MENDING THE HEALTHCARE INDUSTRY WITH ROBOTIC …

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Presentation by JOLT Advantage Group

MENDING THE HEALTHCARE INDUSTRY WITH ROBOTIC PROCESS AUTOMATION

AGENDA

• JOLT OVERVIEW

• Evolution of RPA

• Healthcare meets RPA

• UiPath: Leader In RPA For Healthcare

• Use Cases & Case Studies

• Take The Next Steps

ABOUT JOLTOUR 360° SERVICES:

RPA and Intelligent Automation

• UiPath Consulting, Implementation and RPA Managed Services (RPAaaS)

• Robotic Translation and Organizational Change Management

Transformation

• Cloud Solutions: Oracle HCM, ERP Cloud and Workday

• ERP Solutions: PeopleSoft, Oracle EBS

• QA and System Testing Automation

Performance

• Training Strategy, Development, Delivery, Performance Support

• UPK Transition

Project Staffing On-shore and nearshore certified resources

JOLT was built on the idea that end-to-end 360° customer-centric solutions are required to solve the diverse set of challenges faced by our customers. Our world-class resources are passionate about our clients’ success.

AGENDA

• JOLT Overview

• EVOLUTION OF RPA

• Healthcare meets RPA




© JOLT Advantage Group 2018. All rights reserved.© JOLT Advantage Group 2018. All rights reserved.

THE EVOLUTION OF PROCESS AUTOMATION

Outsourcing

Automated single tasks

Optimized business processes

Outsourcing of business processes leveraging Labor arbitrage

Automation of business processes across the enterprise with high efficiency

MACROS

RPA

BPM


WHAT IS RPA

CONFIGURES SOFTWARE

TO AUTOMATE ACTIVITIES OR TASKS

TOOLS range from task level to

enterprise scheduled orchestration

SYSTEM INTEGRATION

TASK AUTOMATIONREPLACES REPETITIVE TASKS

Open email and attachments

Read and write to databases

Copy and paste

Move files and folders

Log into web/enterprise applications

Fill in forms

Scrape data from the web

Follow “if/when” decisions/rules

Extract structured data from documents

Make calculations

Connect to system API

Collect social media statistics


PROCESS AUTOMATION ACROSSMODERN & LEGACY ENTERPRISE SYSTEMS

Legacy/HomegrownCloud

ERPCRM

BPM CMS

On-Prem

HR Web Apps

© JOLT Advantage Group 2018. All rights reserved.

KEY BENEFITS FROM RPA

BETTER CUSTOMER EXPERIENCE

MAXIMIZES OPERATIONAL

EFFICIENCY

ENHANCED PRODUCTIVITY

RAPID DEPLOYMENT & ROI (COMPARED TO

TRADITIONAL TECHNOLOGIES)

MINIMIZE ERROR INCIDENTS AND BOTTLENECKS

MAXIMIZE ACCURACY AND

SPEED

DIGITAL WORKFORCE (24/7

PRODUCTIVITY)

IMPROVED EMPLOYEE

SATISFACTION

BUSINESS BENEFITS TECHNICAL BENEFITS

LEGACY APPLICATION INTEGRATION

UNSTRUCTURED DATA MANAGEMENT

DATA GATHERING TO ENABLE AI &

COGNITIVE PLATFORMS


RECORD ADOPTION RATE ACROSS VERTICALS

78%of those who have

already implemented RPA expect to

significantly increase investment in RPA over

the next three years

72%of organizations will

have adopted RPA by 202053%

have already started their RPA journey

Source: “The robots are ready. Are you? Untapped advantage in your digital workforce”, DeloitteConsulting. September 2017

• In 2018, RPA was the largest investment and focus area for enterprise buyers, eclipsing Cloud.

• 60% of organizations with $1B in revenue have adopted RPA and moved passed the pilot stage

• The average company has 900+ business processes, 85% of these can be automated.

Sources:• Gartner, 2018• McKinsey & Company, 2015

https://www2.deloitte.com/content/dam/Deloitte/at/Documents/technology/at-technology-robots-are-ready.pdf

AGENDA

• JOLT Overview


• HEALTHCARE MEETS RPA





Continuous digitization of

patient records

Data regulation & compliance

Budgetary pressures

Lack of admin and IT

personnel

Clinical staff need to reduce patient care time for a growing

EMR data entry and update tasks.

Lack of integration

and support for multiple

EMR systems

KEY CHALLENGES IN THE DIGITAL AGE

By 2025 there will be 2.5 clinician to 1000 patients in the Unites States

1 Physician will manage and average of 20,000 documents per year

A Clinician performs an average of 4000 clicks in the EMR every shift.

Most Hospital systems have 2-5 EMR with no internal HIE to support them.


RPA has evolved from performing only repetitive task automations to now completing end-to-end processes that can help boost productivity and reduce errors in complex health IT environments.

HEALTHCARE INDUSTRY MEETS RPA

Reads underlying code instead of onscreen UX. Minimizing efforts when system upgrade changes previous UI.

Computer Vision

Orchestrator allows for scalable automation solutions, easy distribution, frameworks and version control.

Orchestration

Drag and drop process flow experience makes it easy to train, develop and implement.

Easy to Use Designer


Improve patient experience

Automating admin tasks such as patient scheduling and insurance verification helps speed up processes turn around times and enable a superior patient journey.

Boost operational efficiency

Clinical staff no longer have to spend hours of manual labor to enter data and operate multiple electronic medical and healthcare records systems. RPA can eliminate the need for manual data entry and extraction and keep patient records and charts updated with minimized errors.

Better Health IT interoperability

Decrease the manual labor required to perform daily batch extractions from EMR systems in multiple data formats (ie HL7, unstructured data such as scanned forms, etc)

WHY RPA IN HEALTHCARE

RPA Reduces the administrative burden that impacts care and coordination


IDEAL PROCESSES FOR RPA

HIGHLY MANUAL AND REPETITIVE •Routine processes running

•periodically (daily or weekly)

RULE BASED•Standardized processes

•Decision making based on predictive rules

MATURE AND STABLE•Documented, stable, and predictable

•Predictable operational costs

LOW EXCEPTION• low variation scenarios in the activities that could lead to different handling of procedures

ROI POTENTIAL•Choose processes that can provide significant automation savings, usually 2 FTEs work-effort

NOT SUBJECT TO METHODOLOGY CHANGES•Does not process in systems that are due to undergo fundamental changes to interface or configuration in the short term

READABLE INPUTS•Processes that are triggered by standard and readable electronic inputs like MS Word, Excel, XML, PPT, PDFs

• If working with scanned images, OCR add-on would be needed.

HIGH VOLUME•Process performed by large teams

•High transactional value

•Low complexity


HEALTH IT APPS AUTOMATED

EHRs Document Management

Claims Operations

ERP /BPM

Patient Access


WHERE DOES RPA APPLY IN HEALTHCARE

60% of a

Providers Value Chain can benefit from RPA before AI

UiPath partners use un-attended automation for after hours claim status research


• EMRs will move from ‘systems of records’ to ‘systems of engagement’

• A transition from EMR-centric improvement to strategic improvement

• EMRs will be leveraged to analyze their data to drive strategic decisions, improve patient care and control costs

• Data-driven approaches will provide organizations with the ability to diagnose a and correct problems by measuring and evaluating performance across specific metrics

• Information from patient portals, wearables, lab results, and health apps integrated with EMR

• Data gathered from EHRs, warehouses, and other systems to gain insights for providers to a diagnosis and best practice for care

• Expedited insurance approvals and automatic determinations of patient eligibility. Relevant data pulled from aa EHRs to provide evidence for care processes and potential costs

• Expedited patient registration, admissions and discharges, as missing information is found in other systems

EMR AUTOMATION

• Quick access to accurate, up-to-date, and complete patient information

• Securely share information electronically

• Providers diagnose patients more effectively

• Complete documentation and accurate, streamlined coding and billing

• Reduced costs for paperwork and duplication of testing

The potential benefits of EMRs remain valid, but results to date have too often fallen short.

EMR Value Augmented with AIEMR Value Augmented with RPA

Current EMR Value

AGENDA

• JOLT Overview


• Healthcare Meets RPA

• UIPATH: LEADER IN RPA FOR HEALTHCARE




“UiPath is a Leader with shared services and ease of bot design. UiPath is one of the fastest growing RPA vendors.

The platform easily handles attended robots developed by employees as well as unattended robots that can handle large-scale processing.

Customers noted its deployment flexibility.”

Source: Forrester Research, Forrester Wave for Robotic Process Automation, June 2018

THE FORRESTER WAVE LEADER


Control, monitor, and analyze the performance of your virtual workforce

UiPath Robots

UiPath Orchestrator

UiPath Studio

Digitize your

process

Manage and Secure

EXECUTE

MONITOR

DEPLOYBig

Scale

Deploy and scale

Easily create automations in a visual editor across various

software applications

Your attended andunattended robots

UIPATH: ENTERPRISE RPA PLATFORM


UIPATH IN HEALTHCARE

170 + Global Healthcare and Life Science Organizations

use UIPATH today at an Enterprise Capacity

3200 robots have been deployed

35% is the average short term productivity savings

5 weeks is the average time to implement


OPEN TO A GROWING HEALTH IT ECOSYSTEM

✓ Intelligent Document Intake

✓ Patient 360

✓ EMR Gaps in Care

✓ Process Mining

✓ Clinical Recommendations

✓ Intelligent Get Next

✓ Real Time Compliance

✓ Rx Utilization Trending

✓ Real Time Adherence

✓ Patient Education Chat Bots

✓ Voice to Action EMR


CITRIX PROCESSING

Advancement in computer vision allows for accurate Citrix automation

Automation can occur at the desktop level or at the server level which enables RPA to be a unique product capability

Clients use UiPath to extract clinical documents from Citrix based EMR for AI processing


SECURITY & COMPLIANCE

UiPath has ability to initiate un-attended automation from smartcard authenticated PC

“UiPath underwent

security testing, including

conducting manual and

automated web

application security

testing on NASA’s high-

risk applications. Using a

combination of

automated and manual

testing techniques, UiPath

software passed the NIST

800:53 revision 4

standards.”

ALL CODE IS VERACODE TESTED

STRONG AUTHENTICATIONSAML 2.0 support for SSO and MFA. Smart card authentication.

ENCRYPTION EVERYWHERE256-bit Encryption — From network security to managing credentials

ACCESS CONTROLRole-based and passwords use individual encryption keys

AUDIT EVERYTHINGCustomizable Log files capture everything; Provides non-repudiation

GDPR & HIPAA CompliantData is protected in the UiPath platform at rest and transit

800-53 (Rev. 4)


GATEWAY TO AI IN HEALTHCARE

AGENDA

• JOLT Overview




• USE CASES & CASE STUDIES



IDEAL PROCESSES IN HEALTHCARE• Insurance Verification•Claim Status Check •NPI Lookup• Sanction Review• Education Validation•Benefit Updates• Enrollment Updates•Pricing Audits•Charge Master Updates•Claim Edits•CMS Extraction• EMR Testing•Compliance Audits• SAP Integration • Email Categorization• Integrated KPI reporting•Clinical Analytics

•Clinical Assessments•Patient 360 •Provider 360•WIZMO updates•Accumulator Audit•Performance

Dashboards •Document Intake AI• Chat Bot Extraction•Adherence Alerts• Pharmacovigilance• Social Listening• COB Rebilling• FAP Billing• Billing Audit• Clinical Doc Extraction•Patient Pay write-off

• New Hire Onboarding • Background Checks• Nurse Scheduling • Time card Audits• T&L Audit• Telehealth Summary• Small Balance Write-Off• Cash Application• POD Extraction• Same and Similar Audit• Document Indexing• Prior Auth Submission• Vendor Scorecards • Patient Profile Updates• SCM Integration•ICD 10 Audit•DME Education

• DME Education• Referral Management• SSO provisions• Risk assessment• DUR Alerts• MLR Audit• Work Utilization• Process Mining • Benefit Explanation • Product Enrollment• HIPAA Compliance• Regression Testing • Patient Data Entry • Benefit Validation• Insurance Card Readmit• Eye Glass Order • Swivel Reduction


EMR USE CASES

• Insurance Refunds• Finance Automation• Backup, Planned Downtime and Disaster Mitigation• Mass Data Upload• System to System Data Migration / Conversions• Reports Generation• Third Party Reliance Elimination or Integration• Coding – ER Nursing Assessments• Quality Enhancements and Data Correction at Time of Entry• Bad Debt Collections• Online Payment Posting• Third Party Lab Vendor Billing Integration• Medicare Denial Tracking• Automated Discharge of Inactive Patients

COMMON BACK OFFICE USE CASES

• Invoice processing

• AR, AP, and Order to Cash

• GL, Reporting, and Collections

• Bank reconciliation

• Fixed assets analysis

• Vendor management

• Incentive claims

• Sales orders

• Master data management

• ERP logging from another system

F&A• Payroll

• Time and absence management

• Benefits administration

• Compliance and reporting

• Personnel administration

• Employee on-boarding

• Data entry into multiple systems

• Performance appraisal

• Management

HR• Software deployment

• Server and app monitoring

• Creating new user accounts

• Email processing and distribution

• Batch processing

• Password reset/unlock

• Back-up and restoration

• Printer set-ups

IT• Customer inquiries

• Order Management

• Customer Account Setup

• Document Processing

• Duplicate system entry

CX


STORIES OF RPA IN GLOBAL HEALTHCARESwiftqueue is the largest patient registration platform in Ireland for NHS. RPA drives real time appointment scheduling post emergency room discharge, drives schedule set up via a chat bot and auto recommends another clinic if one has a significant delay. Pilot shows over 20,000 hours of time saved and an average waiting room time of less than 10 minutes

Australia largest health network has an issues with standing inventory. They currently have all devices and supplies RFID tagged but supply chain is managed outside of the EMR. RPA is used to synchronize used inventory with claims to show true consumption. Inventory was reduced by 50% overnight.

The largest laboratory in Canada wants to improve their 7 day turn around on specimen tests. Majority of the time is data entry of orders before the specimen is analyzed and tested. RPA and OCR reduced data entry by 60%. Pilot indicate a 72 hr turn around for new requests and 48 for returning patients/re-tests

33Slide /

THE BENEFITS

• Degree of robotization: 100%• Manual effort reduction: 1 FTE• Error rate: 0%• Elimination of backlogged payments

THE CHALLENGE

The inflow of insurance refunds needing to be processed was outpacing by the ability to process a refund. The challenge was to efficiently and effectively process insurance refunds without hiring additional staff.

THE SOLUTION

UiPath bots were implemented to automate the insurance refunds process.

One bot can process 15 times the number of refunds as one person per day and reduces processing time by 77%.

Process: Insurance Refunds

Customer(s): Hospitals, Clinics, Healthcare Facilities

Revenue Management

Patient Administration

Materials Management

Clinical Clinical Auxiliary

Healthcare Information Systems Area

Machine

LearningOptical

Recognition

BPM

Platform

Conversational

AI/NLP

Data

Aggregation

Integrated Technologies

Management Info. Syst.

User/Security Administration

HR/Payroll

Hospital Administration

34Slide /

THE BENEFITS

• Degree of robotization: 100%• Manual effort reduction: 80% - 90% • Error rate: 0%• Decreased days in A/R• Improved Collection Percentage• Enhanced Cash Flow

THE CHALLENGE

Improve cash flow, reduce days in A/R and bad debt write-offs and reducing dedicated manhours.

THE SOLUTION

RPA is used in a variety of healthcare settings and at points of service to enhance revenue cycle.• Payment posting: banks send files on a daily basis of payments received. RPA runs through the

file and posts the payments.• Expense reimbursements: RPA automatically reads the email content, and posts the content

into the required payment systems fields.• Insurance over- and underpayments: RPA matches the insurance company’s contracted amount

to the actual amount received and will prompt a user to take action.• Bad debt reduction: RPA used to identify and send accounts that show no payment within 45

days to the bad debt category for immediate processing and transfer to a third party.

Process: Finance Automations


Revenue Management





Machine

LearningOptical

Recognition

BPM

Platform

Conversational

AI/NLP

Data

Aggregation




HR/Payroll


35Slide /

THE BENEFITS

• Improved, faster information flow, no lag time

• Improved HIPPA compliance• Providers gain time to focus on patient• Degree of robotization: 100%• Manual effort reduction: 80% - 90% • Error rate: 0%

THE CHALLENGE

Eliminate errors and need for manual data re-entry between systems, expedite the transfer of patient information and clinical testing results to improve provider decision making and care quality.

THE SOLUTION

RPA is used to improve the operational efficiencies between several departments.• Patient registration and insurance information: Ambulatory medical offices use different

systems than the hospital.• Connecting hospital departments: Billing insurance for a patient stay requires the information

from the Emergency, Nursing and Lab departments. RPA is utilized to migrate the data from the three different IT systems and eliminated the manual data entry.

• System conversion: Replacing a current EMR system with a new one can be performed stress free by utilizing RPA to transfer the data.

• Specimen tracking: Patient information of specimens going from clinics and physician offices to hospital labs was paper or handwritten. RPA integrated the lab registration with the hospitals.

Process: System to System Data Migration / Conversions


Revenue Management





Machine

LearningOptical

Recognition

BPM

Platform

Conversational

AI/NLP

Data

Aggregation




HR/Payroll


36Slide /

THE BENEFITS

• Increased Report Accuracy• Timelier Information• More effective decision making• Degree of robotization: 100%• Manual effort reduction: 80% - 90% • Error rate: 0%

THE CHALLENGE

Improve efficiency, accuracy, and timeliness of reports.

THE SOLUTION

RPA can access several different systems to provide consolidated, more robust information for managers and executives to use to make decisions.• Time dependent reports: Reports were manually run at midnight requiring additional staff and

expense. RPA automated this process.• Day Close and Month End: A third shift was required to perform the daily close which included

the reading and posting in external journals, managing patient bills and transmitting insurance claim files from the HIS to a third-party scrubber. Using RPA, the third shift was eliminated.

• Reports distribution: RPA is used to push the reports to appropriate personnel immediately after they are generated.

Process: Reports Generation


Revenue Management





Machine

LearningOptical

Recognition

BPM

Platform

Conversational

AI/NLP

Data

Aggregation




HR/Payroll


37Slide /

THE BENEFITS

• Decreased days in A/R• Improved Collection Percentage• Denials rework reduced• Improved Charge Capture• Degree of robotization: 100%• Manual effort reduction: 80% - 90% • Error rate: 0%

THE CHALLENGE

Eliminate inaccurate coding of nursing assessments that result in lost revenue. Capture and document correct codes into patient record during ER visit.

THE SOLUTION

RPA is used to generate a spreadsheet of the billing codes for the nursing assessments in the emergency department. Every assessment is entered into a batch that is automatically posted each night, and the spreadsheet is time-stamped for validation. In order to be billed correctly, patient charges must be posted on the same day. Automating this process ensures that a complete, accurate batch posts each night, guaranteeing the billing cycle and maintaining a steady and accurate revenue flow. RPA greatly simplifies a process that would have required two full-time employees manually entering billing codes.

Process: Coding – ER Nursing Assessments


Revenue Management





Machine

LearningOptical

Recognition

BPM

Platform

Conversational

AI/NLP

Data

Aggregation




HR/Payroll


38Slide /

THE BENEFITS

• Degree of robotization: 100% of effort automated

• Higher standardization of process• Quality improvement to 0% error rate• Faster processing time – reduction of 85%• Manual effort reduction to 10%

THE CHALLENGE(S)

Improve accuracy of online payment posting.

THE SOLUTION

The solution eliminated the need for a designated staff member that would daily check for online transactions, print the transaction, and post the transaction to the practice management system. The automated solution queries the website’s database, looks for and finds transactions, which are then posted to the patient’s account without manual intervention. Automating this manual activityeliminates errors and expedites payment processes.

Process: Online Payment Posting


PR001

Denials Management

Registration

Claims Submission

Insurance Ver. Coding and Documentation

Revenue Cycle Functions

Machine

LearningOptical

Recognition

BPM

Platform

Conversational

AI/NLP

Data

Aggregation


Hospital and Health Systems

3rd Party Collections

Account Management

Patient Billing

Payment Posting

39Slide /

THE BENEFITS

• Degree of robotization: 70% - 80% • Claims throughput increases from approx.

150/day to approx. 320/hour.• Quality improvement to 85% error rate• Revenue capture = >20M• Manual effort reduced to 20% - 30%.

THE CHALLENGE(S)

Reduce Medicare claims review process cycle time to improve payments to the hospital. Staff unable to correct and resubmit all claims with errors. Revenue was being lost.

THE SOLUTION

RPA can be used to mine the failed Medicare claims reports and automatically correct and resubmit claims with missing or incorrect diagnosis codes, NPI numbers, service duplication charges, and modifiers. Claims requiring advanced knowledge are flagged to be approved by the appropriate staff.

Process: Medicare Denial Tracking


PR001

Denials Management

Registration

Claims Submission



Machine

LearningOptical

Recognition

BPM

Platform

Conversational

AI/NLP

Data

Aggregation




Account Management

Patient Billing

Payment Posting

40Slide /

THE BENEFITS

• Degree of robotization: 100% • Quality improvement to 20% error rate• Est. staff hours saved = 1560 hours/year• Revenue increase = >

THE CHALLENGE(S)

Remove inactive patient accounts to eliminate erroneous posting of charges. Improve revenue cycle by removing those records so they are not inadvertently billed.

THE SOLUTION

RPA was used to identify and archive inactive patient accounts according to rules set by the health system. The results were a decrease in billing errors and staff time correcting the accounts.

Process: Automated Discharge of Inactive Patients


PR001

Denials Management

Registration

Claims Submission



Machine

LearningOptical

Recognition

BPM

Platform

Conversational

AI/NLP

Data

Aggregation




Account Management

Patient Billing

Payment Posting

AGENDA

• JOLT Overview





• TAKE THE NEXT STEPS

WHY WORK WITH EXPERIENCED RPA SERVICE PARTNERS

• Scalability• Operating and Governance Structure• Internal RPA Expertise• C-Suite Support• Business vs. IT Drive• Security and Compliance• Optimal Support Model

NEEDS• Scalable RPA Solutions Delivered• Industry and Functional Expertise• Certified RPA Trainers• RPA Operating Model Design &

Implementation• Enterprise Digital Transformation• Organizational Change and Talent

Management• RPAaaS

JOLT


WITH YOU IN EVERY STEP OF YOUR RPA JOURNEY

RAMP UPPILOTPROOF OF CONCEPT

Begin your digital transformation journey by selecting one simple process to automate during a quick, 60 day POC to use as a RPA success use case to help justify a larger-scale effort.

10 weeks piloting of additional processes while setting up the planning, governance, security, and roll-out.

Accelerate the identification of additional RPA opportunities and work to evangelize the success of RPA across the entire enterprise

Roll-out your robotic workforce to all business units and geographies

ROLL-OUT

JOLT 360° INTELLIGENT AUTOMATION SERVICES

C-SUITE SERVICES

• Intelligent Automation Strategy • ROI Management • Change Management • Transformation

CENTER OF EXCELLENCE

• Governance • Enablement • Tech Integration • BOT Management • Vendor Management • Quality & Innovation

DELIVERY SERVICES

• Discovery • Design • Development • Deployment

SUPPORT SERVICES

• PROD Support • DevOps • Product Availability • Incident Management • Change Management • BOT Health Management


RPA JOLT PROGRAM

GIVE YOUR RPA PROGRAM A JOLT FORWARD

✓ Maximized Business Outcomes

✓ A Developed Strategic Direction for Your RPA and Overall Intelligent Automation Program

✓ An Established Process Automation Pipeline for Immediate ROI

✓ Defined RPA Governance Including: Roles, Scope and Responsibilities

✓ Learned Essential Development Skills for RPA


Education & Discovery

Strategy & Planning Process Automation Pipeline

Development

Platform Installation & Configuration

RPA Development Training

Robotic Process Translation

RPA Proof of Concept (POC)

CONTACT US

Our team will work as your guide towards real and sustainable digital transformation. We are passionate about agility and are driven to excellence when partnering with our clients to deliver unparalleled expertise in intelligent and robotic process automation, IT transformation, training and performance support.

facebook.com/JOLTAdvantageGroup

linkedin.com/company/2741918

twitter.com/joltadvwww.JoltAG.com

(855) 238.5658

[email protected]


www.JoltAG.com

THANK YOU!

MENDING THE HEALTHCARE INDUSTRY WITH ROBOTIC …

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Transcript of MENDING THE HEALTHCARE INDUSTRY WITH ROBOTIC …