The healthcare industry is a complex ecosystem of interconnected clinical, administrative, regulatory, and revenue cycle workflows. Despite the widespread adoption of health information technology and the availability of modern artificial intelligence, inefficiencies persist. In the rapidly evolving world of healthcare, the key to success lies in recognizing the impact of health information technology on both clinical and administrative workflow. To accelerate workflow automation in healthcare, let’s analyze these inefficiencies and explore opportunities for automation:
- Inefficient workflows affect many healthcare stakeholders including patients, caregivers, clinicians, and administrative staff
- Digitized paper-based workflows that simply copy how a paper-based workflow is performed have led to an ecosystem that contributes to burnout and impedes the full use of technology to optimize patient care through the use of automation
- Inefficient workflows are a pervasive problem that affect everyone in health care, including clinicians facing burnout due to managing care delivery tasks, patients trying to achieve better outcomes, and administration buried in paperwork
Reducing Administrative Burden Through Workflow Automation
A recent study highlights the potential of AI in transforming administrative processes in Medicaid, a joint state-federal benefits program. The administrative burden in such programs is high, with estimates of administrative spending ranging from 15% to 30% of total healthcare spending. This burden, characterized by non-clinical spending such as billing and insurance, is seen as unsustainable. However, the advent of AI and associated technologies promises to reduce this administrative waste and increase efficiency.
- Administrative spending constitutes a significant portion of overall healthcare spending, with recent estimates reaching $1 trillion annually
- A large number of non-clinical staff perform routine or repetitive tasks that could readily be automated
- The potential savings from automating these tasks using existing AI technologies could be as high as $200-$360 billion in healthcare spending over the next 5 years
While AI holds immense promise, it’s important to note that the technology may not be ready for fully autonomous implementation. Instead, Generative AI could be deployed to complete manual tasks such as classifying a document or indexing the patient in the document – reducing the need for manual data entry while keeping a ‘human-in-the-loop’. Advancing workflow automation in healthcare by automating routine tasks, healthcare providers can significantly reduce waste and improve efficiency. This includes everything from patient scheduling of referrals, to managing medical records, to reducing manual data entry. Automation through Gen AI can reduce errors and free up healthcare professionals to focus on patient care. Addressing these inefficiencies is not just about improving processes – it’s about transforming the healthcare system. By embracing workflow automation, we can make strides towards a more efficient and effective healthcare system.
The Financial Impact of Not Automating Workflows
Let’s take the example of a Cardiologists office that primarily sees patients through referrals from primary care physicians. The cost of losing a patient referral for a cardiologist can be significant, but it’s difficult to quantify precisely as it depends on various factors. These include the type of services the patient would have needed, the number of visits the patient would have made, the patient’s insurance coverage, and more. However, consider the financial impact of a lost referral:
- The cost of an initial consultation with a cardiologist can range from $200 to $500, and follow-up appointments can cost between $100 and $300
- If a patient is referred to a cardiologist, they typically visit at least two to three times to receive a proper treatment plan, have all the tests taken, and recieve a diagnosis
- This could bring the total costs, with tests, closer to $800 to more than $3,000
In the United States healthcare system, more than 100 million specialist referrals are requested each year in the ambulatory setting. However, only half of these are completed. The incomplete referrals often result from process errors such as missing information and communication failures. These breakdowns in the referral process can lead to delays in diagnosis and treatment, and lost revenue. Approximately 50 million referrals could potentially be lost each year due to document workflow errors!
Workflow automation powered by Gen AI is the solution to these challenges. By automating routine tasks such as document classification and routing, primary care providers can significantly improve efficiency. Imagine using Gen AI to route the right document to the right staff member in seconds, not weeks. Improving the referral process is a critical aspect of enhancing patient care and safety in the healthcare system and could dramatically increase revenues for the clinical practice that implements automated workflows.
Navigating the Regulatory Labyrinth with Workflow Automation
In today’s complex business environment, ensuring regulatory compliance is a constant challenge. Hospitals and clinics of all sizes must navigate a constantly changing landscape of healthcare laws, regulations, and interoperability standards. The secret weapon to tackle this challenge? Workflow automation in document management systems. Workflow automation can be a game-changer to not only improves regulatory compliance but also mitigates risk. Here are some ways it can help:
- Automates document review and approval, ensuring timely reviews and required approvals
- Tracks changes to documents, ensuring the most up-to-date version is always used
- Generates workflow history with audit trails, helpful in demonstrating compliance with regulatory requirements
- Sends notifications to stakeholders when documents are created, modified, or approved
Beyond the specific benefits listed above, workflow automation in document management systems can also save time, reduce errors, and improve efficiency. In a world where healthcare regulatory compliance is a constant challenge, workflow automation emerges as the secret weapon for organizations to stay ahead of the curve.
By embracing workflow automation, we can make strides toward a more efficient and effective primary care system. Moreover, automation reduces errors and gives healthcare professionals more time to focus on patient care. By automating routine tasks, healthcare providers can reduce administrative and operational waste, leading to significant cost savings and improved patient care. From scheduling appointments to managing patient records, automation can streamline processes, reduce errors, and free up staff to focus on what matters most – patient care. Embracing workflow automation is not just a step toward efficiency; it’s a leap toward a more sustainable and effective healthcare system. Let’s harness the power of technology to transform healthcare for the benefit of patients and their families.
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Contact us to discuss how our Generative AI solution, AI Insights, can help your organization improve workflow automation!