcare providers, some hospitals turn to RPA-enabled self-service kiosks. Upon arrival, people can input their information into a self-service kiosk for further triage by front-desk employees.

With more sophisticated RPA software, the basic triage using patients’ conditions and statuses can also be done by bots. This way, front-desk employees receive a list of patients organized by priority, significantly reducing check-in times.

Apart from reducing friction and improving patient experience, self-service kiosk integration is a significant step towards more optimized data collection.

Streamlined data management

Clinicians heavily rely on medical records in making decisions. However, hospitals still struggle to keep data updated across all healthcare systems and departments, and manual data transfer between different applications leaves room for mistakes and data breaches.

For example, lab employees usually transfer medical test results from the lab’s system to a patient’s profile by hand. Instead, an RPA bot can automatically put the results into any relevant system. This ensures 100% information accuracy, decreases data breach risks, frees employees from doing mundane work, and keeps patient records synced and updated.

Additionally, RPA helps strengthen data security as the software stores only bot-related activity reports while keeping patient information confidential.

Proactive staffing

Achieving appropriate staffing levels every day is a complex task for hospitals that have to prevent personnel burnout and understaffing while meeting their budget.

RPA can help hospital administrators coordinate schedules, manage attendance, and monitor employee performance between different systems. Bots synchronize data across all staff-related systems to obtain performance, payroll, FTE, and other related metrics.

Billing and payment management

Healthcare providers deal with numerous bills and payments, including those for doctor visits, tests, medicines, hospital stays, etc. To settle payment or receive reimbursement from insurance companies, healthcare providers also aggregate and use various data types, such as disease codes, prescriptions, and information from medical records, all from different sources.

RPA bots can be used to streamline the complicated billing process by automatically creating invoices based on the services a patient received, significantly speeding up billing, making pricing transparent for customers, and preventing errors.

Asset tracking

Nurses can spend a lot of time searching for lost hospital equipment. In addition to nurse work inefficiency, equipment misplacement can cause delays in treatment delivery, including emergency cases.

Hospitals can combine RPA software with digital sensors to help staff locate devices, check inventory, and monitor equipment condition. The same RPA-based tracking strategy can be applied to locating organs intended for transplantation, allowing more precise surgery planning and seamless operation.

Data analytics

With vast amounts of useful data on their hands, healthcare organizations streamline internal research by employing RPA tools. Bots can be programmed to input patient data and prepare it for analysis to help healthcare professionals make more accurate diagnoses and offer individual treatment for each patient.

Care consistency

To ensure medical aid consistency for returning patients, healthcare providers should keep clear and easily-accessible records of their previous visits and treatments. Manually digging in multiple registers or looking for an Excel sheet with old data requires too much time and effort and does not always turn out successful.

RPA tools can record patient data from the moment of registration and save all further patient information, enabling hospital staff to access and extract necessary data in just a few minutes. Based on RPA-enabled reports, physicians can track medical case histories and offer personalized treatment plans for different patients.

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Real-life examples of RPA in healthcare

Max Healthcare

Max Healthcare, the largest hospital chain in North India, has implemented RPA to streamline claims administration across all units. A robot designed by UiPath now captures customer information from emails and PDF files and inputs this data in CSV format. The bot can also log into government healthcare scheme portals, capture patient transaction records, and verify their statuses. Upon successful data validation, the robot automatically informs relevant departments via email. As a result, the healthcare provider has saved 65-75% of time spent on government healthcare scheme processing and decreased the turnaround time by 50%.

Northampton General Hospital

Northampton General Hospital teamed up with Automation Everywhere to implement an RPA solution to automatically monitor oxygen supply for COVID-19 patients. Instead of manually checking the oxygen tank level in the system, Oxygen Bot logs into the oxygen supplier’s website where a reading is sent from the tank and then inputs the data into the hospital’s system. With 100% accuracy, Oxygen Bot monitors the oxygen level 24/7 without human involvement, freeing up about 1,500 hours for staff to focus on other tasks and reducing clinical risks for patients requiring oxygen support.

MD Anderson Cancer Center

The University of Texas MD Anderson Cancer Center struggled with poor data synchronization between the HR, attendance and staffing systems that had different interfaces, data formats, and credentials. An RPA solution based on Fortra Automate platform has been implemented for secure between-system data transfer, report generation, and critical data updates and backup. Juan Garcia, System Analyst at the Center, remarks on how easy it was to configure the software. With the drag-and-drop interface, employees developed over 80 automation bots. Additionally, the RPA solution looks for mistakes and sends detailed error logs in case of failure. Garcia says the RPA integration ensures optimal staffing levels, reduces administrative burden, and enhances customer care, saving the center around $150,000 yearly.

University Hospitals Birmingham

Blue Prism has designed a self-service solution for University Hospitals Birmingham (UHB), a large UK healthcare service provider. UHB wanted to efficiently and accurately register a large number of patients using RPA technology integrated with its patient administration system. In its multiple facilities, UHB installed self-service kiosks that received high patient ratings due to the absence of queuing and fast and simple self-registration. With these kiosks in place, UHB has achieved a 50% increase in front-desk staff efficiency and doubled its patient flow without the need to hire 20-30 additional receptionists.

Blue Prism has allowed us to meet and deliver our own business requirements in the timescales and financial constraints we needed.

Steve Chilton

Steve Chilton

UHB’s Chief Digital Officer

Popular RPA platforms for healthcare

Appian RPA is a low-code platform designed to build and configure bots for task automation in the cloud environment.

Key features
Clinical care operations
  • Clinical trial management
  • Patient journey management
  • Care coordination
Clinical personnel management
  • Clinician onboarding
  • Credentialing management
  • Medical student clinical rotation tracking
Healthcare regulations compliance
  • Complaints processing
  • Contract management
  • Fraud and waste investigation
Provider, network, and member services
  • Member enrollment, onboarding, and maintenance
  • Provider onboarding and configuration
Clinician onboarding home page

Image title: Clinician onboarding home page

Data source: appian.com — Clinician Onboarding & Credentialing Management

Automation 360 by Automation Anywhere is a cloud-native AI-powered intelligent RPA platform which helps boost staff productivity, improve patient experience, and ensure data compliance.

Key features
  • Automated quality protocol monitoring against AHRQ, HEDIS, and HCAHPS
  • Critical error reduction
  • Safe data extraction and transfer
  • Automated claims processing
  • Revenue cycle management
  • Contact center automation
  • Inventory management
Automation 360 platform components

Image title: Automation 360 platform components

Data source: Automation Anywhere — About Automation 360, 2022

Kofax RPA offers tools that can automate error-prone and time-consuming manual processes and be integrated with any platform. Kofax RPA also helps streamline front and back-office tasks, enabling healthcare professionals to dedicate energy to more critical tasks.

Key features
  • AI- and NLP-powered document capture and processing
  • Healthcare inventory management
  • Automated documentation generation
  • Digital patient scheduling
  • Support of front office staff dealing with patient data
  • Ensuring compliance with regulations (e.g. HIPAA) with digital audit trails
  • Real-time process insights
Kofax’s data sharing flowchart for a healthcare organization

Image title: Kofax’s data sharing flowchart for a healthcare organization

Data source: Kofax — Kofax in Healthcare. Making healthcare smarter through digital transformation

SS&C Blue Prism offers diverse intelligent automation solutions and a digital workforce for creating high-value workflows, accelerating work, transforming patient and employee experiences, and optimizing operations in healthcare organizations.

Key features
Population health management
  • Patient data aggregation from various sources
  • Knowledge sharing and collaboration
  • Care standardization across the board
Interoperability and data management
  • Connecting disparate systems
  • Referral management
  • Medical claims management
Patient experience
  • Patient processing acceleration
  • Services and communications standardization
  • Contact center automation
Workforce satisfaction
  • Recruitment and onboarding time reduction

Video title: A demonstration of healthcare incident management with Blue Prism digital workforce

Powered with built-in AI features, the UiPath Platform’s RPA functionality makes it easy to build software robots that automate day-to-day work.

Key features
Appointment scheduling
  • Self-service scheduling and registration
  • Reminders
Claims submission
  • First-pass denied claims​ sorting, correction, and resubmission
  • Improving coding model
Chart management
  • Posting documents into EHRs and other systems
  • Medical records extraction, merging, and posting into patient charts
Insurance verification
  • Extracting patient data and logging into the payer’s website
  • Medical necessity confirmation and pre-authorization
Charge capture, coding, and documentation
  • Diagnostic and procedural coding automation
  • Posting non-electronic insurance payments and adjustments

Video title: A demonstration of clinical claim management automation

Datamatics Intelligent Automation is a unified platform that automates tasks, high-volume business processes, and unstructured and semi-structured data management across the value chain and is equipped with RPA, AI, and NLP capabilities.

Key features
  • Healthcare workflow management
  • Appointment scheduling
  • Easy access to health records
  • Self check-in
  • Hospital discharge instructions
  • Treatment cycle management
  • Testing request management
  • Physician credentialing
  • Claims management
  • Account settlement with patient auto-notification
  • Expense payment and medical billing
  • Clinical staff onboarding
  • New provider verification

Video title: Health claim automation

Implementation tips for RPA in healthcare

Examine the workflows beforehand

Since RPA developers are usually unfamiliar with the tasks healthcare workers perform, they can come up with unsuitable automation options. Therefore, healthcare providers should study their workflows through interviewing employees and observing their work to evaluate the time spent on common tasks, measure their impact on care costs, and prioritize critical processes for RPA.

Choose only suitable tasks for automation

Some operations are more suitable for robotic process automation than others. For a successful RPA implementation, healthcare providers should team up with RPA developers to identify processes that can not only improve care delivery but also be sustainably automated from a technical point of view.

Automate in iterations

Healthcare providers should focus on two or three critical processes instead of building an entire hospital-wide solution. After deployment, even the most thoughtfully elaborated RPA program will have room for improvement, and using feedback from the workers who use the RPA solution, IT teams can make its data-driven choice optimization. Moreover, implementing RPA in phases will prevent disruptions in a clinic’s workflow and negative impact on patients.

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RPA in healthcare implementation costs

Although RPA can be used in various healthcare organizations, it is not a turnkey solution and requires preliminary analysis, bot development, and infrastructure setup aligned with a particular hospital’s needs. Therefore, the cost of an RPA solution depends on the selected RPA platform and the number of bots you implement. Generally, the cost of a single bot varies between $5,000 and $15,000. RPA platform license fees comprise 25-30% of the total RPA expenses, while the remaining 70-75% account for other deployment factors. In the end, the total cost of an RPA implementation in healthcare can range from $5,000 to $300,000.

RPA cost factors
Platform license fee
The number and complexity of RPA bots
The number of automated processes
Third-party integrations
Staff training
Maintenance and support
Scaling up

10 benefits of RPA in healthcare

Lower administrative costs

By automating repetitive time-consuming tasks and handling large amounts of data, RPA can partially replace administrative employees.

Enhanced data security

RPA bots handle sensitive information without human involvement, reducing data exposure and vulnerability.

Faster processes

RPA completes mundane tasks several times faster than humans, creating a virtual workforce operating nonstop.

Data accuracy

RPA solutions reduce human error caused by manual data entry and ensure data consistency in all the organization’s systems.

Increased productivity

By automating manual tasks, RPA frees up employees’ time for complex problems requiring human judgment and helps maximize staff capacity.

Better compliance

Data processed by RPA bots can be easily tracked and audited, which ensures data consistency and decreases the number of compliance issues.

Improved patient experience

Relieved of routine workload, healthcare staff can devote more time to patients and address their needs with more attention.

Burnout prevention

By minimizing data-handling tasks, RPA helps increase employee satisfaction, preventing the staff from experiencing exhaustion and quitting.

Improved patient outcomes

With data accuracy ensured by RPA, physicians can choose optimal treatments with fewer health risks for patients.

Scalability

Flexible and easily scaled up, RPA bots can quickly adapt to the ever-changing healthcare market.

4 challenges of RPA in healthcare

Challenge

Solution

Wrong RPA use case

Challenge

A clinic can select the wrong business case and suggest an unsuitable process for RPA development that is unlikely to bring positive operational results and expected ROI in the future.

Challenge

Solution

RPA is not a universal remedy for all healthcare providers as their needs vary significantly. Before implementing RPA, it is vital to correctly identify the organization-specific use cases and processes for automation. This way, you can select the best-fitting RPA functionality and implementation plan.
Siloed legacy systems

Challenge

Healthcare organizations often have data silos in their legacy systems, which can hamper data extraction and task execution for RPA.

Challenge

Solution

Before implementing RPA, healthcare organizations should review their disparate clinical data repositories and make sure data is available for RPA bots. Another important step is establishing a data governance policy for safe collection and storage of sensitive patient data.

Staff resistance

Challenge

Fearing RPA will take their jobs, healthcare employees can resist the technology.

Challenge

Solution

Organization’s management should impress upon the employees that RPA is there to augment but not to replace the staff. Proper training can also foster a better understanding of the technology, new skills acquisition, and efficient RPA use.
Post-deployment issues

Challenge

If an automated process is changed, for example, in line with new regulations, the RPA bot starts working inadequately.

Challenge

Solution

Healthcare providers should assign a responsible person to be the owner of the RPA solution and perform maintenance tasks, such as monitoring bot operation, making adjustments, running endurance testing, and more.
Streamline your healthcare operations with RPA

Streamline your healthcare operations with RPA

RPA is used in healthcare to streamline a plethora of administrative tasks and optimize care delivery. Comparatively easy to implement and providing quick returns, RPA solutions complement the clinic workforce, freeing employees for more intellectually intensive tasks. With RPA, your healthcare organization will be able to focus on delivering more personalized care to patients while maintaining efficient business operation. You can contact Itransition to get implementation advice or start a project for your hospital.

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FAQs about RPA in healthcare

Can RPA bots disrupt the current workflows at my clinic?

Being non-invasive, RPA bots are integrated into your existing systems to complement your current processes without compromising the entire workflow.

How quickly can an RPA solution pay off?

According to the Deloitte Global RPA Survey, organizations that have implemented and scaled RPA solutions achieve payback within 12 months.

What are the downsides of RPA for the healthcare industry?

The major disadvantage is that RPA solutions process only structured data while a portion of healthcare data is unstructured, e.g. medical images and faxed documents. Integrating RPA bots with AI and optical character recognition tools can help overcome this drawback.

Can my employees create RPA bots themselves?

Following proper training, your employees can build low- or no-code RPA bots for their immediate use. Knowledgeable in their field of work, they have a good understanding of the processes and systems and can come up with a more efficient solution, which still should be approved by the IT department.

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