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Automation — The Key to Efficiency in Healthcare's Digital Era

Since we’ve devoted the first three posts in our series on healthcare’s digital era to the foundations of the digital age, the role of analytics in the digital health era, and the value of design thinking in the digital age, we thought we should now turn our attention to the power of automation in healthcare. Because in the digital age, nothing has more potential to increase efficiency and improve the member and patient experience than automation.

Need proof? Let’s take a look at the numbers.

Estimates show that health plans collectively spend a stunning $2.1 billion each year on inefficiently performed manual tasks – and that figure is for provider data management (PDM) related functions alone! Similarly, insurers spend $6 million to $24 million per year to remedy poor provider data quality. And these number don’t even account for fines associated with unmet regulatory requirements associated with inaccurate provider directory maintenance. (Source: Lexis Nexis).

But when assessing the costs of inefficient processes in healthcare, we can’t look at one function alone or limit our examination to the area of regulation.

The Scope of the Problem

The problem of inefficient systems that would benefit from automation is far-reaching, impacting all areas of healthcare operations; from PDM to claims operations, and from billing to customer support. Even though the financial losses we commonly think of when we think of operational inefficiencies are significant, they don’t give a complete picture of the true costs incurred when effective automation is not holistically deployed.

In fact, the Everest Group reports that in the next five to seven years up to 50% of all interactions will be done through automated channels. Organizations that don’t keep pace with this trend will experience more than yearly financial losses. Their competitive advantage will decline even as their ability to earn patient and member loyalty by providing an enhanced customer experience suffers.

Solving for Efficiency with Robotic Process Automation

Clearly, inefficient systems that rely on manual processes are no longer sustainable. In today’s digital age — when the need to increase efficiency, decrease costs and enhance the customer experience can be met by easy access to data and interoperable systems — there is no longer a reason to sustain them. Robotic process automation (RPA) lets your organization solve for efficiency in every area of your operations, so you can reap the benefits of cost savings, member and patient loyalty, and an ongoing competitive edge even as the regulatory landscape and healthcare market continue to evolve.

RPA increases efficiencies by eliminating the need for personnel to perform standardized, rote tasks…but it also does much more than this! Indeed, when used to its fullest potential, RPA leverages software robots to automate even complex processes and actions that require judgement.

Because RPA has dynamic self-learning and predictive capabilities, it can be used to increase efficiencies in both rote and complex operations, streamlining back and front office functions including:

  • Eligibility, billing and enrollment
  • Claims administration
  • Revenue cycle and finance functions
  • Data management
  • A variety of administrative actions

RPA: Your gateway to success in the digital health era

By fully automating processes that currently rely on manual interventions, you will realize not only short-term financial rewards – automation is more affordable than manual intervention – but also the organizational flexibility you need to push toward the leading edge of healthcare in the digital era. As manual process are reduced, personnel can be reassigned in a more intentional way, ensuring that they are focused on the high-level tasks suited to their abilities and in keeping with a more satisfying employee experience.

And that flexibility you gain will increase as cost savings accrue over time, allowing you to shift employees to the positions where they can more fully enhance the member and patient experience as the automation process reverberates throughout your entire organization.

The end result? More satisfied and effectively deployed personnel, more efficient processes, and an enhanced experience. And that is why automation is your gateway to success in healthcare’s digital age.

To discover how Sutherland partnered with a top five health plan to deliver 17 separate automation solutions and saved 3,300 hours of manual claims processing hours. Or, to learn about how Sutherland helped plans in California use automation to meet rigorous state compliance requirements and thrive in the digital age, click here.

Want to find out how Sutherland can help you leverage automation to increase efficiencies and open up new opportunities for success in the digital era? Contact us at healthcare@sutherlandglobal.com.

Up next? The fifth and final installment in our direction of digital healthcare series: a deep dive into Sutherland’s unique role as a thought leader and foundational player in healthcare’s digital age.