IPA in Healthcare: Our Year to Catch Up

By Pavani Munjuluri, Co-Founder, COO, CognitiveHealth
Twitter: @CognitiveHlthIT

When it comes to intelligent process automation (IPA) in healthcare, multiple stakeholders drive technology adoption. Payers, providers and patients all bring their own unique interests and perspectives on how healthcare should operate and in what areas IPA should be used.

To complicate matters, the healthcare industry remains risk averse. Changes take much longer to finalize and implement than in other industries such as banking and retail where IPA is already leveraged for customer acquisition and retention, manufacturing, supply chain, etc.

Healthcare has much catching up to do in the area of IPA. Healthcare workflows that incorporate routine tasks, are highly repetitive and encompass large volumes of transactions are ideal for IPA. I propose that 2021 is the year that healthcare accelerates the adoption of IPA, one step at a time.

Three Smart Steps to Take Now
There are many processes in healthcare fertile for automation. Savvy healthcare technology leaders should focus on three particular areas for IPA implementations in the year ahead: front, back and mid-office revenue cycle operations.

Front-End: Patient access, front end registration processes, and point of care physician support areas are already making advances in IPA. However, there continues to be room for improvement as functions are now performed by a remote workforce.

Mid-Office: Multiple systems and applications still slow down mid-cycle processes. Large numbers of staff are needed to navigate screens, intake data generated by the front-end workflows, assign codes and generate bills to collect revenue.

Back-End: Providers are under constant pressure to meet performance metrics such as cost to collect, denial rates or outstanding accounts receivable days. These processes are very repetitive in nature and are driven largely by business rules making back-end revenue cycle processes ripe for IPA.

Consider IPA as a wrap around on existing applications to bring the next level of efficiencies and effectiveness to healthcare processes.

Case in Point: Cash Reconciliation and Correspondence at Yale-New Haven Health
Yale-New Haven Health started their IPA journey with the back-end process of cash reconciliation. The first step in the process involved staff members reconciling bank statements with remits received from payors and reports from the RCM module in their EMR (in this case Epic). The dollars were then balanced and any account with an outstanding balance was reviewed and reconciled. With the application of IPA, the first two steps in this process are now automated and human intervention is required only for the final step. The organization now saves up to 80% of manual efforts outside the EMR for this process.

The second use case at Yale-New Haven Health involves incoming correspondence. A significant volume of correspondence is received every day including overpayment letters, denial letters, approvals letters, etc. IPA systems are now used to read and categorize the correspondence received and move to the respective work queues. These are just two examples of how high-volume, repetitive revenue cycle tasks benefit from IPA in healthcare.

Evaluate Your IPA Options
Each organization is on their own unique journey to intelligent process automation. The organization’s culture for technological adoption and expectations from automation are significant factors.

As general guidance, organizations should secure buy in from both leadership and departments to adopt IPA. Look for quick wins to raise team confidence and solidify commitment for the journey forward. Where a solid EMR is already implemented, IPA systems are considered “digital employees” or “digital assistants” for operational teams.

Successful organizations also embrace an enterprise strategy for IPA. Automating workflows in silos is effective, but to achieve maximum benefits an enterprise view is recommended. Understand and document the benefits of automation in each process. It could be a clear effort savings, a reduction in errors, improved metrics or greater employee satisfaction.

IPA is here to stay. Every healthcare staff member wants to contribute and make a meaningful difference to the patients they serve. IPA helps teams achieve these goals by taking away repetitive transaction-based work. Furthermore, the technologies are rapidly evolving and becoming more effective by the day. 2021 is the right time to leverage and measure the benefits and successes of IPA in healthcare.

Check out this episode of The Tate Chronicles where host Jim Tate talks to Pavani Munjuluri, Co-Founder and COO for Cognitive Health IT, about the use of IPA in the Healthcare Revenue Cycle. Where we are today and experiences at Yale-New Haven Health.