Key Points to Consider Before Implementing RPA in Healthcare

Healthcare has been challenging the last six months. We’ve taken on the need for a new model of care delivery to reach a broader patient population with less risk of exposure. According to a report by McKinsey, telehealth providers have rapidly scaled offerings and are seeing 50 to 175 times the number of patients via telehealth than they did pre-COVID-19. Telehealth has surged since the start of the pandemic resulting in many healthcare organizations struggling to keep up. The need to connect information silos with the EHR, labs, portals, and financials can be a daunting task hindering the adoption curve.

Repetitive healthcare tasks that create unnecessary bottlenecks between people and process(es) seem to be prime candidates for Robotic Process Automation (RPA). According to Gartner, the RPA market will reach $1 billion in 2020. But, to know which tasks will have the fastest ROI, you need to plan accordingly. Here are a few key points to consider before undertaking an RPA journey:

Prioritize Your Projects

More CIOs are turning to RPA to streamline enterprise operations and reduce costs. When beginning an RPA journey, don’t start with your most complicated process. Instead, aim for smaller projects that provide compelling proof points. Projects that lie beyond the boundaries of other automation approaches are great for showcasing the value of RPA. As you prioritize, consider what’s going to have the biggest impact on your business. Will it improve efficiency? Maybe it will reduce the need for additional workers or overtime? Speed revenue, or increase capacity? Look at one area and prioritize a single project. Once the ROI is realized, you will want to expand to additional departments.

Identify the Low Hanging Fruit

When looking for areas to begin with an RPA solution, look for high-volume, repetitive tasks that involve a lot of manual keying, have high error rates, or slow down people and critical processes. Many of these can be found in tasks revolving around revenue cycle claims. Claim denials is one example. Claims are most often denied for the following reasons:

  • Missing information—this can be prior authorizations, required medical record numbers, a digit that was left off or transposed, etc.
  • Duplicate claim submission, which requires time-consuming efforts to resolve
  • The time limit for claim submission already passed, requiring proof of original submission to appeal the denial
  • Errors in the original claim

Most of the time when claims are denied, it is the result of errors or oversights with manual data entry. RPA positively impacts the rate of denied claims as well as the rate of successfully appealed denials. By examining the claim denial process, and looking for errors or missing information, “bots” can easily correct the issues and re-send without the need for manual oversight. This is a win/win for people, process, and revenue.

Quantify the Value

Adoption of RPA solutions in healthcare is starting to heat up, many are looking for projects that can provide quick wins, especially during these uncertain times. Taking a little time to plan on the front-end provides realistic expectations and keeps projects on track. RPA provides value to many associated tasks and people across the healthcare ecosystem. It’s important to quantify the benefits before beginning the journey. This way, realistic expectations are set from the onset. Look at your current error rates for example. Then look at the time and cost associated with the duplicative processes surrounding them. The value of health IT is demonstrated in many ways; some may be unique to each organization, while others may be highly scalable. This will provide you with an idea of the true value. It’s likely that you will realize additional value once the automations are in use. Look for a solid, stable platform, strong project management skills, and a product that works as promoted, with a clear focus on ROI:

  • Reduce or repurpose FTEs
  • Improve workflow efficiency
  • Improve accuracy
  • Reduce keystroke errors
  • Reduce manual processes

Empower the Change Makers

Odds are, that you had some early adopters who were quite confident of the project and the process of implementing an RPA solution. These champions are the ones who will carry the torch forward throughout the organization. According to a survey conducted by Deloitte, “Organizations that have succeeded in scaling RPA tend to have engaged people.” Give them everything they need to succeed. An easy-to-use, intuitive UI is an important aspect of adoption and sustainability. Being able to create automations in hours versus days goes a long way toward future adoption efforts. At Boston Software Systems, we treat our clients as valued partners, and our commitment to their continued success remains paramount throughout each project. To integrate RPA into a broader IT strategy, it’s important to consider it as part of an ongoing change affecting people. Empowering your change makers on process selection, design, and key messaging may not seem like much, but it ensures workflow continuity, supports revenue targets, and prevents potential risks down the road.

Why Boston Software Systems?

Boston Software Systems has been ensuring RPA projects remain on track since 1985. For more information on how we can help your organization navigate the healthcare automation landscape, contact us at: 866-653-5105 or visit us at

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