Building resilience after COVID-19 with RPA
Within days of the COVID-19 pandemic being declared, robotic process automation (RPA) became an essential day-to-day tool for many healthcare providers, rather than a long-term aspiration.
For organisations suddenly burdened with staff shortages and other constraints caused by the COVID-19 crisis, the benefits of automation were no longer purely about making cost efficiencies, but about building resilience.
Tasks like billing, processing claims, managing patient records and other repetitive, time-consuming tasks are well suited to software bots, as they can help free-up time for healthcare staff to spend with patients.
"Healthcare organisations have these very complicated types of billing and claims processes, that involve reworking the claims and making sure that codes are properly applied. That's just so much manual data entry, checking of records, sometimes checking of actual scans," says Roberto Valdez, Director of Cybersecurity Automation and Risk Advisory Services at Kaufman Rossin, an advisory firm for US businesses.
A study by Gartner carried out in May 2020 found that while only 5 per cent of healthcare providers had been investing in RPA before the pandemic, 50 per cent plan to do so in the next three years.
This makes sense given that RPA has emerged as an almost tailor-made solution for the challenges of COVID-19. Consider staff who routinely carry out admin duties having to self-isolate for two weeks, along with the increased numbers of patients passing through a hospital. Automation can take care of the increase in patient scheduling and appointment cancellations.
"These are the areas where RPA has the biggest opportunity and can make the biggest impact, and the pandemic will continue to drive adoption," Valdez says.
One example is Indian insurance firm ICICI Lombard, who now used cloud-based automation driven by AI to process cashless claims requested by hospitals. Data like doctor's diagnoses and treatment plans are fed into the algorithm, which decides whether to accept the case, while a machine learning algorithm decides on the claim amount. A process that once took 4 hours to do manually, now takes 90 seconds.
Solving COVID-specific challenges
RPA has also been deployed to solve specific problems that have arisen as a result of the pandemic. COVID-19 testing requires a substantial amount of repetitive admin, including finding and registering patients in the system, correctly labelling test kits for collection and analysis, and logging test results, in some cases into a national database containing millions of other entries. Additionally, there is a huge demand for tests that have created backlogs in many countries, while social distancing rules remain in place for staff.
Back in March, RPA software firm UiPath launched a project with the Mater Misericordiae University Hospital in Dublin, providing their Infection Prevention and Control department with free trial robot licences to process test results. UiPath says this is saving 3 hours per day, which nurses can instead spend on the pandemic response.
In the UK, at the start of the pandemic 750,000 people responded to the Government's call for volunteers to assist with COVID-19 efforts, in the space of just two days. Before taking up their roles, every single person needed to be registered and undergo background checks. Whereas HR would usually perform these functions manually, the sheer numbers of people requiring processing meant that using automation would be much faster and more efficient.
Software firm Credentially was appointed to automate the sign-up and verification process of doctors, nurses and paramedics, registering thousands of clinicians in a matter of days instead of months.
Slow adoption, until now
COVID-19 has really highlighted the benefits of RPA, but why did it take a global pandemic for it to become widely adopted? "There's actually some good reasons for this," Valdez says. "Some of it relates to the sensitivity of patient information, some of which is driven by compliance, but then also just good patient care and stewardship of patient records as well.
"HIPAA compliance provides certain types of constraints, and as a result of that, healthcare organisations have been hesitant to outsource certain types of functionalities historically, though it's become much more common. Then when they do outsource, they often want to restrict it geographically, for instance limiting it to within the United States. In certain conditions, they will offshore, but with really strict and rigid restrictions."
Another reason is purely down to clinicians' habits. "So much of what is done is in a physical space with patients, where healthcare practitioners are writing notes by hand, or marking charts. Even today there's still tons of paper involved in this system. There are healthcare record systems that are increasingly able to provide good apps and interfaces for digital versions of these, but whatever has been baked in the cake and used for a long period of time is still quite prevalent."
Despite this, it looks increasingly like RPA in healthcare is here to stay. "It's very hard to unturn this screw, and part of that is because if you have a nice return on your investment and a nice demonstration of value, then why would you go back?" Valdez says.
"The other part is just as simple as implementation and infrastructure. When you go through the effort, cost and time of integrating a system like robotic process automation, then it's probably to your advantage to just continue on that pathway of digital transformation. That includes the use of the cloud, and Software as a Service types of systems. Automation across the entire value chain is something that's continuing to increase."
RPA is the fastest-growing segment of the software market, and Valdez predicts that providers of other, traditional types of software will see this as an opportunity. "You have enterprise RPA platforms like Blue Prism and UiPath that are just tremendously successful, but then these traditional, huge enterprise companies and software developers are seeing that there's some market share available," he says.
"Providers of electronic health records (EHR), customer relationship management (CRM), and enterprise resource planning software (ERP) are integrating versions of RPA into their existing platforms. Even companies like Workday, which produces a huge ERP system, and Microsoft, are integrating RPA into their platform. We're going to see an increase in that. It'll create a nice competitive overlap which benefits healthcare, and which ultimately benefits the patient as well."
How UiPath robots are helping with the NHS backlog
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.