May 17, 2020

Are RCM changes hampering physicians?

Health Tech
3 min
If a nurse or other staffer incorrectly codes a diagnosis, it creates a financial ripple effect for physicians as well as hospital billing cycles.
Revenue cycle management is what makes hospitals and clinics financially function.

However, there are changes on the way that could have a major impact...

Revenue cycle management is what makes hospitals and clinics financially function.

However, there are changes on the way that could have a major impact on the medical billing process.

With financial health in mind, here are a few ways RCM changes could affect hospitals and physicians for the remainder of 2015:

RCM in health care

Many industries use revenue cycle management software to manage payment processes and the health care industry is no exception. Most hospitals use RCM software to handle revenue generation, payment, and claims processing information.

RELATED TOPIC: Should your hospital be considering an updated RCM system?

This allows health care providers to track billing cycles and quickly discover issues as they arise.

From ensuring payments are collected on time to taking care of denied claims, RCM software helps hospitals keep a continuous stream of revenue.

In addition to the functions above, RCM software also collects co-pays and handles the insurance eligibility process for patients.

Although RCM software helps with time management, it can also adversely affect how physicians handle electronic medical records and other hospital responsibilities.

Training issues

Most physicians are trained in RCM software before it's implemented, but that doesn't mean the rest of the staff is.

The article “Physicians Beware! 3 Revenue Cycle Impacting Changes in 2015,” describes the complications surrounding RCM and the transition from ICD-9 to ICD-10 coding.

Revenue cycle management software requires specific coding in order to be effective. However, most staffs aren't trained in this type of coding, which causes headaches for hospitals and head physicians in particular.

RELATED TOPIC: Why the cloud is the safest place to store medical records

In other words, if a nurse or other staffer incorrectly codes a diagnosis, it creates a financial ripple effect for physicians as well as hospital billing cycles. RCM requires proper training, which is something hospitals and the physicians that run them aren't prepared to implement.

Smaller practices

Revenue cycle management has untold benefits for city hospitals and larger practices, but what about smaller local practices?

Sometimes physicians at smaller practices feel pressured to use RCM software even when their in-house billing process is perfectly functional. This can lead to unneeded stresses, especially for smaller clinics that have no plans for expansion.

Likewise, if a physician only practices in one specialty, RCM software could be completely unnecessary.

Many specialty physicians use unusual codes and billing processes that in-house billing teams are already familiar with. Introducing RCM software could complicate tried and true billing techniques in smaller practices.

Decreased communications

Although revenue cycle management software helps automate billing for hospitals, this could result in decreased communications between physicians and other staff members.

RELATED TOPIC: 3 areas of health improved by efficient hospital communication

Inputting diagnosis codes and medical records can speed up the billing process, but the lack of communication that results could create issues down the line. This is especially the case in larger hospitals where head physicians manage more staffers.

RCM is still beneficial

The issues above are only a small part of the revenue cycle management equation.

There are plenty of benefits that go along with RCM software including workflow and claims management as well as electronic health record compatibility.

At the end of the day, it's up to the hospital and the physicians within to determine if RCM is the right choice.

Although beneficial, it's plain to see that RCM software can also hamper the way physicians run their practices.

About the author: Adam Groff is a freelance writer and creator of content. He writes on a variety of topics including the medical industry and health care technology.

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Jun 11, 2021

How UiPath robots are helping with the NHS backlog

6 min
UiPath software robots are helping clinicians at Dublin's Mater Hospital save valuable time

The COVID-19 pandemic has caused many hospitals to have logistical nightmares, as backlogs of surgeries built up as a result of cancellations. The BMJ has estimated it will take the UK's National Health Service (NHS) a year and a half to recover

However software robots can help, by automating computer-based processes such as replenishing inventory, managing patient bookings, and digitising patient files. Mark O’Connor, Public Sector Director for Ireland at UiPath, tells us how they deployed robots at Mater Hospital in Dublin, saving clinicians valuable time. 

When Did Mater Hospital implement the software robots - was it specifically to address the challenges of the pandemic? 
The need for automation at Mater Hospital pre-existed the pandemic but it was the onset of COVID-19 that got the team to turn to the technology and start introducing software robots into the workflow of doctors and nurses. 

The pandemic placed an increased administrative strain on the Infection Prevention and Control (IPC) department at Mater Hospital in Dublin. To combat the problem and ensure that nurses could spend more time with their patients and less time on admin, the IPC deployed its first software robots in March 2020. 

The IPC at Mater plans to continue using robots to manage data around drug resistant microbes such as MRSA once the COVID-19 crisis subsides. 

What tasks do they perform? 
In the IPC at Mater Hospital, software robots have taken the task of reporting COVID-19 test results. Pre-automation, the process created during the 2003 SARS outbreak required a clinician to log into the laboratory system, extract a disease code and then manually enter the results into a data platform. This was hugely time consuming, taking up to three hours of a nurse’s day. 

UiPath software robots are now responsible for this task. They process the data in a fraction of the time, distributing patient results in minutes and consequently freeing up to 18 hours of each IPC nurse’s time each week, and up to 936 hours over the course of a year. As a result, the healthcare professionals can spend more time caring for their patients and less time on repetitive tasks and admin work. 

Is there any possibility of error with software robots, compared to humans? 
By nature, humans are prone to make mistakes, especially when working under pressure, under strict deadlines and while handling a large volume of data while performing repetitive tasks.  

Once taught the process, software robots, on the other hand, will follow the same steps every time without the risk of the inevitable human error. Simply speaking, robots can perform data-intensive tasks more quickly and accurately than humans can. 

Which members of staff benefit the most, and what can they do with the time saved? 
In the case of Mater Hospital, the IPC unit has adopted a robot for every nurse approach. This means that every nurse in the department has access to a robot to help reduce the burden of their admin work. Rather than spending time entering test results, they can focus on the work that requires their human ingenuity, empathy and skill – taking care of their patients. 

In other sectors, the story is no different. Every job will have some repetitive nature to it. Whether that be a finance department processing thousands of invoices a day or simply having to send one daily email. If a task is repetitive and data-intensive, the chances are that a software robot can help. Just like with the nurses in the IPC, these employees can then focus on handling exceptions and on work that requires decision making or creativity - the work that people enjoy doing. 

How can software robots most benefit healthcare providers both during a pandemic and beyond? 
When the COVID-19 outbreak hit, software robots were deployed to lessen the administrative strain healthcare professionals were facing and give them more time to care for an increased number of patients. With hospitals around the world at capacity, every moment with a patient counted. 

Now, the NHS and other healthcare providers face a huge backlog of routine surgeries and procedures following cancellations during the pandemic. In the UK alone, 5 million people are waiting for treatment and it’s estimated that this could cause 6,400 excess deaths by the end of next year if the problem isn’t rectified.

Many healthcare organisations have now acquired the skills needed to deploy automation, therefore it will be easier for them to build more robots to respond to the backlog going forwards. Software robots that had been processing registrations at COVID test sites, for example, could now be taught how to schedule procedures, process patient details or even manage procurement and recruitment to help streamline the processes associated with the backlog. The possibilities are vast. 

The technology, however, should not be considered a short-term, tactical and reactive solution that can be deployed in times of crisis. Automation has the power to solve systematic problems that healthcare providers face year-round. Hospital managers should consider the wider challenge of dealing with endless repetitive work that saps the energy of professionals and turns attention away from patient care and discuss how investing in a long-term automation project could help alleviate these issues. 

How widely adopted is this technology in healthcare at the moment?
Automation was being used in healthcare around the world before the pandemic, but the COVID-19 outbreak has certainly accelerated the trend.  

Automation’s reach is wide. From the NHS Shared Business Service in the UK to the Cleveland Clinic in the US and healthcare organisations in the likes of Norway, India and Canada, we see a huge range of healthcare providers deploying automation technology. 

Many healthcare providers, however, are still in the early stages of their journeys or are just discovering automation’s potential because of the pandemic. I expect to see the deployment of software robots in healthcare grow over the coming years as its benefits continue to be realised globally. 

How do you see this technology evolving in the future? 
If one thing is certain, it’s that the technology will continue to evolve and grow over time – and I believe there will come a point in time when all processes that can be automated, will be automated. This is known as the fully automated enterprise. 

By joining all automation projects into one enterprise-wide effort, the healthcare industry can tap into the full benefits of the technology. This will involve software robots becoming increasingly intelligent in order to reach and improve more processes. Integrating the capabilities of Artificial Intelligence and Machine Learning into automation, for example, will allow providers to reach non-rule-based processes too. 

We are already seeing steps towards this being taken by NHS Shared Business Service, for example. The organisation, which provides non-clinical services to around two-thirds of all NHS provider trusts and every clinical commissioning organisation in the UK, is working to create an entire eco-system of robots. It believes that no automation should be looked at in isolation, but rather the technology should stretch across departments and functions. As such, inefficiencies in the care pathway can be significantly reduced, saving healthcare providers a substantial amount of time and money. 

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