A comprehensive analysis of the RPA vendors operating in healthcare and understanding the use cases
Max Healthcare was facing challenges in processing large volumes of patient transactions while ensuring the accuracy and security of documents. Being one of the largest hospital networks in North India, Max Healthcare was dealing with a lot of patient transaction data that needed to be processed on a daily basis. From recording customer details to claims processing and reconciliation of data for government health schemes, everything needed a high level of accuracy and efficiency. Manually processing such large volumes of information was not just time consuming, but was also e prone to a lot of errors and security issues.
What emerged as an antidote was the Max Healthcare adoption of UiPath Enterprise Robotic Process Automation (RPA) Platform to streamline high volume processes like claims processing, data entry, and reconciliation for government healthcare schemes. RPA ensured a massive reduction in turnaround time in current processes but also paved the path for the organization to move faster on its digital transformation journey. Welcome to the world of increasing RPA deployment in healthcare; the Max example makes it obvious that this market is driven by the increasing demand to automate claims and process management. RPA can benefit the healthcare sector to rely on desktop automation for some basic to complex repetitive workflows. The growth of RPA is expected to assist hospitals and other healthcare entities in monetizing various back-end processes.
Dissecting the Healthcare RPA Market: Understanding Vendor USPs
How big is the RPA market for healthcare? According to Markets & Markets, the RPA market is expected to reach $5.9 billion by 2025, at a CAGR of 32.6% between 2019 and 2025. The RPA market for the healthcare and pharmaceuticals industry is expected to grow at the highest CAGR till 2025. The healthcare and pharmaceuticals industry is highly information-dependent, as it involves medical records of patients, credentials of patients, information on claims processing, revenue cycle management, etc. In this regard, RPA not only helps reduce operational costs but also ensures greater accuracy.
The interactive solutions offered by RPA help efficiently manage data, reduce medical transportation costs, lower appointment scheduling errors, and so on. Services contribute the majority of the healthcare RPA market. Within services, support and maintenance is expected to grow at the highest CAGR till 2025. The major hospital chains are planning for investments in RPA and increase their profit margins. The key players in the RPA market are adopting various organic as well as inorganic growth strategies such as collaborations & partnerships, joint ventures, and few other strategies to be in a strong position in the market.
The key vendors include the likes of Blue Prism, UiPath, Automation Anywhere, Thoughtonomy, WorkFusion, Kofax, Nice Systems, Celaton, IPSoft, Pegasystems, Redwood Software, Jidoka, Kryon Systems, EdgeVerve Systems, Contextor, Antworks, Another Monday, Verint Systems and Xerox among others. These companies are striving in the market sphere by acquiring clients across regions from telecom operators to stay ahead in the competitive world. For instance, SAP acquired Contextor thereby enhancing its internal policies as well as making it a suitable vendor for RPA.
Each of these vendors has its own RPA USP though which differentiates them in healthcare too. Automation Anywhere delivers an enterprise-grade digital workforce platform. Blue Prism offers secure, scalable, and central control. UiPath is a Leader with shared services and ease of bot design. EdgeVerve brings a combined services and product approach. Kofax shifts focus to software robotics. Kryon builds from contact center performance assessment. NICE surrounds automation with analytics. Pegasystems merges robots, analytics, and case management. Thoughtonomy provides a SaaS-based platform for frictionless work. WorkFusion remains focused on human/machine collaboration. Another Monday takes a broader automation view. AntWorks builds from unstructured content. Contextor is an integrated development environment that targets agility.
In addition, there are several promising RPA startups active in healthcare with their own specializations including the likes of FeatSystems (Appointment Scheduling), EnterBridge (Insurance Claims Management), T-impact (Hospital Management), Computing System Innovation (Medical Data Structuring) and CloudMedx (Optimal Care Delivery) among others.
Analyzing Healthcare RPA: Building Successful Use Cases
The next logical question obviously would be to identify the RPA applications in healthcare.
Claims management is the most popular application with the largest market share in 2019 and will continue to remain so till 2025. Typically, managing claim processing is a time-consuming activity that encompasses mundane tasks and collection of huge amounts of data information from different sources. Doing this process manually and without predetermined regulation can even lead errors in entire claim processing. Even reports show nearly 30-40% health claims can be denied due to non-compliance of regulations. Hence, leveraging RPA can extract defined and undefined data, update systems and streamline the process of claim filing.
Clinical Data Extraction
RPA tools help healthcare companies retrieve data from both digital and physical clinical documents. They can automate the process of searching through a database for the correct documents and routing them to the appropriate user within the healthcare company’s network. This type of software usually needs a human employee to supply it with login credentials so that it can access that network or an EMR system.
Healthcare companies discover that even with an AI solution for this type of data extraction, they can still improve and build upon their processes to improve efficiency in ways AI may not be suited for. Natural language processing (NLP) solutions may be useful for digitizing clinical documents and identifying them based on the data within. However, RPA may be able to recognize and transfer them faster and based on fewer credentials.
Self Service Terminals for Hospitals
Hospitals, especially their emergency rooms, have an opportunity for RPA in automating patient check-in. They can set up self-service kiosks with screens that allow the patient to type in their information. There may also be a scanner on the kiosk to take a picture of the patient’s insurance card and ID if necessary. RPA software can then automate the kiosk’s responses to the patient’s input, which would load their information into a triage system and allow the front desk employees to review each patient’s information.
Processing Healthcare Credentials and Payroll
Another possibility for RPA in healthcare is the automation of processing healthcare employees’ credentials and payroll information such as timecards and other documentation of hours worked. RPA software can automate the transfer of data from the customer-facing method of information entry, such as an employee mobile app, to the backend verification method.
Healthcare Workflows Management
Managing and synchronizing healthcare, case and utilization management, remote healthcare monitoring, and populace wellness are such vital workflows for a healthcare organization. These workflows are often managed manually, which can be an inept approach, and encompass routine tasks that are essential for caregivers and patients. Nonetheless, it can be performed and streamlined by leveraging RPA solution in care delivery services.
Moving these routine tasks to RPA tools from human agents can result in cost savings and better outcomes for healthcare organizations. Also, this approach can advance efficiency across the board. By automating such workflows, medical professionals can spend the majority of their time on patient care and other care facilities.
Patient Appointment Scheduling
In today’s internet age, patients often schedule their appointments with their doctors online. Scheduling appointments based on patient data can be a tedious procedure, as healthcare organizations have to gather patient data, diagnosis, and insurance details in the registration process. These concerns related to scheduling patient appointments can be resolved by leveraging RPA tools. RPA solutions can automate the process of patient data collection and processing, as well as optimally schedule patient appointments according to their diagnosis, doctor availability, location, among criteria.
Stimulating Account Settlements
Maintaining records of multiple tests, treatment, doctor subscriptions, wardroom cost, among other care facilities are indispensable for a precise calculation of every patient’s bill. Embracing RPA into the entire billing process can accurately result in better outcome to care providers and ease the burden of the hospital staff. It can also lessen payment delays and inaccuracies in the account settlements process by informing patients of their bill amount and receive payments.
Implementing Post-discharge Guidelines
RPA can help hospitals by ensuring the precision of discharge guidelines and send reminders to patients about prescription pick-ups. With this automated service, care providers can also inform patients about upcoming doctor’s appointments and health check-ups for maintaining their health. In a need of further assistance by a patient for their health condition, RPA can also alert care providers to provide better medications promptly.
RPA Benefits in Healthcare: In a Nutshell
|Healthcare||Areas of RPA Implementation||Benefits to Healthcare Providers (Hospitals)|
|Back Office||· Human resource management|
· Finance and supply chain management
|· Streamline onboarding process to improve efficiency|
· Clinicians can impart care without interruption caused by administrative functions
· Human resource management
· Ensure new clinical staff gains access to systems and facilities from day 1
|Middle Office||· Revenue cycle management|
· Claim submission and reconciliation
· Patient scheduling
|· Accelerate revenue cycle by automating coverage eligibility verification process, claims posting, and claim resubmission|
· Insurance data management
(relatively untapped by RPA)
|· Care delivery setting|
· Health data utilization and report generation
|· Integration of disparate care management systems to assimilate date efficiently|
· Ensure clinicians spend more time for patient care by minimizing their administrative work
· Enhance case management
RPA Opportunity in Indian Healthcare Ecosystem
In India, a key challenge hospitals face is managing and processing the information they currently possess as physical documents or paper trails. This includes information from internal and external sources, billings, claims management, patient enrolment, reports, etc. Integration of this data can help healthcare organizations identify existing gaps across all processes and automate mundane, repetitive tasks as well.
The future of healthcare in India could look very different when technologies like RPA come into play. Automating routine tasks could reduce task time and eliminate manual errors while improving the patient experience. As hospitals like Max Healthcare progress from depending on manual tasks to applying RPA and cognitive computing, the workforce also shifts from being “doers” to “reviewers.” Health IT leaders and providers should focus on developing proactive, winning strategies to attain long-term financial sustainability and improved patient experience.
As RPA is emerging as the most affordable and flexible option, India is poised to appear as a front-runner in its establishment and benefit significantly from this opportunity