The use of Robotic Process Automation (RPA)-a robotics precursor to artificial intelligence in the past two years has led to drastic improvements in productivity at Steward Health Choice Network (SHCN) Health Plan Division, a division of Steward Health Care Systems. Steward Health Choice Network (SHCN) implemented RPA. Within 30 days of implementing its first RPA script, SHCN began realizing an ROI. Since that time, the labor automation—Foxtrot RPA from EnableSoft—has processed 4.5 million transactions, with a cost avoidance of $2.75 million for the $1.4 billion organization.
SHCN’s Health Plan Division’s efficiency gains illustrate what RPA can deliver to the healthcare industry. Within the industry, many organizations are experiencing budget cuts, while increased regulation and higher demand for services (spurred by the aging of the baby boomer population) contribute to workloads—thus making efficiency almost a necessity. Yet, adoption of RPA lags other industries, notably banking and financial services.
SHCN’s Health Plan Divisions’ President, Troy Smith, says understanding RPA’s deep capabilities almost requires having to see it to believe it. “Historically, many healthcare organizations relied on single systems to complete their work. But now they are operating multiple systems—such as claims processing systems and care management systems—and the need to communicate between them is escalating,” he says. RPA becomes highly relevant because it can inject efficiency in cross-platform communication. In the case of HCA, RPA enabled it to insource two previously outsourced areas. “It gave us additional capacity with existing staff, which allowed us to bring certain processes in-house and eliminate the outsourced arrangement.”
Robotic Process Automation (RPA) Is A Game Changer for Healthcare
According to the Gartner hype cycle of 2016, machine learning is at its peak of inflated expectations. Effective machine learning is difficult because finding patterns is hard and often not enough training data is available; as a result, machine-learning programs often fail to deliver. RPA streamlines back-office processes, eliminating paperwork and reducing file processing periods—which is akin to hiring error-free employees that never go on vacation or get the flu.
RPA Deployment at SHCN
Before implementation, SHCN Health Plan Division suffered from low productivity, high levels of error and significant use of manual processes. “We were operating in a culture of using people over technology to resolve issues. Multiple reviewers would approve and process each transaction so that Person B was checking the work of Person A. Our transaction system was also incapable of significant automation.”
The use of RPA rewrote the culture of the 800-employee organization. “We increased automatic processing, no human touching the transaction, from 40 percent to 66 percent. We’ve also increased productivity in manual processing transactions by 80 percent. We used to process 15 transactions per hour, but we’re now processing at approximately 27 per hour,” says Smith. “We have converted [our employees, who] are standing in line to get their processes updated with RPA. Our IT group wants [an] RPA [script] for developing system integration test cases, which would allow retroactive testing. Our project management group is looking to RPA for data conversion. We are also looking at automating medical record chart pull requests.”
RPA Improves Both Employee and Customer Engagement
Employee enthusiasm for RPA is not unexpected, because it means they are no longer tasked with handling manual, tedious tasks. Foxtrot RPA completed the work equivalent of 21 full-time employees over the course of one year for SHCN Health Plan, with the top most-used RPA functions involving cleaning up inventory backlog and changes in client demographics, as well as submitting transactions to regulators. Freeing up employees allowed them to focus on high-value responsibilities.
“Our employees are no longer just pressing keys on the keyboard, what I call widget-making. We are leveraging their skills and expertise in our resources in different, much more meaningful ways, including in customer engagement,” says Smith.
RPA Impact for Revenue Cycle Management
Any rule-based process involving structured data is suitable for RPA, and in the context of the healthcare industry, such processes are more than abundant. RPA robots can assist greatly in case management, revenue cycle management, customer support, and care coordination. Foxtrot RPA provides an extremely powerful tool without the IT headache, one that HCA employees without programming skills have found easy to use. To date, the organization has implemented 40 RPA scripts into its systems. “The ROI for each script has ranged from a minimum 3-to-1, all the way up to 30-to-1,” says Smith.
Established in 2008 as the physician network for the hospitals of Steward Health Care System, SHCN extends across eight states and takes pride in its community-based care model, which drives value-added tools and services to our communities, patients, physicians and hospitals across the continuum of care.