Transforming Healthcare with Simplicity

Most of us read (and love) the Dilbert cartoons. Scott Adams captures classic workplace inefficiency so masterfully. There’s one that comes to mind, about keeping things simple. It goes like this:

Dilbert: “The secret to success is to keep things simple.”
Alice: “Do you mean simple in the absolute sense or relative to the alternatives?”
Dilbert: “It depends on the situation.”
Alice: “That sounds complicated.”

Like Dilbert and Alice, we tend to make things more complicated than they need to be in healthcare and HealthIT. We create workarounds, we release software with bugs to be “fixed in a later iteration,” we make EHR systems proprietary and difficult to interact with and then we don’t provide adequate training. Subsequently, people spend copious amounts of time inputting data only to be corrected later, unable to connect critical information, or trying to correct duplications of time and effort, over and over, expecting different results each time. If you work in healthcare, you understand the quandary.

Automation Simplifies Technology Hurdles

Automation can fix a lot of healthcare’s pain points. Automation tools like Boston WorkStation fit into existing IT architectures, without the need to disrupt things. Boston WorkStation makes it easier to connect, compare, and contrast information in multiple disparate systems, while removing the burden from people. As the only company with a pure focus in healthcare automation for over 30 years, we can lessen claims challenges, speed “dollars in the door,” and reduce denial rates by ensuring accuracy. We can speed processes in Human Resources by onboarding employees and clinicians faster, without a human burden. Healthcare teams are tired and resources are tight. Automation technology can simplify tasks in the following areas:

  • Claims Processing
  • Human Resources Tasks
  • Scheduling and Follow-up
  • Data Transfer
  • Supply Chain Management
  • Invoice Processing

And so much more…

We Have The Tools To Simplify Healthcare

Information is power, but sometimes there can be too much of a good thing. Information overload affects healthcare workers in a major way, increasing burnout rates and dissatisfaction scores. There’s still an inordinate amount of manual work that goes into accessing data that is siloed and unstructured. Too much information is still on paper, even when it has been migrated to the EHR, lab systems, practice management, and so on. By automating tasks, healthcare teams are free to spend time on higher value work that requires human skills. The beauty of healthcare automation is in the ability to empower humans, by improving digital access, reducing workloads, and seamlessly maximizing revenue. A survey by the research company Black Book, showed that 86% of CFOs and senior finance leaders who automated key financial processes at their hospital or health system reported a “substantial” return on investment (ROI). Automation just makes it easier for healthcare to get things done.

Simply Prevent Burnout

Healthcare is still at a breaking point. Stress levels are at an all-time high for employees and clinicians. Given the challenges of navigating the COVID-19 pandemic for the last three years, staffing challenges, and limited resources, it’s easy to understand why burnout levels are elevated. Most healthcare facilities continue to rely on a patchwork of spreadsheets, manual data entry, and legacy systems that make information sharing difficult, and cause duplication in documentation, increased tasks, and mounting frustrations. Automation is a key enabler of change, redesigning the way people work, for maximum benefit and personal satisfaction.

We’ll leave you with this Dilbert cartoon, because many times it feels like no one is acting fast enough to change the paradigm:

Dilbert: “When will we upgrade our internal networks?”
Mordac: “We were just having a conversation about that.”
Dilbert: “That doesn’t help me at all.”
Mordac: “Note the pattern.” (lots of talk but no action)

Why Boston Software Systems?

Boston Software Systems understands healthcare. For over 30 years, and with consistent, 5-star support rankings, Boston Software Systems has been creating efficiencies in hundreds of hospitals, healthcare organizations, and technology partner offerings. Schedule a call today to discuss the best projects with the greatest ROI. Take your automation ideas to the next level with Boston WorkStation.

Automation Provides a Rapid ROI to Common Healthcare Finance Processes

Robotic Process Automation (RPA) empowers healthcare organizations by enabling them to scale common finance initiatives with a proven ROI and minimum investment. There’s no wonder that growing numbers of Chief Financial Officers (CFOs) are automating financial processes. This allows finance teams to refocus time and energy on tasks that require human intervention, while offloading mind-numbing, tedious ones to machines. What are the majority of CFOs automating? Let’s take a look:

Invoice Processing

Invoicing and payments are one of the top four challenges facing healthcare today. In addition to providing greater efficiency, healthcare departments that automate invoice processing tasks reduce errors by 90%, using only 10% of human effort to review or handle the exceptions. By offloading invoice processing to a digital workforce, or machines, employees stop wasting time on repetitive, time-consuming tasks, and can focus on communicative ones that require people skills. Unlike human data entry clerks, machines never get bored, tired, or distracted. They work 24/7/365 without breaks and can process hundreds of invoices in just minutes for pennies per transaction. By automating invoice processing, CFOs can quickly see real-time snapshots of account payables to aid in faster decision-making. Data breaches and compliance risks, which are magnified by humans, are minimized by machines, while employee productivity and satisfaction scores are boosted by 85%.

Insurance Verification and Benefits Eligibility

With hospital margins waning, it has become more important than ever to avoid the cost of working (and re-working) denied claims. It’s important to know if a patient is covered by insurance before services are rendered. Eligibility describes whether the patient is eligible for services and if those services are covered by the payer and plan. Verification of benefits allows you to go deeper and find out exactly to what extent services are covered for the patient. Both largely manual processes are very labor intensive, with revenue cycle teams manually checking and rechecking numerous payer portals and websites for each patient. With as many as 18 different portals for insurance verification, it’s easy to see how human teams can become overwhelmed. A 2021 healthcare research study showed that 59% of health systems use RPA for eligibility verification, making this one of the most common processes CFOs are automating.

Prior Authorization

This largely manual process prohibits timely patient care, delays needed medications and treatments, and when time is converted to dollars, costs providers between $23-$31 billion each year (yes, billions).

Pre-authorization is required for most non-emergency medical procedures, treatment plans, medications, and services. According to a 2021 CAQH report, providers could save 16+ minutes per authorization with an automated process, which takes a little less than a minute. That’s a savings of two working days a week. RPA-enabled prior authorization has proven results. Not only can the task move faster, automation eliminates up to 98% of errors, which improves re-work queues, denial, and collection rates. And at a time when staffing shortages are high, and hospitals are struggling to meet financial burdens, automating this process addresses time, efficiency, and financial burden with a clear solution.

Claims Status Checks

Claims status checks, or manual inquiries from a provider to a health plan to check the status of an impending claim, is complicated and tedious. When a provider contacts a payer to check a claim status, it takes an average of 14 minutes and costs the provider roughly $7.00. By the time a claim reaches a denied status, the provider has lost at least two weeks of valuable time. Considering that the time between claims submission and payment can be as long as four weeks, processing delays are costly. Do the math on an average employee working a 40-hour work week and it’s easy to understand that humans can only perform so many claims status checks each week. By automating the manual process, one “bot” or machine can check claims statuses in one-fourth of the time, eliminating 98% of errors. By automating this manual, tedious process, our customers have realized an average ROI of 330% within the first 6 months.

Why Boston Software Systems?

There are a lot of RPA vendors out there, and more entering this competitive market on a daily basis. No other vendor has a healthcare-only focus with 35 years of proven success in the field. Boston Software Systems receives daily, consistent, 5-star support reviews. Our demonstrated leadership, outstanding performance, and successful technology partnerships are unparalleled. Give us a call. We look forward to automating your healthcare finance challenges in 2023, making it easier for you to focus on patients, instead of paperwork.

Reduce Healthcare’s Pain Points in 2023

Healthcare organizations are stretched to the limit from illness, stress, burnout, and staffing shortages. The current situation is impeding our ability to provide quality care, by increasing long hours amidst continued staffing shortages. COVID-19 is not over, and as hospitals and health systems scramble to take care of increasing workloads with less people, burnout, anxiety, and depression numbers are skyrocketing. How can Robotic Process Automation (RPA) reduce the pain points and help drive efficiencies in 2023?

Automate Prior Authorizations

Prior authorization, or prior approval, is a health plan cost-control process by which physicians and other healthcare providers must obtain advance approval before a specific service can be obtained. Everything from medications to treatment plans, surgeries or durable medical equipment (DME), requires prior approval. The process can take anywhere from one day to one month. This is a largely manual process, and when time is converted to dollars, the staggering cost for providers is between $23-$31 billion each year. According to a 2021 CAQH report, providers could save 16+ minutes per authorization with an automated process, which takes a little less than a minute. That’s a savings of up to two working days, or 16 hours a week. Not only can the task move faster, automation eliminates up to 98% of errors, which improves denial rates.

Power Human Resource Management

With healthcare staffing at a tipping point, the accompanying paperwork required to process new employees is mind-numbing. Whether you are sending employee emails, onboarding staff, credentialing physicians, or setting up change management processes, automating the tasks can remove hours or days of interactions and allow employees to eliminate duplicate documentation and errors. There are many tasks that can be automated in the Human Resources (HR) department including internal employee recruitment letters, offer letters, standardized forms, salary information and changes, payroll, promotions, ongoing training, and password management tasks. The typical onboarding process routes and re-routes paperwork back to the new hire to fix errors, then sends to stakeholders and leadership for signatures and follow-up. It’s a repeating cycle, made easier by automation. Automating HR tasks keeps the process moving faster, without errors, and ensures compliance and completion.

Perform Claims Status Checks

A healthcare claim status inquiry is a communication between a provider and a payer about a healthcare claim. When a provider contacts a payer to check a claim status, it takes an average of 14 minutes and costs the provider $7.12. By the time a claim reaches a denied status, the provider has lost at least two weeks. Considering that the time between claims submission and payment can be as long as four weeks, these delays are costly. Add to that repeated checks, and it’s easy to see how this cost can rise. This is a largely manual process in many healthcare organizations, and making sure claims were received by the payers is a perfect area for automation tools. Automation allows healthcare organizations to quickly identify missing claims or information, eliminate timely filing denials, and increase “dollars in the door.” One client added 1,500 providers without adding one additional FTE – all due to automation in the claims status check process.

Manage Supply Chain and Materials Management Processes

2020 brought with it many new challenges in the healthcare supply chain that continue to plague healthcare organizations. PPE shortages, lack of visibility, stockpiling, and the need for additional testing and vaccination supplies. Supply chain automation refers to technology solutions to streamline supply chain processes without human attention, effort, or involvement. Automation can be used everywhere from inventory management and control to procurement, ordering, inventory, and payment protocols. Everything from surgical preference cards to products, shipping and transportation costs, and invoice processing. Automation ensures there are no errors in calculations, and can easily compare and contrast tier-based pricing, rebates, and other cost-saving measures, identifying and completing repetitive tasks that are both time-consuming and/or error-prone.

Why Boston Software Systems?

Boston Software Systems understands that people are driving the processes in caring for patients every day. Let’s have a conversation about your 2023 digital strategy. We won’t take up much of your time, and most solutions are deployed in under 30 days. We have helped healthcare drive operational efficiencies for over 35 years. We’ll help you achieve your goals in the coming year and have your cost estimate and Scope of Work completed in 5 days.

What Can We Expect From Healthcare in the Coming Year?

Healthcare is at an inflection point. Healthcare leaders must look for new ways to deliver efficient and secure care while continuing to adapt to the post-pandemic world. Labor costs and current clinical shortages are causing hospitals to operate with much smaller budgets. Many are easing the financial pain by having clinicians work at the top of their license and creating strategies around automation, which helps with staffing shortages and reduces cost. What are some of the additional issues facing hospitals and health systems in 2023?

Additional Losses for Hospitals and Health Systems

2022 has turned out to be the worst year for hospitals since the beginning of the COVID-19 pandemic. The COVID-19 pandemic has put extreme stress on the healthcare workforce in the United States. More than a third of hospitals are operating on negative margins as the COVID-19 pandemic continues to cause financial losses and additional challenges for health systems. Before the pandemic, labor costs made up more than 50 percent of total expenses for hospital systems. As COVID-19 impacted the hospital workforce, workers started leaving their positions due to burnout, job stress, and inadequate compensation. These occurrences have been severely detrimental to hospital finances, leading to billions of dollars in losses and over 33% of hospitals operating on negative margins. Hospitals and health systems continue to face intense pressure on staff and resources while dealing with rising expenses for supplies, drugs, and equipment, as well as for the workforce. According to a recent Forrester prediction, there is no change in sight anytime soon. Hospital and health system expenses are expected to increase by nearly $135 billion in 2023, driven by a projected $86 billion increase in labor expenses.

Big Box Healthcare

Retail health competition and wellness incentives are driving retail healthcare growth as we enter 2023. Walmart Health announced recently that they are planning to expand their footprint in the state of Florida, opening 16 new retail clinics. The goal is to increase community access to healthcare while making strides toward better quality and health equity. Walmart’s convenient health supercenters, with an aggressive cash-pay pricing strategy of $40 primary care visits and $25 dental exams, not only bypass insurance companies, but can also reduce administrative costs. Walmart operates 3,600 stores in the U.S. with 195 million weekly shoppers. CVS Health is opening 1,500 HealthHUBs, and Walgreens partnered with VillageMD to open over 500 primary care clinics. These options offer convenience, price transparency, and an above average patient experience. In addition, they are upping their telehealth offerings, providing the ability to carry out live consultations in the comfort of your home. Big box retailers like Walmart, CVS, and Walgreens have a far-reaching geographic presence and extended hours, which make them extremely accessible and consumer-centric. There’s a huge opportunity here, but we’ll have to wait to weigh the health outcomes.

Hospital at Home Models

Since the pandemic began, we’ve noticed an uptake in the speed and availability of healthcare innovation. Healthcare delivery in the United States will continue to transform rapidly as we enter 2023 and beyond. The expansion of in-home based healthcare options appeals to both Medicare and non-Medicare patient populations that were previously committed to inpatient care models. In-home care can be appealing to maternity patients, the elderly and frail, those with chronic conditions, and weakened immune systems. Data available from remote patient monitoring appliances, apps, and wearables are advancing the capabilities of healthcare at home. According to The New England Journal of Medicine (NEJM), hospital-at-home programs are growing, because they improve outcomes at a lower cost and with higher patient satisfaction scores. New technologies such as AI, or augmented reality, surgical navigation, and tele-monitoring will enable procedures to shift to community surgical centers, supported by changes in reimbursement models. Likewise, telemedicine services will enable clinicians to deliver chronic disease management programs that are no longer anchored to a hospital or clinic. With less exposure to germs and a better patient experience, we should see growth in this sector in 2023.

Human Resources

Human Resource (HR) professionals will need to hone and develop new skills if they want to contribute to their organization’s future goals. Nowhere is this felt more than in the healthcare system. HR trends like DEI (diversity, equity, and inclusion), hybrid and remote work, employee skills management, employee benefits, company culture, engagement, technology, quiet quitting, and a renewed focus on retention may represent the most significant challenges for HR professionals in 2023. The HR department plays an important role in every industry, but its role in healthcare is particularly critical. Attracting and retaining top talent will be a priority as well as a challenge in 2023. It will be important to find people who are adaptable, flexible and open, and then do everything possible to lessen tedious tasks and empower employees to create a culture of trust and belonging. Automation can help companies lessen the impact of administrative tasks like onboarding, change management, training, and communications.

Why Boston Software Systems

As we enter 2023, we must remember that we are still recovering from the effects of the last three years. In order to keep moving forward, lessen stress, and promote mental health stability, we will need to work smarter together by dividing processes between those that can be automated and those that cannot. Just as RPA has helped healthcare professionals deal with the onset of the pandemic, it can now form part of the recovery. In a world where problems are getting more complex, problem-solving says everything about a company. At Boston Software Systems, our people are passionate about listening, teaching, and supporting long-term RPA goals. Give us a call. We’d love to discuss your 2023 projects. Until then, be safe, stay well, and thank you for your support in 2022. Wishing you a Merry Christmas, Happy Hanukkah, Happy Kwanzaa, and Happy New Year!

Empower Your Customers to Succeed with Technology

Technology touches nearly every aspect of our daily lives. Yet, powering the new automation age in healthcare requires more effort than merely choosing a vendor. Alongside every successful technology implementation there’s a need for human interaction. Customer success is created and sustained by training, support, and ongoing communication. To empower your customers and your business to thrive in a digital world, include the following four tips.

Be Honest with Your Customers

Being honest with customers builds credibility and creates trust. A healthy mix of taking responsibility and fixing what goes wrong lets customers know that your business was built on integrity. Once you’ve lost integrity, it’s difficult to keep customers loyal. Listening to the needs of customers, empathizing with pain-points, and encouraging enhancement requests lets customers know that their opinions are valued. Honesty sets the tone for the kind of work culture embraced at your company. In our 2022 Best in KLAS reviews, customers interviewed stated that Boston Software Systems keeps their promises. This is an integral part of why we’ve been successful in healthcare for over 30 years.

Know Your Product

Just as you can’t manage customer expectations without being honest, you can’t support a customer’s needs without a thorough knowledge of your product. Customers want to feel assured that your knowledge is not displaced. Knowing the intricacies of your product lets customers rest easy knowing that if a problem arises, you will know how to fix it. Gone are the days of Shiny object syndrome (ironically called SOS). Shiny object syndrome is a pop-culture concept where people focus on a new and fashionable idea, regardless of how valuable or usable it may be. The shiny object focuses on something new, exciting, and maybe even trendy, but in the end it’s just another variation of the same old thing. Health IT has become really good at SOS, which doesn’t reflect well in the long-term. Build a product that provides meaningful value to the customers who use it. That’s why Boston WorkStation consistently receives such high scores in product value. Because we created and enhanced a product, based on customer input at every juncture.

Have a Clear Vision and Dedicated Leadership

There’s no doubt about the effectiveness of data to promote the right behaviors in Health IT. Communicating these touch-points to customers through “use cases” gives customers a better understanding of how and why a particular change is tangible and measurable. But, everyone in leadership must share the same goals and priorities. If one person believes in demonstrating value by one method and another by something entirely different, delays and confusion in how the product aligns with existing priorities can get lost in translation. Focus on your customers’ needs, how you’ll meet their evolving demands, and the resonance of your products and services with your overall capabilities. There was one lesson we learned as we navigated the pandemic. The companies who lead with a dedicated vision will emerge from this crisis (and future ones) stronger and more resilient than they were before.

Always be Accountable

When you’re accountable, you take ownership of customer challenges and barriers to success. You do whatever it takes to correct issues when things go wrong. To become more accountable, make sure that you’re clear about your roles and responsibilities. Highly accountable people are clear about what needs to be done. They think carefully and realistically about a project and give you an (honest) answer that you can rely on. When something gets in the way, they assess it, resolve it, and communicate proactively to everyone involved so there is no confusion. Making sure everyone is on board with the results is an important aspect of accountability. A good leader always takes responsibility for their actions and the consequences of their decisions. Accountability as a core value provides your company a distinct advantage. This advantage creates a level of integrity that keeps customers loyal and brings them back again and again.

About Boston Software Systems

Being successful for 35 years takes honesty, a clear vision, product knowledge, and accountability. By building trust, listening actively, recognizing and addressing issues, and showing customer appreciation, our leadership team and all employees have fostered an atmosphere of continuous learning and sustainability. Our loyal customers depend on us as a digital ally to optimize workflows, boost revenue cycle margins, and bridge the gaps between disparate systems. Let’s continue this conversation. We’d love to speak with you about our key differentiators and the reason behind our three decades of success in healthcare automation.

5 Healthcare Revenue Cycle Challenges and How to Overcome Them

Healthcare revenue cycle challenges exist at every stage of the healthcare journey, beginning with patient authorization and extending all the way through claims, billing, payment, and collections. Providers lose billions each year due to inefficient processes, the inability to collect on bills and claims, and the complicated, manual process of claims management. What are the top 5 areas in which Robotic Process Automation (RPA) adds value to the revenue cycle?

Prior Authorization

Providers and hospitals must go through a process to obtain “approval” from health plans for medically necessary procedures, treatment, or medications. This process is called prior authorization (PA). 44% of doctors say PA requests “often or always” hold up care, according to the American Medical Association (AMA). This largely manual process can take anywhere from 10-40 minutes per PA, delaying timely patient care. A study by Health Affairs stated that when time is converted to dollars, the national cost for providers, from interactions with health plans, is between $23-$31 billion each year. According to a 2021 CAQH report, providers could save 16+ minutes per authorization with an automated process, which takes a little less than a minute. That’s a savings of up to two working days a week. This is an area of high return. By automating prior authorization transactions, providers and health plans could save $437 million each year.

Claims Status Checks

When a provider contacts a payer to check a claim status, it takes an average of 14 minutes and costs the provider roughly $7.12. By the time a claim reaches a denied status, the provider has lost at least two weeks. Considering that the time between claims submission and payment can be as long as four weeks, delays again become costly. At Northwestern Medicine, automating claims status checks revealed a 330% ROI within the first year, one that will continue to grow into perpetuity. Northwestern was able to offset 25 full-time employees (FTEs) worth of work on an annual basis. That did not mean reducing their workforce by 25 people, that meant they were able to double in size (from 1,500 to 3,000 providers), without adding one additional team member.

Denial Management

Shifting from tedious, manual tasks to an automated process reduces the time spent on each task from minutes to fractions of a second. According to the Centers for Medicare & Medicaid Services (CMS), 20% of all claims are denied, 60% of lost or denied claims will never be resubmitted, and 18% of claims will never be collected. It generally takes 2-3 minutes and costs about $25 to rework each denied claim. RPA allows claims to be worked and resubmitted in a fraction of seconds, eliminating the burden on people. An interesting RPA initiative focused on automating preparation of “Modifier 62 reconsiderations” (surgical payment appeals) for reimbursement. Under certain circumstances, two surgeons (usually with different expertise) may be needed to perform a specific surgical procedure. Both surgeons bill using the same CPT procedure code, and the Modifier code 62. Boston WorkStation allows them to automate a complex combination of document processing steps (more than 20) necessary for reimbursement. The Modifier 62 reconsiderations are aligned and streamlined for submission to payers, minimizing delays and errors. This significantly accelerates payment to the health system for advanced procedures.

Payment Processing

By automating payment processing, productivity is improved and the manual, time-consuming process of posting insurance payments is streamlined, resulting in reduced operating costs and increased time management. By automating the payment processing tasks, activities like invoice capture, coding, and vendor contract approvals proceed without human intervention. Boston WorkStation has been keeping hospitals on track with payment and collections automations since 1985. On a daily basis, Boston WorkStation queries databases, looks for transactions, and then posts them through multiple EHR modules on the proper patient account. By automating multiple touch-points, errors are reduced or eliminated, collections avoided, and payments expedited.

Collections

RPA can also be used to proactively identify payment/default trends and take preventive measures to reduce the manual burden on collection teams. RPA can be used to configure multiple parameters such as invoice age and credit risk to prioritize collections, or to send periodic reminders to delinquent accounts. Boston WorkStation automated many of the “sticky” areas of collections; which would have been written off as bad debt. Instead, the hospital saved 180 hours per month and $20 million in failed claims resubmissions. Using automation in the collections department allows people to concentrate on higher priority tasks, while automation sorts through and sends out invoices. “Boston WorkStation helps us automate time-consuming tasks and is doing about eight staff hours’ worth of work a day. I know we’re saving money because we are getting accounts into an actionable category, instead of keeping them in a
holding pattern.”

Why Boston Software Systems?

Boston Software Systems is the global leader in healthcare-specific RPA solutions. For over 30 years, Boston WorkStation has been creating efficiencies in hundreds of healthcare organizations, technology partner offerings, and provider offices. Boston WorkStation is implemented on-premise, in a hybrid way or in the AWS cloud. Our project teams understand healthcare workflows and exactly how to implement an RPA project for maximum impact and a fast ROI.

RPA is an Important Aspect of Value-Based Healthcare

Centers for Medicare & Medicaid Services (CMS) states that value-based care is a healthcare delivery model in which healthcare payments are linked to improvements in patient outcomes. This methodology is supposed to increase patient satisfaction, lower costs, and improve healthcare delivery. But, the value-based care model has proven to be more difficult than originally thought. How can technology advances like Robotic Process Automation (RPA) help with this effort? Let’s explore:

RPA Improves the Collection of Meaningful Data

Significant data is generated in one prior authorization request, but not all of it is usable. There are multiple touch-points and various issues with data quality and accessibility. In fact, the cost of duplications, errors, and manual data input costs the U.S. economy more than $3 trillion a year. RPA reduces these costs by taking tedious, highly repetitive tasks out of human hands, and completing them with machines. This includes opening emails and attachments, logging into web apps, filling in forms, or pulling data from disparate internal and legacy systems. RPA follows through with rules (“if this happens, then do this”), and extracts meaningful data from documents and databases. By adding a digital worker to the team, hospitals, health systems, and providers can improve the quality of data, increase efficiency, reduce labor costs, and improve staff morale. RPA can collect, organize, and translate data into actionable formats, improving time to value while ensuring accuracy and compliance.

RPA Optimizes the Prior Authorization Process

According to the American Medical Association (AMA), 34% of physicians have reported that a prior authorization for services led to serious adverse events for patients. In addition, prior authorization issues are associated with 92% of care delays. Most physician practices spend an average of two business days (16 hours) of physician and staff time solely on this process, hiring additional staff to work just on prior authorizations. Simply by adding automation, work queues are optimized, barriers and errors reduced, and avoidable delays in both patient care and financial reimbursement avoided. The manual process can take as many as forty-five clicks on various screens. Automation searches for the treatment, applies the necessary codes, corrects inaccuracies or missing information, sends it to the payer, and lets staff know if the treatment needs further clarification. This nearly seamless process requires no manual intervention. By automating prior authorization transactions, providers and health plans could save $437 million each year.

RPA Standardizes Healthcare Operations

Aligning organizational goals and processes is an important part of working in healthcare. When the duplication of effort is reduced, people not only work smarter, they get more important work done. RPA allows people to focus on the important daily tasks of value-based care, while automation takes care of the repetitive ones. We are all too familiar with the challenges and barriers to data access in multiple disparate systems. What seems like a simple fix of manually entering demographics or legacy appointment data, literally turns into months of manual data entry and an overwhelming financial and administrative burden. Access to information in multiple, disparate systems can be improved by automating the data transfer, enabling providers to access the data in the right system, at the right time, reducing care delays.

RPA Increases the Speed and Accuracy of Revenue Cycle Tasks

Revenue cycle integrity and speed are paramount to operational sustainability. According to industry numbers by HFMA and MGMA, failure to accurately capture claim charges can result in a 50% loss in revenue. By infusing claims management, prior authorizations, denial management, and payment processing with RPA, health systems and providers are better able to secure a firm foundation for revenue cycle growth and future sustainability. Boston WorkStation allows health systems to automate remittance processing and track all data flowing into and out of the EHR. Instead of monumental delays, inaccuracies, and added stress, clients can streamline tasks and processes and re-define higher patient priorities.

Boston WorkStation Supports the Value-Based Care Model

Since our beginning 35 years ago, Boston Software Systems has taken on the toughest challenges in healthcare, solving problems for our partners, providers, and customers that others can’t. Together, we can customize our service offering to meet the needs of your practice, your plans, and your patient populations. If you’re not a customer yet, we invite you to check out our blog, our website, or give us a call to see how you can benefit from using the latest version of Boston WorkStation 20; because when the path isn’t clear, you’ll want a team that you can count on to lead the way.

Insights From 35 Years of Healthcare RPA Success

Sara and Rich McNeil, the founders of Boston Software Systems, were no strangers to the Science and Technology field. Sara McNeil earned a BA in Chemistry at Mount Holyoke College, an MS in Medicinal Chemistry from Northeastern University, and an MBA from the Amos Tuck School at Dartmouth College. Rich McNeil was a nuclear engineer and served four years in the Navy as an officer aboard nuclear submarines. He graduated with a BA in Physics from Dartmouth College and earned an MBA at the Amos Tuck School at Dartmouth College. Boston Software Systems was their 2nd entrepreneurial endeavor, their 1st being the development of one of the very first practice management (PM) systems for physicians, built in 1981 on the first IBM PC, and run off of two “floppy” disk drives.

Providing a Toolkit for Healthcare’s Pain Points

According to Sara, “Boston WorkStation was born from necessity, when one of our first customers came to us with a problem. They wanted to interface their physicians with the hospital system without having to go through a complicated vendor customization process. We came up with the idea of moving data from the User Interface (UI) of these applications so that it did not require vendor involvement. This is how Boston WorkStation was born.” The McNeils wanted to develop a toolkit for healthcare, allowing end users to build the workflows themselves. There were no other RPA vendors in healthcare at that time, and they were familiar with the technical work requirements necessary for success. They licensed the software to Microscript and became their primary development group for the next 10 years. Boston WorkStation was deployed throughout the United States, Canada, and other countries, and continually optimized to work with all the various EHR systems as they entered the market.

Meeting the Needs of People, Through Core Values

While their 35-year journey has been about adapting and growing, their core values have remained consistent. Boston WorkStation was created to meet the needs and challenges of people working in the healthcare sector. Their goal was to insert automation technology into operations and workflows in order to make healthcare delivery more efficient, improve financial retention, reduce burnout, and optimize the patient experience. With the use of Boston WorkStation, clinicians are able to reach out to patients in a more efficient way, eliminating repetitive, manual tasks. Reimbursement challenges are improved, and patient care is enhanced by cutting the rising costs of inefficiency and improving the time associated with manual data transactions.

Making Customers’ Lives Easier Was Our Mission

The McNeils envisioned less of a need for the software after HL7 was introduced. Yet, the opposite became true, as there is a greater need than ever today, for healthcare automation. Sara goes on to say, “We chuckle to ourselves about the recent attention our small corner of the market has received as new players come in to make RPA the “next shiny object” that it is today. We have been making healthcare RPA solutions make sense for the last 35 years. Our greatest satisfaction to this day is still in making our customers’ lives easier, by reducing the tedious tasks that they have to do.” Boston WorkStation supports a resilient, scalable, and adaptable healthcare operating model, and has been the global leader in healthcare automation for 35 years.

Culture: The Heartbeat of the Business

The McNeils built and maintained the business model for Boston Software Systems by placing the needs of people at the epicenter of every project, and delivering an exceptional customer experience. A strong company culture remains the context for every accomplishment. In a survey of approximately 700 business professionals, only 15% said their organization is currently effective in delivering a relevant and reliable customer experience. Boston WorkStation surpassed competitor rankings in the “Best in KLAS 2022” report, with a final total score of 93.8. 100% of customers interviewed gave Boston WorkStation a solid 100% rating in product value, delivering a money’s worth return on investment, and driving tangible outcomes. Boston WorkStation outperformed industry giant, UiPath, and hundreds of other vendors in most categories.

Passion, Purpose, and Integrity

Let’s face it, creating a company is hard work, and most entrepreneurs fail. In fact, only 341 technology companies have been in existence for more than 35 years. Founders give us a reason to look back and ponder. They give us a reason to look forward with hope and aspiration from their initial footprints. To the McNeils, thank you for creating a successful business model through passion, purpose, and countless hours of hard work. Your solid foundation and unified vision to improve the lives of people working in the healthcare industry continues to this day. To our many customers, thank you for your support and your loyalty over three decades of service. If you’re not a customer yet, we invite you to check out our blog, our website, or give us a call to see how you can benefit from using the latest version of Boston WorkStation 20, because when the path isn’t clear, you’ll want a team that you can count on to lead the way.

How to Create a Great User Experience (UX)

Steve Jobs said it best, “Some people think design means how it looks. But, if you dig deeper, it is really how it works.” The User Experience (UX) says everything about how your technology offering defines, connects, and cares for end users, the folks who actually use the product or application. The UX is subjective in nature, because it is centered around an individual’s experience, performance, feelings, and thoughts. It is dynamic, because it changes over time as individual circumstances change. The first requirement for an exemplary UX is to meet the needs of the person involved. To do this, you need to close the gap between expectation and experience. What are some additional points that factor into a great User Experience?

Clear and Concise Communication

Clear and concise communication is imperative to creating a great UX. Create a clear vision, by stating your truths and being transparent about how the product will align with existing systems, applications, and additional users. An ambiguous situation can occur when you see more than one solution to a problem, but you aren’t sure which one to use. Make sure that the people sitting on the receiving end have a clear understanding of the product or application, and that there is no margin for ambiguity. To avoid issues with retention, share memorable information at the beginning and the end of a presentation. And to create a strong, mutually beneficial bond with users, be honest with them at each step of the UX journey.

Identify Pain Points

An inconsistent UX occurs when the support team is unavailable or the queues are too long. When there is a quality issue with products and services, or a lack of adequate knowledge and experience from the leadership team. If the buying process is a complicated one, it’s a big red warning sign to watch out for additional delays in support and training. A good UX is the net result of the good experiences minus the bad ones. It occurs when the gap between expectation and experience is closed. Our customers say it best; “Know what you need to accomplish, and know the workflow to get there.” Workflow is a crucial element of UX design. Whether you are working on a new project or attempting to optimize an existing one, knowing and understanding the workflow process is imperative to creating a good UX.

Improve Product Usability

Usability is the extent to which a user can actually use a product for its intended purpose. It can be measured through time, effort, errors, and user satisfaction. A great example is Electronic Health Records (EHR). Initially, they were sold to physicians by inflating the features and functionality without addressing individual user pain points. To adequately use the application, it was almost always necessary to create custom templates, shortlists, formulary shortcuts, and much more. Yet most salespeople never mentioned this at the beginning of the user journey. As a result, users were misled, misinformed, and mistaken about the effort required to use EHR systems. Customer touch-points are the point of interaction with the brand across three main phases of the customer lifecycle, awareness, evaluation, and post-purchase experience. It’s important to thoroughly understand each step of the customer journey and to anticipate needs and remove friction throughout the entire process. This is how you improve usability.

Request User Feedback

Whether via email, a pop-up survey, support feedback, or third-party reviews, it is imperative to monitor the user experience and gain knowledge from their feedback. By asking for user feedback, users feel their opinions are truly valued. Their feedback will enable you to avoid these same, duplicative issues with future users. It is the task of customer support to identify the right solution and explain it using the right words so that the user doesn’t need to ask again. The adage “Teach a man to fish,” comes to mind. A consistent support experience is a crucial part of the UX journey. When questions come up (and they will), be sure to teach users why the incident occurred, and how to prevent it in the future. Ensure that everyone on the support team consistently follows the same protocols. Efficient problem-solving builds future trust.

Why Boston Software Systems?

A good product may get a customer engaged, but after-sales support keeps them loyal. Boston WorkStation surpassed competitor rankings in the “Best in KLAS 2022” report, with a final total score of 93.8. 100% of customers interviewed gave Boston WorkStation a solid 100% rating in product value, delivering a money’s worth return on investment, and driving tangible outcomes. Boston WorkStation outperformed industry giant, UiPath, and hundreds of other vendors in most categories. We are experts on streamlining workflows, reducing costs, and improving the user experience. We’d love to share our successes with you and add you to our growing list of loyal customers. With 95% of our projects completed in < 45 days, savings in time and money are right around the corner.

5 Key Ingredients for RPA Project Success

Robotic Process Automation (RPA) is being deployed by healthcare organizations to optimize and improve repetitive, manual processes. But, an RPA implementation is more than a technology project. At its core, it’s a business initiative. What does it take to create success? Here’s 5 key ingredients you’ll want to include.

Define Your Objectives

Sifting through a deep technology landscape to find the right technology partner may seem like a daunting task. To help define the right partner for your RPA project, you will want to look at their support queues, their customer experience scores, and their depth of experience in deploying similar projects. Often, what sounds great on paper, may actually not be the best fit for RPA success. A successful project requires the proper design, planning, and governance to improve business processes. You’ll need someone who understands the unique workflow challenges in healthcare, and the barriers that may occur during the onboarding process. Some of the factors to consider include:

  • Low-code, content based capabilities
  • Cloud-based, hybrid, or on-site deployment
  • Integration and/or interference with existing applications
  • Flexibility and scalability

Choose Well Documented Processes

Before developing and implementing a “bot,” it is essential to have your processes well documented. Statistics say that 30% of initial RPA projects fail. These failures are typically due to the poor choice of projects, unreliable governance, or third-party integration issues that were never uncovered during the discovery phase. A recent global RPA survey by Deloitte shows the benefits of RPA adoption are significant. The survey found:

  • 92% of the respondents reported improved compliance
  • 90% admitted an improvement in work quality and accuracy
  • 86% reported improved productivity
  • 59% reported cost reduction

Processes that are well documented and properly scoped, including SLA’s, are accompanied by a test plan and example input materials. They list dependencies, and are easy to understand. Your test plan and test cases should be properly aligned. This sets the expectation of all parties, and provides the necessary criteria to determine if the “bot” is implemented and performing well.

Simplify and Scale

Scaled automation projects have proven time and again to drive impressive impact and measurable financial returns. As organizations move forward with their automation initiatives, many projects become more silo-oriented with scalability challenges. RPA project teams should have a thorough understanding of business processes and exception workflows to ensure that bots are tested and validated for all working scenarios. In healthcare, it is particularly important to choose a flexible, customized solution that supports a wider approach to digital transformation. The most important advice we give our clients:

  • Don’t fall down the rabbit hole
  • Don’t try to boil the ocean
  • Start small and expand from there

Simplify and scale by creating a project with a fast ROI, gain project success and executive buy-in, then roll it out to additional areas. Simplify with a more hybrid approach. Create bots for clients, onboard them, train and support them. We enable simplified self-service with our automation projects, doing as much or as little as our customers prefer. This saves time and creates faster onboarding success.

Test and Validate

Before a “bot” is developed and placed into production, it’s important to make sure it has been validated, works predictably, and meets the requirements for benchmarking. The total number of cases processed without the need for human intervention should exceed 95%. Here’s a real life example from a partner today – the customer was going from testing into production – different environments. We were able to visually test ContentObjects, and make necessary modifications without the need to run anything. Since the automation is in code, it’s easy to swap items out, or verify without the need to commit records, and rapidly test any number of scenarios within a matter of minutes. That’s why it’s important to have the right team with the right testing skills to validate workflows, processes, and exceptions thoroughly.

Why Boston WorkStation?

Everything sounds great in an online demo, and many companies have some pretty snazzy PowerPoint decks and talking points. Prospective clients want to believe that what you say is what you will do, but not all vendors keep their promises. Consider these key points:

  • Support is paramount to RPA project success
  • Without the right technology partner you’ll find yourself in long queues, losing time, and getting nowhere
  • Boston WorkStation consistently receives 5-Star reviews, surpassing competitor rankings in the “Best in KLAS 2022 report
  • 100% of our customers say that Boston WorkStation works as promoted and delivers product value

Boston WorkStation outperformed industry giant, UiPath, and hundreds of other vendors in most categories. We are experts on streamlining workflows, reducing costs, and improving usability for hospitals, health systems, and technology partners. We’d love to share our successes with you. With 95% of our projects completed in < 45 days, savings in time and money are right around the corner.