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Robotic Process Automation ​​For CHIME/HIE Integration

SphereGen Case Study

A not-for-profit area hospital partnered with SphereGen to automate its error correction process for HIE integration to CHIME. The end process saved thousands of hours of backlog transaction processing and ongoing savings of multiple hours per month.​

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Robotic
Process Automation
​​For CHIME/HIE Integration

SphereGen Case Study

A not-for-profit area hospital partnered with SphereGen to automate its error correction process for HIE integration to CHIME. The end process saved thousands of hours of backlog transaction processing and ongoing savings of multiple hours per month.​

uipath silver partner badge

O V E R V I E W

Our Hospital client participates in a Health Information Exchange (HIE) program through CHIME (College of Healthcare Information Management Executives). EHR information is uploaded monthly. If any data is erroneous, the record is rejected from the upload and must be resolved manually for resubmission to fulfill compliance guidelines.

The resubmission process is time-consuming as each record must be researched in CHIME, which can mean scrolling through hundreds, sometimes thousands, of account numbers to find the matching transaction. The CHIME resubmission process became overwhelming with a large backlog of work. With the development of an RPA automation, bots could cycle through the backlog of records and clean up data that had been sitting for months. The automation saved over 5,000 hours of manual work.

Challenges

Rejected CHIME data, uploaded monthly, had to be manually corrected and resubmitted for approval. The process for resubmitting this data is very labor intensive, requiring hours of manual work. The research for finding the matching CHIME record and correcting the data could take as much as 5-7 minutes per transaction, depending on the type of error. The backlog of unsubmitted data grew, especially during COVID, as all hands were on deck to meet the demands of the pandemic.

SOLUTION

SphereGen created a UiPath automation that processed each flagged transaction, found the corresponding transaction in CHIME, corrected the erroneous data, and reset the auditing flags for CHIME. ​This automation resolved 90% of the erroneous data.

RESULTS

Man Hours
Saved

0 +

Transaction Processing Time Reduced from 5-7 Minutes to 2.5

0 +%

Staff Able to Focus on Optimizing Patient Process

0 X

THE DETAILS​

Manual Process

Every month, data is submitted to CHIME as part of an HIE initiative. Rejected data is aggregated in data files, noting the cause of the rejection. The data is corrected in CHIME to maintain compliance standards.​

For this use case, the customer focused on CHIME 999 errors – invalid CPT/HCPCS code or CHIME 242 errors – invalid provider number. A full-time employee had to manually look through hundreds of transaction records in CHIME to find the corresponding transaction for a patient. This work was extremely taxing as the account or Bill numbers are multiple digits and not easily identifiable in a list of hundreds of records. Once found, invalid data was corrected. The total time to process each transaction was 5-7 minutes.​

Automated Process

SphereGen was able to automate 90% of the process by auto-correcting CHIME data when there is a one-to-one match for the data in error. ​

The automation reads through the rejected CHIME transactions. The Bill number is used to retrieve the appropriate records in CHIME through their Encounter process. If the retrieval is successful, the proper HCPCS or provider code is updated, the Encounter process completes, and the CHIME transaction status is marked complete.​

If the retrieval of the CHIME record is not successful, as might be the case for older transactions, then the CHIME transaction status is updated as Incomplete. These transactions must still be researched and handled with manual updates.​

CONCLUSION

When processed manually, the time required to complete each transaction correction took upwards of 7 min per transaction. The automation can retrieve, correct and resubmit each flagged transaction in 2-2.5 minutes. Additionally, the Bot can continually run 24/7 to keep processing back errors, significantly reducing the transaction backlog.​

The estimate is that this automation saved roughly ~5,000 person-hours in correcting transaction backlogs​. As it runs monthly, the automation saves 10-15 hours/month. ​

The apparent benefits of this automation allowed for significant time and money savings for the hospital. However, the savings which are not so easily measured but equally as important are the benefits of relieving staff of hours of tedious work. For a Hospital, the staff is free to handle more demanding tasks, resulting in improved patient care.​

Using UiPath technology to integrate with legacy systems and custom-built workflows, SphereGen was able to help our hospital client make scalable, impactful business changes with little disruption to current processes. Our client has freed up hours on paperwork to focus on making operations run more smoothly to serve their patients better.

TECHNOLOGY USED

  • UiPath RPA Studio and Orchestrator
  • Visual Basic – VB.net

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