In addition to advances in medical equipment and medicine, another technological advancement is changing healthcare: Automation.

We all want greater efficiency and effectiveness in healthcare. We all want to use the most advanced systems and strategies available. And we all desire consistently excellent outcomes.

Automation is transforming healthcare today, paving the way for even more advancements to come.

In healthcare, automation could look like a daily batch of text messages that remind patients of their appointments the next day. Or automation could invoke a database that detects and warns clinicians of known contraindications and drug interactions.

In this article, we’re going to review some of the benefits of healthcare automation by following a patient through a hospital stay. The patient’s journey will help us explore 17 ways strategic automation can make a positive difference.

Our patient is Gary, a 43-year-old man. He presented at the emergency room with swollen glands of the neck. Gary had a tooth pulled four days earlier and noticed minor swelling a few hours after the surgery. The swelling spread slowly and was now constricting his throat.

With Gary’s help, we’ll experience healthcare automation from the perspective of four groups:

  1. Patients
  2. Clinicians
  3. Administrative support staff
  4. Organizations
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Automation in Healthcare: How Can It Help Patients?

Shortly after Gary arrived at the Emergency Room, the attending ordered a Head and Neck CT. When the EHR received the results, it immediately forwarded them via secure text message to the treatment team.

The CT scan showed an abscess. The attending used her mobile phone to access the hospital’s Clinical Communication and Collaboration (CC&C) system, sending a consult request to the Oral Surgery department. Two minutes later, the on-call Oral Surgeon viewed the CT and recommended an incision to drain the abscess.

As soon as an operating room was available, Transport took Gary to the Operating Room. Just as Gary reached the OR, he said his throat was closing, and he would not be able to breathe much longer. Upon reaching the operating table seconds later, a surgeon intubated Gary, made an incision, and inserted a Penrose drain to draw off the abscess.

After a short stay in the post-anesthesia care unit (PACU), Gary was admitted for 24 hours of antibiotics and observation.

Twenty minutes into Gary’s inpatient stay, he felt his body getting hot very quickly, resulting in a 102o fever. He knew this was a dangerous situation, so he spoke to the bedside Amazon Alexa unit, expressing urgent fears of his rapidly rising body temperature.

Thirty seconds later, a nurse arrived to assess Gary’s condition, and within a minute, she began cooling his body with an electric fan and wet towels.

Later that afternoon, during a routine vitals check, a nurse aide noticed a suspicious mole on Gary’s arm. The aide told the attending, and the attending ordered a consult from Dermatology. The Dermatologist sent an image of the mole to his Mole Database, which correctly identified an early-stage basal cell carcinoma. The Dermatologist prescribed an anti-tumor cream and told Gary he’d need no further treatment.

After a shift change, Gary’s new attending reviewed his ECG results from several hours earlier and noticed an anomaly. After a consult with Cardiology and a conversation with Gary’s PCP, the three physicians agreed Gary should wear a small mobile heart monitor for two weeks. The doctors assured Gary he would not have to cancel his upcoming out-of-state trip. By leveraging information technologies like Remote Patient Monitoring (RPM) and secure cloud-based infrastructure, the device could report heart irregularities if Gary was within range of a cell signal.

When Gary’s doctor posted a discharge order, secure messaging alerted each person on the discharge team and set up their worklists. Forty minutes later, the CC&C system detected the completion of all Discharge Team tasks and automatically sent a message to Transport and Environmental Services. Less than two hours later, Gary was on his way home, and the CC&C system sent a Discharge Summary to his PCP.

“We can capture ADT data streams from your EHR and have it automatically assemble a care team for patient-centric conversations, which can carry on until patient discharge.”– TigerConnect

Based on Gary’s experience, here are four benefits patients may experience from automation.

Benefit #1: When every minute counts, fast and accurate diagnosis and treatment can prevent further progression of a surging health threat.

Benefit #2: Patients can return home sooner because of shorter wait times at four stages:

  1. The Emergency Room – Results from the CT scan were texted to the attending physician moments after they hit the EHR.
  2. Consults – Through the automated scheduling system, staff quickly identified and alerted the appropriate Oral Surgery and Dermatology specialists.
  3. The hospital bed – Instead of pressing a nurse call button that might only send a general alert to the nurse, Gary spoke details of his urgent concern, and the nurse responded immediately.
  4. Discharge – A quick, secure text message alerted the discharge team, and each person knew their responsibilities.

Benefit #3: Patients can learn of skin cancers at an early stage when they can be treated … and before they pose any serious risk to the patient’s health. This advancement is a result of a collaboration between physicians and computer scientists at Stanford University. They applied a machine-learning algorithm to 130,000 images of 2,000 skin diseases. Their artificial intelligence product proved to be as effective as 21 board-certified dermatologists in distinguishing harmless moles from deadly ones.

Benefit #4: Wearable medical devices, like the remote cardiac monitoring unit Gary wore, mean patients can undergo some diagnostic activities with almost no inconvenience. When the wearable device is paired with Remote Patient Monitoring, patients do not have to travel to a doctor’s office or clinic to check-in. The unit automatically logs data and sends alerts to the designated physician if the device detects any pre-specified conditions.

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Automation in Healthcare: How Can It Help Clinicians?

Let’s turn now to how automation can help clinicians with their goal of providing exceptional patient care.

After the ER staff added Gary’s information to the EHR, the CC&C system immediately sent a secure text message to notify his PCP that Gary was in the ER. After OR staff scheduled Gary for surgery, the system sent a text message to inform his PCP of the upcoming surgery. The system also sent automatic notifications after Gary was admitted to the hospital, and then discharged.

There was no need for a human to send (or forget to send) these messages. Because of automation, Gary’s PCP knew what was happening during every step of his experience as a patient.

Meanwhile, the clinicians taking care of Gary in the hospital benefitted from automation in at least two ways. They were able to provide care that was both more timely and more efficient.

Timely Patient Care

Gary experienced a lot of rest time, but the peaceful time was punctuated with two critical moments. Without a fast and accurate response, Gary’s health – and possibly his life – would have been in danger.

Here’s how automation supported timely patient care during Gary’s scary moments:

  • When CT results were available, the CC&C system forwarded the images within seconds. Clinicians received the pictures on their mobile phones, which means they didn’t have to walk to a workstation and log into an EHR. This automation saved them time and enabled them to decide their next steps right away. A delay of even 10 minutes would have pushed every other action back 10 minutes, allowing the expanding abscess to cut off Gary’s breathing before he reached the operating table.
  • When Gary used Alexa to report his rapidly rising body temperature, the nurse had no doubt she needed to rush to his side. A generic nurse call button may not have signaled the urgency.

Efficient Patient Care

We’ve described results and images that an EHR can automatically forward to a clinician’s phone. We’ve also seen the integration with Alexa that enables patients to speak a message which clinicians receive as a secure text message on their phone. This activity is similar to voice-to-text medical transcription solutions like Dragon.

Behind the scenes of these two processes are computer programs that automatically perform repeatable tasks. The programs are examples of what has become known as Robotic Process Automation, or RPA for short.

RPA allows clinicians to become more productive as they offload monotonous, repetitive tasks such as:

  • Logging into an EHR and looking up a patient so they can retrieve results and view radiology images; RPA pushes results and images to their phone.
  • Typing notes about a patient’s vitals, medical history, and prescription drugs; RPA records and transcribes their spoken notes.
  • Looking up the name of the clinician currently filling a role on the patient’s care team; RPA tracks clinician roles in real-time, and the CC&C system keeps this information at the clinician’s fingertips.

“Robotic Process Automation (RPA) is a technology that produces more time for professionals to perform the tasks they are uniquely qualified to do and innately better at, because it can carry out the important routine work that tends to be less fulfilling for human professionals.” – UiPath

In summary, Gary’s experience shows how clinicians can experience these three additional benefits of automation:

Benefit #5: PCPs and referring physicians are informed as their patients move through various hospital departments and functions.

Benefit #6: Clinicians want to do good work, but they’re often thwarted by systemic obstacles that delay information flow. Automation enables real-time alerts and results at the point of care so clinicians can make timely decisions and help their patients.

Benefit #7: Strategic RPA workflows essentially “create time” for clinicians by doing repetitive tasks and allowing them to spend more time with patients.

Automation in Healthcare: How Can It Help Administrative Support Staff?

Gary spent 30 hours at the hospital. During that time, four different care teams cared for him. The hospital’s role-based scheduling system always made it easy for everyone to know the right person to contact.

Before Gary was discharged, he scheduled an appointment for two days later to remove the Penrose drain. He received an automated text message 24 hours before his appointment as a reminder. He received another automated text message 11 days later to remind him to return his mobile cardiac monitor and meet with his PCP to discuss the results.

And on the backend, we find Robotic Process Automation again, this time helping with revenue cycle functions. Although Gary was at the hospital for only 30 hours, his experiences created a lot of billing complexity:

  • A CT scan
  • A surgical procedure
  • Three consults
  • An advanced mole analysis
  • A new prescription
  • A wearable mobile heart monitor with Remote Patient Monitoring capabilities

Fortunately, the professional and hospital billing systems relied on RPA and were not perplexed by the tangle of services Gary received. Instead, billing’s software services worked day and night, tirelessly collecting data from multiple systems, flagging potential billing risks, submitting an accurate bill, and interacting with the payer’s website to monitor the status of the claim.

We can now build on the previous seven benefits, as Gary’s experience shows how support staff can experience these three additional benefits of automation:

Benefit #8: Nobody spends any time updating staffing schedules at shift changes. Role-based scheduling automation means anyone in the health system can immediately identify and contact current on-call staff and specialists. Support staff gains a small bump in productivity since they have more time for other priorities.

Benefit #9: Nobody spends any time calling patients to remind them of their appointments. This provides another bump in productivity.

Benefit #10: Billing managers conquer their workload. Backlogs are a thing of the past because revenue cycle RPA works 24/7, quickly producing accurate claims that dramatically reduce denials and resubmissions. Billers and coders spend their time only on exceptions.

But time is not the only win for support staff through automation. They also avoid aggravation and stress caused by tedious tasks that must be done accurately, every time.

Automation in Healthcare: How Can It Help Organizations?

Despite all the drama in Gary’s brief hospital encounter, he didn’t touch all the ways automation can help health organizations. We’ll zoom out from Gary’s experience to see the bigger picture of how automation allows organizations to take better care of their patients, their employees, and their finances.

Automation Allows Organizations to Take Better Care of Their Patients

We saw automation prevent delays in Gary’s consults and the response to his nurse call. Here are other ways organizations are rolling out automation to improve their service to patients:

  • In one study, Smart beds that automatically monitor a patient’s heart and respiratory rate 100 times per minute reduced code blue events by 86 percent.
  • An IoT connected pillbox at a patient’s home knows if nobody opened it at the scheduled time. If it hasn’t been opened, the patient receives an automated reminder on her phone. If there’s still no response, the system automatically prods a clinician to follow up.
  • An Intel AI system learned to distinguish between two heart diseases that have similar symptoms but very different treatments. Highly skilled cardiologists get it right 75 percent of the time, but the AI system got it right 90 percent of the time. These results mean more patients will avoid incorrect – and possibly fatal – treatments.
  • Using data such as pain medicine prescriptions and the number of ER visits per year, an AI system was 80 percent accurate in predicting when people would attempt suicide up to two years in the future. This information can trigger early intervention and prevent untold grief for those patients and their families.

Benefit #11: Patients experience better and more consistent care, safety, and outcomes.

Automation also impacts patient satisfaction. The HCAHPS scoring system focuses on eight core areas, and three of them are directly improved by automation:

  • Communication with doctors
  • Communication with nurses
  • Responsiveness of hospital staff

Benefit #12: Organizations experience higher patient satisfaction.

Automation Allows Organizations to Take Better Care of Their Employees

A primary reason clinicians become healthcare professionals is because they want to help people. And as each of us has learned from various life situations, when we’re trying to do good things for other people, there’s hardly anything more frustrating than flawed workflows and processes that hinder us.

Automation removes some of those annoying barriers. Through automation, Gary’s care team and administrative support staff completed more work in less time with fewer mistakes and less rework.

Benefit #13: Employees experience increased productivity.

Automation streamlines workflows and helps employees complete more work more accurately with fewer roadblocks, making it possible to help more people.

When automation takes away monotonous and tedious tasks so clinicians can spend more time with patients, doing the work they want to do, work becomes more enjoyable and rewarding.

Benefit #14: Organizations experience higher employee satisfaction and retention.

Automation Allows Organizations to Take Better Care of Their Finances

Automation in the form of Remote Patient Monitoring increases patient engagement because patients are much more conscious of their health and their healthcare provider. Automation in the form of appointment reminder calls and text messages also keeps patients more engaged. When patient engagement goes up, missed appointments go down, and health organizations save money.

As we saw in Gary’s encounter, automation sped up the elapsed time for consults, results routing, and discharge. These time savers reduce the length of stay (LOS). When LOS goes down, hospitals save money.

In FY20, readmissions will cost hospitals approximately $563 million. That’s across 2,583 hospitals. But automation can help hospitals reduce readmissions:

  • In the emergency room, RPA can flag a patient who was discharged less than 30 days earlier. When a nurse navigator learns his patient is in the ED, it can ask the ED staff to adjust the patient’s medications to prevent readmission.
  • Remote patient monitoring can detect an escalating heart condition, and clinicians can intervene before hospitalization becomes inevitable.
  • A CC&C system can bolster the discharge process by clarifying who is responsible for overseeing the patient’s next steps. It can also forward images and test results to relevant providers and send text messages to remind the patient what they need to do.

When readmissions go down, hospitals save money.

Increased hospital staff productivity drives two other changes: Employees don’t have to work as much overtime, and employees can get better rest between shifts, both mentally and physically. As the pressure at work decreases, so does the desire to find a less stressful job. When employee overtime and turnover go down, organizations save money.

Benefit #15: Health organizations save money.

To assist cash flow, automation gets bills out the door faster, while at the same time reducing billing errors, rejections, and payment delays.

Benefit #16: Organizations experience stronger cash flow.

Conclusion

We’ve seen how automation in the healthcare industry can benefit patients, clinicians, support staff, and organizations. And we’ve seen the many forms of automation:

  • Computer programs of Robotic Process Automation
  • Wearable devices that leverage Remote Patient Monitoring
  • Artificial Intelligence applied to the diagnosis of moles and heart conditions

Now, we’re just getting started with automation in healthcare. UiPath estimates that RPA can positively affect 60 percent of the healthcare value chain. The average implementation time for these enhancements is 5.2 weeks, and the average ROI is 5.3 months.

Artificial Intelligence is also coming on stronger:

AI is only just beginning to change the way doctors see, diagnose, treat, and monitor patients. The potential to save lives and money is tremendous; one report estimates big data-crunching algorithms could save medicine and pharma up to $100 billion a year, as a result of AI-assisted efficiencies in clinical trials, research, and decision-making in the doctor’s office. – Wired

These developments are helpful, but they’re also becoming essential. We face challenges of continuing to provide quality healthcare with a healthcare workforce that isn’t growing as fast as the aging population. We will need more clinicians, not fewer. But the trend is against us, as evidenced by the fact that 21 hospitals closed in 2018.

Automation provides needed answers for improved efficiency and productivity, allowing fewer people to accomplish more work. With technology that speeds up and even takes over some of our human tasks, we can keep pace with society’s increasing healthcare needs.

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