Healthcare’s Quadruple Aim was suggested as a framework to optimize healthcare system performance. The four areas it speaks to are:
1. Enhancing patient experience
2. Improving population health
3. Reducing costs
4. Improving the work life of health care providers
The question that all industry experts struggle with is how to achieve these goals? How can technology play a part?
The healthcare industry is renowned for the many administrative processes it deals with on a daily basis. Unfortunately, most of these procedures are manual, paper-based, time-consuming, and prone to errors, making it a painstaking activity. A simple visit to a doctor, submission of a referral form to a specialist, or scheduling of a medical procedure can trigger cumbersome paperwork that only starts the process. Healthcare organizations need a way to manage these workflows in an efficient, cost effective, streamlined manner to improve their operations. By implementing automation technologies, healthcare providers can decrease administrative burdens and eliminate paperwork-related errors while significantly optimizing their employees’ productivity, allowing them to focus on higher value activities.
Manual, paper-based processes have multiple challenges.
1. It’s expensive. Printers, toner, paper, and time are estimated to be an organization’s third largest expense, with payroll being first and rent second.
2. It’s cumbersome. Paper stacks up, gets misplaced, and takes up valuable office space.
3. It’s insecure. Paper can easily be stolen, copied, or faxed by the wrong people.
4. It’s inefficient. In most cases paper needs to be manually input into the EHR, wasting valuable time and opening the opportunity for mistakes.
5. It’s not easily communicated. Paper needs to be mailed, faxed, or scanned in order to be shared. This also opens the possibility of mistakenly sharing with the wrong people.
6. It’s not conducive to good healthcare. When patient information is spread across paper files, handwritten notes, PDFs and digital content that reside in multiple locations, it makes it difficult for clinicians to have a full understanding of patient history, which could result in worse medical outcomes.
Manual processes heavily rely on a well-trained and experienced staff working around the clock to ensure that the process runs smoothly without any disruptions. The absence of these dedicated individuals can certainly compromise the effectiveness of the entire system. It’s important to note that even with such a staff in place, success isn’t necessarily guaranteed. The sheer volume of paperwork present in healthcare often makes it impossible to stay on top of the demand.
At healthcare facilities, the number of patients and procedures, combined with the requirement of completing multiple, and often redundant, forms, are causing major setbacks due to the staffing crisis enveloping this sector. This often translates to an inability to pursue referrals, long queues of forms waiting to be manually entered into the system, medical professionals taking work home with them to be completed outside their regular work hours, and the aggravation of delays in submission of services to be reimbursed by insurance providers. These further culminate in medical errors resulting from inaccurate coding, which often result in insurance denials, the need to resubmit claims, incorrect invoicing of patients, frustration by both provider and patient, and eventually declining medical practices.
As healthcare organizations seek to improve their operational efficiency, it’s crucial to evaluate the consequences of their current procedures. Frequently, existing manual and time-consuming processes overburden employees, engendering a marked increase in operational expenses and, ultimately, a strain on profitability and revenue loss for the facility. However, there is a path to consider that can bring significant change: the transformation of these manual procedures into automated, streamlined digital processes. With the power of innovation and technology, healthcare organizations can improve employee working conditions, dramatically increase productivity and achieve higher returns with less operational overheads.
We’ve all heard the term “digital transformation.” This is a very popular term in healthcare and it can mean different things to different people. However, at its most basic level, as a provider, if you recognize that change within your organization needs to take place and you agree that technology can be an effective instrument to effecting change, the next step is determining where that change needs to occur, and which technologies make the most sense for your organization. Today’s automation tools can be very effective in enhancing the amount of work a team can complete, often resulting in an increase of 35% to 50%. Leveraging these tools enables staff to work much faster, and can reduce data processing times by as much as 30% to 50%. With the efficiency improvements, healthcare organizations can achieve significant cost savings of 25% to 50%, leading to higher profitability. But it doesn’t end there. Employees are less taxed and experience better working conditions, Patients aren’t frustrated by having to fill out the same forms every time they visit a physician and their bills are correct. Digital transformation may begin by focusing on one issue, but it often results in solving multiple challenges in multiple areas of your organization.
Peeking behind the healthcare curtain
It is important to consider the intricacies of a healthcare provider’s administrative responsibilities and what they do for every patient every day. Automating certain processes can significantly reduce costs, improve accuracy and staff efficiency, which in turn enhances the satisfaction of all stakeholders involved. These are just a few examples of the processes that can be greatly improved with automation:
|Check bed and doctor availability and respond to patients quickly, resulting in a boost in admission rates.
|Schedule appointments according to diagnosis and doctor availability.
|Obtain approvals prior to or during patient admission to confirm patient coverage.
|File a claim and audit to ensure no claims are overlooked to minimize denial rates.
|Ensure compliance with discharge instructions.
|Reduce delays by calculating the bill amount, what’s been paid by insurance, and notifying the patient through an Explanation of Benefits (EOB) for expedited payment.
|Process invoices; scan pricing and availability of products commonly used in a healthcare facility.
Workflow automation can be highly beneficial for businesses apart from reducing cost, enhancing the accuracy of information, and improving worker efficiency. Here are some other advantages:
Reduced compliance risk: Automation helps ensure that all workers comply with industry regulations, reducing vulnerability by lowering the risk
of costly errors.
Automation tools ensure that sensitive data is only accessible by authorized personnel, reducing the chances of unauthorized access.
Improved quality of care:
By automating critical procedures, increasing communication of patient information to clinicians’ healthcare organizations can improve the quality of patient care and eliminate the risks of errors.
Since employees get more time to focus on value-adding activities, the workload on them is relatively less, which can result in boosted morale.
Enhanced patient experience:
Automation allows for less frustration and faster and reliable care, making it easier for patients to receive timely assistance and increasing patient satisfaction.
Drive interoperability between disparate systems: By connecting different software applications, automation tools support organizations to interact with different systems and software applications more effectively.
Improved revenue cycle operations:
Automation of revenue cycle management activities can provide immediate improvements in cost reduction, elimination of human errors, increased employee satisfaction, and a better patient experience.
At the forefront of many organizations, including healthcare providers is the movement towards automation. The drive for automation can originate from executive leadership or trickle up from departments that are faced with arduous processes. By utilizing workflow automation, time-consuming tasks can be expedited, resulting in real ROI from simplifying inefficiencies and streamlining for speed.
In particular, the COVID-19 pandemic has highlighted the necessity for digitization and the adaptation of hands-on processes to digital ones due to the lack of available personnel. This pressing need has continued beyond the pandemic, prompting healthcare providers to recognize the importance of back-office assistance to remain competitive.
Thankfully, intelligent information management (IIM) solutions have emerged as an answer, presenting the tools necessary to make digital transformation a reality for healthcare providers. And while healthcare organizations will continue to work toward the objectives set forth by the Quadruple Aim, it is clear that technology can play an important role in achieving these goals.