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Hesitant to Implement AI? Start Small using Intelligent Automation in Non-Clinical Processes

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When the topic of conversation turns to using AI, it is not unusual to hear voices of concern and apprehension about implementing this technology. Worries relate to loss of data privacy, staff replacement, liability, and important decisions being made based upon data that has not been certified—expanding the possibilities for error. When it comes to using AI in healthcare, those concerns have become extremely prevalent as we now talk about the quality of medical decisions and patient outcomes.

These concerns are valid and should remain at the forefront of every conversation involving the use of AI. However, these concerns should not stop the conversation.

AI is and will continue to be part of our everyday lives – and AI is already helping healthcare organizations process data more effectively, leading to improved patient experiences and overall efficiencies in business processes.

So how do you cross that bridge of overcoming the hesitancy of implementing AI to begin  realizing the benefits that it has to offer? We advise that you start small, in business areas that improve patient experiences and organizational benefits. Your organization will realize the benefits of AI without affecting clinical processes or patient care. Once you become more comfortable with the technology and its abilities, then it may be time to branch into applying AI in clinical areas.

We will talk about the gains achieved by applying AI to business processes using Intelligent Automation, citing specific use cases that benefit healthcare.

Why start with Automation?

Organizations have been using tools to automate processes for years. Multiple industries, including healthcare, have substantially benefitted from Automation in terms of time savings, cost savings, and increased staff morale.

What has changed in the last few years, however, is that AI is now built into automation tools to make them more autonomous. Tools are easier to use and process data more effectively. Implementing Intelligent Automation with AI is a direct foray into adopting AI technology. Starting small by automating a few processes garners success with AI, without causing major disruptions in the organization – a great start on your AI journey.

How AI has transformed Automation

Having the ability to process and extract meaning from unstructured data is what makes AI such a powerful element in Automation tools. AI can use a combination of images, text, and audio to identify patterns so data can be categorized and analyzed.

Intelligent Document Processing (IDP) is an AI technology used to read and process documents in any format. Prior to AI, the document would have to be defined to the Automation tool, specifying data location and identifiers. Due to AI, definition of the document is no longer required – keywords are used to pull the desired data. As more documents are processed, the tool’s proficiency in recognizing data improves. This includes data in handwritten and typed formats.

This same type of logic is used for reading computer screens. Computer vision can read a screen identifying data elements. This allows an Automation tool to find fields on a screen and automate data entry. As with IDP, the action of AI identification allows automation processes the flexibility to respond to screen changes without having to recode and regenerate the automation.

Process and Task Mining are also born out of AI engines. These tools analyze business process events to identify the process flow. The study of these flows supports discovery and insight of potential inefficiencies and opportunities for optimization. They also identify candidates which are ideal for automation.

Automation is a powerful tool on its own, providing the opportunity for staff to forgo low-level work so they can focus on strategic tasks which improve patient experiences. With the incorporation of AI, time and cost savings are amplified allowing process automation to serve as an extremely effective advantage in business.

Understanding the Benefits of AI and Automation in Healthcare

Relief of Work Burdens/Staff Shortages

Overcoming the challenge of staff shortages and burnout is a top priority in healthcare. Intelligent Automation satisfies those priorities by eliminating or reducing tasks and improving operational efficiencies. Task shifting provides more time in the day for staff to focus on strategic work, relieving the total burden of daily deliverables.

Improved Patient Experience

Automation improves patient experiences in multiple ways. Task shifting allows staff to center efforts on the patient instead of the paperwork. The ability of AI and Automation to pull information from multiple sources provides staff with tangible answers more quickly. Efficiencies streamline operations resulting in faster resolution of patient billing and claims processing.

Interoperability/Streamlined Operations

When implementing Automation, the predominate goal is to integrate systems and improve interoperability. IA is perfect therefore, in bridging communications between EHRs and other internal or third-party systems. Operations are streamlined saving days of data entry and processing time.

Accuracy

Elimination or reduction of data entry removes the opportunity for input error. Accurate data increases efficient processing.

Improved Staff Morale

When all the above benefits are realized, staff have the bandwidth to effectively tackle their work, leading to healthier work environments and happier staff.

Cost Savings

For healthcare organizations, these benefits result in substantial ROI and increase competitive advantage. Organizations who have implemented AI and Automation are saving up to hundreds of thousands of dollars a year.

Healthcare Use Cases for Automation

Below are just a few of the processes which can be automated in healthcare. For each use case the achieved benefits are rated.

USE CASE

TIME SAVINGS

TASK SHIFTING

STAFF MORALE

COST SAVINGS

Eligibility Verification

All data required for Eligibility Verification is pulled from multiple systems and submitted. Only exceptions require human intervention.

 

HIGH

HIGH

HIGH

HIGH

Denial Follow up

Rejected claims are continually corrected and resubmitted. Many denials are converted with no human intervention.

MEDIUM

MEDIUM

HIGH

HIGH

Cash Posting/Claims Clearing

Adjustments for insurance auto applied, exceptions are flagged and reported for review.

HIGH

HIGH

HIGH

HIGH

EOB Remittance Posting

Remittance Receipts auto posted with inputs from multiple systems.

MEDIUM

MEDIUM

HIGH

MEDIUM

CHiME/HIE Rejection Resubmission

CHiME 999 and 242 errors are corrected and resubmitted to resolve error backlog.

HIGH

HIGH

HIGH

HIGH

ICD Code Correction and Resubmission

Rejected codes are corrected and resubmitted for processing.

MEDIUM

MEDIUM

HIGH

MEDIUM

Prior Authorization

Automate data retrieval from multiple sources and submit requests

HIGH

HIGH

HIGH

HIGH

Data Migration

Automating data migration tasks eliminates rekeying of data, improving accuracy and speed of conversion.

HIGH

HIGH

HIGH

HIGH

Moving Toward AI Application in Clinical Use Case

The possibilities which are and can be achieved with AI are astounding. However, organizations struggle with the decision of bringing AI into their daily operations. In healthcare, studies show that both doctors and patients show reticence in relying on AI to source medical data and guidance. Some of this reticence is in regard to the transparency of AI-sourced data used in making clinical based decisions. Doctors want to ensure that the content they receive is from an AI tool trained by medical experts and professionals.

That is why we feel it is important for healthcare organizations to start their AI journey through business processes. The strength of using AI and Intelligent Automation in this realm is to begin realizing the benefits of AI operationally, with data that is more concrete and not open to interpretation.

Applying AI to non-clinical processes through Intelligent Automation will get organizations ready to apply strategy, preparation, governance, and oversight which is needed for AI implementations. Once an organization is comfortable operating with a level of AI, the journey to progress to clinical applications becomes less overarching.

Conclusion

By starting on a smaller scale and investing in AI and Intelligent Automation to improve non-clinical operational efficiencies, healthcare organizations begin their AI journey. Although the initial investment starts small, the benefits gained can be substantial and improve patient experiences, staff morale and overall effectiveness – a journey definitely worth starting!

SphereGen logo on white backgroundSphereGen is a unique solutions provider that specializes in cloud-based applications, Intelligent Automation, and Extended Reality (AR/VR/MR). We offer full-stack custom application development to help customers employ innovative technology to solve business problems.

Learn more about what we do in IA: https://www.spheregen.com/intelligent-automation

SphereGen logo on white backgroundSphereGen is a unique solutions provider that specializes in cloud-based applications, Intelligent Automation, and Extended Reality (AR/VR/MR). We offer full-stack custom application development to help customers employ innovative technology to solve business problems.

Learn more about what we do in IA: https://www.spheregen.com/intelligent-automation

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