The global response to the coronavirus pandemic is now almost a year old and the largest vaccination program in history has just started. When this pandemic started, healthcare organizations worldwide put focus on business continuity and operation rigor to balance the new way of work with the increasing COVID-19 cases in their emergency rooms.
In the July/August timeline, there was a considerable shift to future business integrity to improve cash flow and front line operations to keep hospitals doors open for the public. Healthcare systems globally looking for a fast and low cost solution adopted UiPath and quickly implemented automated solutions. Many organizations have reported a higher demand for software robots than they originally expected because uses for the robots extend beyond COVID.
As the world looks at health systems for vaccinations, public and private health systems worldwide are being presented with a growing number of new challenges. Just as health organizations looked to robotic process automation (RPA) to provide solutions at the beginning of the pandemic, healthcare organizations are now looking at RPA to support the human workforce that will be responsible to vaccinate whole community populations.
Process automation can be used in every aspect of healthcare operation but we are seeing a number of common themes:
Data transparency was the largest hurdle to overcome through the COVID pandemic. Avoiding prior mistakes, new platforms and APIs were prepared early to support vaccine rollout. However, older electronic medical record (EMR) platforms that cannot ingest API and human resource (HR) applications that aren’t integrated still require manual intervention. Automation has been used heavily to automate the entry of data into government web portals to improve accuracy and meet compliance timelines.
A great example of maintaining data confidentiality and segregation with automation can be seen at the European Medicines Agency (EMA). Working together with the pharmaceutical industry and European Union (EU) countries, in April 2020 EMA launched the first phase of its enhanced monitoring system to help prevent and mitigate supply issues with crucial medicines used for treating patients with COVID-19.
The software robot implemented at EMA assists in the monitoring and reporting processes, collecting relevant information, and performing necessary updates. With automation, EMA has reduced the time spent on manual processes from 40 days to 7.4 hours. It has also eliminated the lengthy, error-prone manual work for template customization and information gathering from multiple sources.
Other common healthcare automation use cases we’ve seen during the pandemic include occupational health vaccination updates for state employees, clinic state vaccination records for first responders and teachers, and vaccine batch tracing updates.
In the United States (U.S.), we’re working with a state health and human services (HHS) department looking to automate the state occupational health web database for its 180,000 employees to meet the 24-hour COVID reporting requirements.
Health systems have made significant investments in digital front door solutions like Direct Schedule, MyChart, and Swiftqueue to manage the registration of vaccination requests from the public. However, many organizations do not have Epic (healthcare software) or have not invested in a digital front door solution. Web portals and event platforms like Eventbrite are being used to connect the public to vaccination centers. These platforms require back-end data entry followed by clinical coordination to register and communicate with the patients. Automation is being used to keep web portals and registration in sync, with many of the software robots creating new medical record numbers (MRNs) and looking for duplicate patient profiles.
There is a growing demand for outreach solutions that include automated interactive voice response (IVR) registration and communication points.
RPA related to pandemic vaccination scheduling can assist with global prioritization, rule validation and audits, vaccine appointment registration via IVR, creating MRNs for patients receiving vaccinations, and chatbot-integrated solutions.
For example, a global health system (with more than 11 million patients) is implementing a multichannel automated solution that includes a chatbot for the 24-40 age demographic and an IVR communication solution for the 40+ age demographic and multi-language citizens.
The paper record that will be distributed to every citizen will be managed differently by geography but unlike mass vaccinations of the past, this COVID vaccination record will have a digital record behind it in case you lose it. The digital vaccination records will be recorded but portable access is becoming a growing concern as employers and airlines are proposing vaccine verification.
Digital solutions like MyChart will be available but vaccinated citizens who are not part of the health system that vaccinated them will not have immediate access. Phone lines are already at peak volumes with citizens looking for a vaccine, and concerns are growing that future call volumes will be replaced by citizens looking for their digital vaccination records. Automation is being used to help activate and communicate access to these vaccination records.
For example, process automation can be used in MyChart and public health chart activations and activation outreach to increase adoption of the digital chart system.
One U.S. hospital system is working to automate the MyChart activation during vaccine appointments for an expected 500,000 out-of-network patients. Reminders for the second COVID vaccination doses will be communicated to people via automated text and IVR reminders to drive adoption.
Global providers have one common goal: to vaccinate as many people as fast and safely as possible in each roll out phase. Mass vaccination locations are being established to handle 800-1,000 people per day and with an average 30 minutes for each appointment time, the number of on-hand staffing needs is large. Many organizations are looking to volunteers and first responders to support tasks such as check in, eligibility checks, and account activation. Training for these processes can be three to five hours and compliance will impact wait time and downstream processes.
Health systems are looking at automation to streamline the end-to-end process, starting with the check in to reduce wait time and improve data quality.
Automation can assist with guided check ins, single-form data entry, and one-click patient account activation. One U.S. hospital is looking at attended automation with UiPath Forms to build a single check-in tool for volunteers. This guided tool will reduce the need for hours of training and automatically update the back-end platforms.
Allocation management is a global issue as organizations work daily to find the personal protective equipment (PPE) their employees and clinicians need to work every day. At the height of the COVID pandemic, organizations automated their special request processes to adjust available PPE volumes before the day started so that research into substitute sources could be done proactively. Organizations that did not automate this or are now pulling back from third-party vendors and looking at how to manage future vaccine allocation requests.
RPA can assist with vaccine supply chain management by automating special request allocations, integrating vial/batch data reporting and manufacturer reporting.
For example, a global hospital has recently automated their special request allocation reporting for PPE and future vaccine allocation requirements. The automation has reduced PPE inventory cycle time by almost one full week.
Globally, the public will not be responsible to pay for the vaccine for the four-phase roll out. However, in the U.S., providers can seek reimbursement for administration costs with the health insurance companies or through the CARES Act for non-insured patients. Many organizations are seeing an increase in claim edit 230* occuring when submitting the claim to the payer. Normally, due to incorrect coding, automation can easily audit and correct this coding mistake proactively or reactively when the code error occurs. The manual process is not difficult, but the frequency and volume adds up to significant labor requirements.
For example, one U.S. health clinic has built an unattended robot that works from the daily edit report to resolve and resubmit the claim when edit 230 occurs for COVID vaccinations.
UiPath automation platform has become a necessity for many health organizations because it has a very low barrier to entry, fast development time, and has no sunk cost risks. A big misconception is that development requirements are large and short-term spend is a future sunk cost. Global providers are often surprised to see that UiPath attended robots can be implemented in a day and solutions can be delivered in a few days with testing. As a digital workforce, the robots can be reassigned to other work, making every RPA investment a long-term value and not a cost.
*In the U.S., the claim edit 230 is a rejection that occurs when a digital invoice is submitted to an insurance payer. The edit happens when the code doesn't match up with the diagnosis. This seems to be happening a lot due to the way COVID vaccines need to be claimed at the moment. If the rejection occurs, a person must review the invoice (and rejection), fix the issue, and resubmit the digital invoice. Healthcare organizations I’m speaking with are expecting the volumes of claim edit 230 instances to vastly increase in the near future.