While there have been numerous significant technological advancements in healthcare, the ecosystem still face challenges associated with data integrity, management, coordination, privacy and security, and poor collaboration due to existing silos. Many of these challenges can be strategically addressed by intelligently introducing automation and AI at various touchpoints. This will help streamline processes, enhance productivity, cut costs, increase accuracy, and improve patient experiences.
In 2016, McKinsey reported that the healthcare sector had a 36% technical potential for automation, and as per the 2017 CAQH Index, lack of automation for administrative transactions costs the healthcare industry more than $11 billion each year. Hence, automation represents several billion dollar opportunity for improving operations, reducing costs, delivering better quality care and strengthening future strategies.
Repetitive tasks like data collection and processing show a high potential for automation as compared to customer-facing tasks or human skills like problem solving, creativity, and people management. Since a big part of payers’ work is based on collecting and processing data, they appear to be one of biggest potential beneficiaries of automation programs in healthcare. While claims processing is seen as one of the most significant and direct sector where the touch of automation can help, other areas of potential success include using auto-validation algorithms to improve data quality, using smart portals to strengthen customer-agent relationships and streamlining workflows, and simplifying the enrolment and onboarding process using bots.
Moreover, beyond cost savings, automation can have other positive impacts like improving customer experience and satisfaction, enabling better data-driven decision-making, and strengthening organizational health to support long-term sustainability. Hence, the entire healthcare industry is swiftly adopting Robotic Process Automation (RPA), which is emerging as one of the leading technologies to shape the future of healthcare.
While most big payer organizations have started launching automation, some are struggling to build capabilities, generate bottom-line impact and are unable to scale swiftly. Lack of implementation expertise, lack of proper governance, and lack of funding are observed to be some of the stumbling blocks.
Hence, while automation presents itself as a tremendously beneficial opportunity, particularly for payers, to leverage it, stakeholders have to be more thoughtful and organized in its implementation and scaling. There is a need to collaborate effectively, strengthen buy-in across the organization, devise innovative strategies to train and equip employees, create scalable deployment model, and establish a recurring process to turn activity into impact.