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What to Know when Selecting the Right Automation Partner

Healthcare organizations will need to determine whether they build and manage robotic process automation themselves or require assistance from a strategic partner and expert in the field.

Revenue cycle management with automation

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Sponsored by Cloudmed

- The market for robotic process automation (RPA) has exploded in recent years as healthcare organizations seek increased efficiency and improved customer experience, particularly as it relates to the revenue cycle.

According to current projections, the global RPA market will increase by billions of dollars over the next decade. This crowded market and a wide variety of choices can make the process of choosing the right RPA partner complex and confusing for health systems and hospitals. Further, providers must also identify the proper balance of internal and external support required to implement, maintain, and optimize their use of RPA.

As noted in the first installment of this three-part series on RPA in healthcare, there are myriad opportunities for RPA to have a significant impact across the revenue cycle. However, recent RPA research showed that despite optimism around automation, barely half (51%) of hospital and health system leaders have adopted RPA technology. Interestingly, across all  survey respondents, , only 7% consider themselves to be “mature” in their automation journey — confirming that healthcare organizations still have a long way to go in knowing when, where, why and how to apply automation.

To enable a future-ready revenue cycle, healthcare organizations will need to determine whether they build and manage automations themselves, or require assistance from automation vendors and experts in the field.

The 3 Different Models for Adopting RPA

Healthcare organizations have no shortage of options when working with RPA technology, each with their own strengths and weaknesses. Providers are by no means forced to choose only one, with some able to automate simpler processes on their own, while employing a full-service partner when addressing complex revenue cycle-specific tasks. Altogether, organizations have three main options:

Automation as a platform, DIY implementation

Under this approach, a healthcare organization purchases the RPA software from a vendor, trains its team, and writes bots to automate processes. On the positive side, the organization owns or leases the technology and controls how they use it. However, this approach relies on revenue cycle and IT staff for all bot creation — a critical challenge, particularly with healthcare organizations grappling with workforce shortages and/or competing IT projects. As a result, this model can lead to delays and prevent the organization from proving the value of the RPA investment quickly. What’s more, RPA software may be hard to use out of the box and requires bot maintenance, which can be significant when automation touches multiple systems (EHR, payer portals, AP or billing systems, etc.).

Automation as a platform with an advisory partner

By taking this approach, a healthcare organization purchases the RPA software and trains a few members of its team, but also has access to experienced implementation resources, often from consulting firms. The strength of this RPA adoption model comes from having control over the purchased or leased technology while being able to learn from other experts to shorten the time to value. That said, the organization is unlikely to build up its competency internally, relying heavily on third-party support for technical expertise. Additionally, that expertise might be limited, expensive, and/or insufficient to the task of identifying aspects of the revenue cycle most ripe for automation.

Automation-as-a-service

In keeping with technology trends across multiple industries, healthcare organizations can also benefit from using a full-service provider. In this scenario, an organization signs a contract with an RPA vendor who will identify, design, develop, maintain, and optimize bots over the life of the contract using their proprietary RPA software. The benefits of automation-as-a-service are threefold. First, a service contract focused on specific revenue cycle process areas to automate helps healthcare providers prioritize revenue cycle tasks with the greatest value. Second, the vendor provides deep and proven expertise. Third, the model delivers dedicated maintenance to quickly update bots when changes occur.

The downside of this model is that the organization does not own the technology and is dependent on the RPA vendor for ongoing support and maintenance. Likewise, the automation-as-a-service model has contributed to significant automation “noise” from vendors with overly narrow and specific use cases. Therefore, it is important to select a partner that can meet multiple automation requirements to help organizations scale, rather than a patchwork of automation vendors and products for different parts of the revenue cycle.

Tips for choosing the right RPA partner

Choosing the right RPA partner is key for healthcare organizations to reap the benefits of automation. Considering the complexity of the healthcare system, an RPA partner that understands the industry, its workflows, and IT infrastructure will stand out from the rest.

“Some health systems bought into the idea that they can just buy a platform and use citizen developers to automate things within their organizations,” says Lynne Hildreth, Vice President of Workforce Automation at Cloudmed. “Having a partner that has revenue cycle knowledge is critical. Some organizations have gotten frustrated using experts with experience writing bots in retail or financial services, but when they hear healthcare terms, it’s all Greek to them.”

According to Cloudmed Vice President of Automation Matt Jarvis, subject-matter expertise is fundamental to knowing where and how to thoughtfully apply automation, particularly in the nuanced world that is the revenue cycle. “We want organizations to take a step back and think about the problems they’re trying to solve, and then decide which tools in the toolbox to pull out,” he explains. “Knowing where to start is vital.”

Beyond having deep revenue cycle expertise, a qualified RPA partner should be able to demonstrate how they can safely and effectively integrate automation directly into an organization’s IT systems. Healthcare organizations have spent millions, if not billions of dollars, investing in EHR technology, and automation can help optimize that investment, enabling a resilient, future-ready workforce.

“Having a partner that’s going to invest the time in understanding your specific IT configuration and adjust to it is highly important,” Hildreth notes. “A great automation partner is going to work well with whatever you’ve got to automate as opposed to applying their hammer to every nail.”

To help healthcare providers make the best RPA choice for their organization, Hildreth and Jarvis recommend answering the following questions:

  • What is the best automation strategy for us: DIY, automation with an advisory partner, automation-as-a-service, or a hybrid approach?
  • Which partners will understand our business, processes, and where the biggest impact will be?
  • Which partners have experience implementing and integrating automation with our existing technology?
  • Does the partner have a deep bench of experts in the revenue cycle?
  • Will the partner be around to ensure the results are achieved?
  • What are the measurement models used to determine where automation is driving value?

Successfully navigating a crowded RPA market will require healthcare organizations to think carefully about their bandwidth for managing automation independently. Right now, the workforce is king, and organizations are feverishly pursuing solutions to build sustainable financial and staffing models. Solutions like RPA are a significant component of a long-term strategy, and as leaders invest in their automation journey, they must be prudent in selecting the right automation partner to solve the needs for today and the future.

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Cloudmed, a leading provider of Revenue Intelligence™ solutions, partners with over 3,100 healthcare providers in the United States and recovers over $1.7 billion of underpaid or unidentified revenue for its clients annually. We are unique in our ability to utilize industry-leading expertise and the powerful CloudmedAI™ Platform to help providers boost productivity and increase revenue. Cloudmed was awarded 2022/2021 Best In KLAS: Robotic Process Automation and 2021 Best in KLAS: Revenue Integrity/Underpayment Services. Our solution suites have HFMA Peer Review status and are HITRUST certified. To learn more about where healthcare leaders are on their automation journey, visit https://go.cloudmed.com/rpa-infographic-2022. For more information about Cloudmed, visit www.cloudmed.com.