Robotic Process Automation Archives | HealthTech Magazines https://www.healthtechmagazines.com/category/robotic-process-automation/ Transforming Healthcare Through Technology Insights Mon, 14 Feb 2022 16:44:47 +0000 en-US hourly 1 https://wordpress.org/?v=6.7.1 https://www.healthtechmagazines.com/wp-content/uploads/2020/02/HealthTech-Magazines-150x150.jpg Robotic Process Automation Archives | HealthTech Magazines https://www.healthtechmagazines.com/category/robotic-process-automation/ 32 32 The Age of Bots for Healthcare – Robotic Process Automation (RPA) https://www.healthtechmagazines.com/the-age-of-bots-for-healthcare-robotic-process-automation-rpa/ Mon, 14 Feb 2022 16:44:28 +0000 https://www.healthtechmagazines.com/?p=5785 By Hamed Abbaszadegan, Chief Health Innovation & Informatics Officer, Phoenix VA Health Care System BOTS! Love them or hate them,

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By Hamed Abbaszadegan, Chief Health Innovation & Informatics Officer, Phoenix VA Health Care System

BOTS! Love them or hate them, but they have been in existence for ~ 50 years based on some estimates. In simplistic terms, a Bot is a software robot (“Robotic”) that is given instructions (“Process”) to perform (“Automation”). Therefore, RPA is written rules/instructions you tell a software to do in an automated manner.

In this day and age, you have probably recently encountered software robots as chatbots. These chatbots may have scheduled an appointment for you or even performed a task such as booking a hotel room. Beyond chatting, you might have tried to buy tickets to a concert/game or purchase a certain clothing item (such as the notorious streetwear brand Supreme) only to get beat out by someone who deployed a bot. Leveraging bots allows you to tell the application software to complete a transaction in <1 second. My personal online transaction time is about 15-20 seconds, so I often do not get the hyped item I intended to buy. Despite the annoyances many encounter with bots, they play a significant role in automating repetitive mundane tasks (copy-pasting text into structured fields on a template). Let’s explore how this applies to healthcare…

Right now, there is a lot of interest in the “Digital Front Door” for patient care. How can I prep a patient before they see a physician? Scheduling quickly comes to mind, but you can also have the RPA engine copy/paste certain health information to tee up your data at the moment you will see a physician. Imagine having your latest labs, outside records, images, and medications ready to go so that your encounter is meaningful and full of decisions in your health journey! This has yet to be realized in our current health systems. Often, we scramble to gather information at the right moment, looking through many tabs and unstructured data. Leveraging RPA could be a link to realize functional interoperability without true interoperability. You also remove having humans pull open charts and re-chart in new documentation packages. All of these mundane tasks can be completed in split seconds in the background. As electronic record keeping in healthcare continues to be burdensome, deploying Bots with RPA technology can really get the right information to the right person at the right moment in a workflow. That is the holy grail with regards to healthcare applications.

Mundane task elimination can be realized through deployed RPA. Therefore, RPA integration will be part of the new world order in healthcare that brings back the human touch!

Looking beyond the digital front door, there has been a success with the use of chatbots for procedure-related preparation. For those of you who have had a colonoscopy, you are aware that the most difficult part is the preparation, not the procedure itself. Engaging patients with automated messaging and specified “conversation” can help better troubleshoot or understand the process of preparing for any procedure. Think of this as a real-time directed FAQ based on your medical procedure. If your prep is done right, your procedure will go smoother and be of higher utility. My definition for this type of technology is simply “patient engaging applications”. Patients are being engaged in a relevant manner on the topic of interest, such as bowel prep. As you can imagine, the development in this space is red hot as you can create pathways and algorithms for so many different medical conditions, procedures, preparation, etc. Everyone wants very minimum no-shows and improved compliance with personalized health delivery.

Connecting the dots, RPA is what leads to the realization of promises of early diagnosis and improved quality of care. When health information is prompted in a structured manner to the right person, prioritization of care delivery can be realized (think of timely cancer screening) as the computer can automate the names of patients with the most risk factors. Everything comes down to how you leverage RPA for your desired outcome. Are you looking only to schedule more efficiently and prevent “no-shows” or are you seeking a wider efficient whole health approach to how your system/network delivers care? Once you determine how RPA can be leveraged, it’s up to you how you want to connect the dots.

What does the future hold for RPA? Obviously, more and more “simple” tasks will be automated. However, as we have all experienced frustrations of being on hold or misdirected by a chatbot (think credit card company calls), RPA will be a part of the wider advanced technology ecosystem that brings back the human touch. Just as “google it” hasn’t replaced expert consultation, bots can only go so far before human intervention is needed to weigh the risks/benefits of decision-making. Medicine is an art and what to do with diagnosis is complex depending on very personal circumstances. Mundane task elimination can be realized through deployed RPA. Therefore, RPA integration will be part of the new world order in healthcare that brings back the human touch!

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Lessons Learned from our Robotic Employees https://www.healthtechmagazines.com/lessons-learned-from-our-robotic-employees/ Tue, 18 Jan 2022 14:20:19 +0000 https://www.healthtechmagazines.com/?p=5681 By Steve Leblond, VP of IS Operations & COO, Ochsner Health RPA is an emerging technology that has received a

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By Steve Leblond, VP of IS Operations & COO, Ochsner Health

RPA is an emerging technology that has received a lot of attention lately. A technology that automates manual functions currently conducted by employees; it was viewed as a solution that could reduce costs while delivering consistent results. After reviewing our organization found that RPA did have the potential to deliver significant value, and so like many others, we were excited by the possibilities. This was a capability that our Information Services division didn’t have initially but would benefit our organization if we did. As a result, we pursued a dual-path approach to leveraging RPA; first partnering with a vendor to move quickly, and secondly starting our internal program that could deliver automation as a new offering in our service portfolio.

Healthcare revenue cycle processes are often very manual and repetitive, as providing the appropriate information to scores of insurance agencies requires numerous people manually logging into insurance portals to upload data. As such, we saw this as a ripe target for automation and our partner was chosen due to their experience in this area and the speed at which they were able to engage. Learned two main lessons from our partnership efforts; outsourcing required more internal resources than expected and clarity on what systems you will allow your “robot” to write into is critical.

RPA is a useful tool now, but in the future, it will be coupled with AI providing further benefits.

Regarding the first, it probably should have been more obvious, but we believed that our outside partner would be very self-sufficient. It became evident quickly that our Information Services team needed to be closely involved since they proposed automated solutions. Automating a function exactly as a human didn’t always make the most sense. Humans find interesting workarounds to problems, and when you are programming a workflow, leveraging technologies that are being phased out isn’t always your best path. As our partner ran into the natural time, it takes for Information Services to review, understand, and execute their requests got larger to provide more flexibility and autonomy. Requests for 100 virtual machines so they would not have to ask every time they needed one does allow for more speed but at the cost of valuable resources that may sit idle for months or years. Virtual machines do cost money, after all, contrary to the perspective of many solution providers.

The second main lesson was that Information Services trusts our fellow employees more than we do our new RPA tool. A hospital’s EMR is at the center of all the care we provide. And having comfort with a computer accessing the EMR and potentially writing information into it was unnerving for some. The benefits of the solution suddenly became the problem. As an early adopter, our EMR manufacturer would not provide us much guidance, so it was “if it breaks something, don’t call us,” which is not a position with which any Information Services division is comfortable. And the fact that this technology can work quickly and without interruption gave us pause because if it does start incorrectly writing into the EMR, we weren’t sure how big the problem might get before it was identified. Couple these concerns with the fact that the largest cost savings items all point back to your EMR and you can see that it takes a lot of time just to get clarity and comfort…all while your RPA partner is waiting.

Our internally developed program has some lessons learned as well. Since it is an emerging technology, we did not have staff with any initial experience. We neither have an RPA tool, nor did we have a prime area to focus our automation toward as the ripest fruit was for our partner.

We set out to find our tool. When we started our selection process, we found that all RPA tools currently offer similar capabilities. Our initial thought of finding the “right” solution showed us that functionality wasn’t a differentiator. We quickly learned that while there was minimal differentiation between products, large differences often occurred in the manufacturer’s strategy and capabilities. We chose to go with a larger, pre-established company due to their advantage in human capital and their efforts in R&D. RPA is a useful tool now, but in the future, it will be coupled with AI providing further benefits.

Secondly, we needed to staff and train the team. We started with two resources, an engineer to do the programming and a business analyst to do process discovery and testing. We partnered with our RPA tool vendor for training during the first three workflows. Our approach was that the vendor would not touch the keyboard for those first three workflows, rather they would instruct our engineer step-by-step to expedite knowledge transfer. In discussion with the team afterward, they agreed that was helpful, but also acknowledged that they really did not have the full grasp of the tool until after they completed their 5th workflow, roughly ten months after the start of our RPA program. Our engineer in this space was a known high performer, so that length of time could be longer depending on talent.

Lastly, and probably most importantly, you need to ensure an effective process for reviewing proposed automation requests and rule out poor submissions. We found many poor candidates being submitted to our internal team. Some poor candidates were requests to automate work that creates little organizational value; 2 hours of manual effort that people didn’t want to do but would require weeks to automate. We got requests that require decisions that are non-standardized, a showstopper. And some poor candidates are requests that have no process defined at all. These made up about 40% of our requests. Our customers wanted us not only to automate existing processes but also to create and automate new efforts. Having the talent to create process was key. Our business analyst in this space was also a stellar employee with an excellent history in process creation, so we could successfully automate those as they often were value creation endeavors.

So as your organization pursues RPA, make sure you have the appropriate alignment and clarity on what and how it will interact with existing systems. And if you are creating your own program, remember that it is the people behind the tool that will make all the difference. While we love our new robotic employees, it is still our human ones that make them successful.

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Robotic Process Automation in Hospitals – Challenges and Results https://www.healthtechmagazines.com/robotic-process-automation-in-hospitals-challenges-and-results/ Wed, 15 Dec 2021 16:31:13 +0000 https://www.healthtechmagazines.com/?p=5666 By Jerry Adach, Director Enterprise Data and Automation, Central Maine Healthcare Robotic Process Automation (RPA) really took off a few

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By Jerry Adach, Director Enterprise Data and Automation, Central Maine Healthcare

Robotic Process Automation (RPA) really took off a few short years ago, even though much of the technology has been with us for some time. The modern tools and platforms available for automation have revolutionized this space.

My RPA journey began approximately three years ago. As Manager of Data Access and App Development at Ellis Medicine in Schenectady, NY, I was instructed to have my team automate a very complex process using the typical approach of SQL Server stored procedures, PowerShell, VBScript, scheduled tasks, etc. I thought there must be a better way. That’s when I stumbled upon RPA. Once I downloaded and tested a trial version of the RPA software from an RPA vendor, the light bulbs went off – in a big way. I clearly saw this as a potential game-changer. I believe my many years of experience working in hospitals allowed me to see beyond the use case at hand.

Fortunately, my CIO at the time was a forward-thinking CIO who has a strong business sense and agreed to take the leap into RPA. Now the pressure was on. It didn’t take long though to prove how powerful RPA was. We nailed the original use case requested and moved on to automate many, many manual and painful tasks as well as using it for most of our ETL work and file delivery to third parties. Before we knew it, a full year went by and we were approaching 100 complex automated workflows.

One year ago, I followed that forward-thinking CIO to Central Maine Healthcare where I am now Director of Enterprise Data and Automation. We stood up in the same environment, that brought so much success to Ellis Medicine, at Central Maine Healthcare. One year later, we are approaching 200 automated workflows. These processes range from simple file extraction/delivery to complex ETL, interacting with applications, and sending SMS alerts. Our RPA platform is hyper-connected to all kinds of back-end data sources to include Cerner Millennium. We ingest data from outside entities such as Press Ganey.

My goal is to showcase success stories from other hospitals and start the conversation about the reality of using a digital workforce to supplement the human workforce.

We are fast becoming a real powerhouse here at CMH and my goal is to add value, especially to our over-stressed clinical staff. In a very short period of one year, we made huge strides and showed CMH something very new and exciting. My current team has six members. I am very fortunate to have two strong RPA Developers on my team, along with a few high-end data programmers and even app developers. We are all experienced and understand IT at large, especially as it relates data. It was almost easy to succeed.

Now it gets tougher. I believe there are countless opportunities in hospitals. Hospitals have a broad array of specialized areas to include; Finance, Accounting, Revenue Cycle, Human Resources, Clinical Physicians, Clinical Nursing, Supply Chain, Primary Care Practices, Marketing/Communications, Plant Maintenance, etc., etc. It’s like all industries under one roof. I know each area can benefit in a big way from RPA. The challenge is; what are they doing and where can we find opportunity? IT can’t possibly know all of what’s going on in the back-office, and the leaders overseeing those back-office operations have little understanding of Robotic Process Automation.

There are a few options. One would be to look at process mining or discovery, using software, while the other is to educate decision-makers. In my opinion, educating is the best way. I’m not opposed to process mining, but I find that when we identify a process that should be automated, we typically re-engineer the entire flow. This is largely due to my team’s access to technology, whereas the departments performing these manual tasks do not have that type of access or even an understanding of what can be achieved. We don’t want to automate bad processes. Not to mention how employees do not like to be monitored.

I will be bringing in experts from a leading RPA vendor in the first quarter of 2022 to help educate the senior team and key leaders at Central Maine Healthcare. My goal is to showcase success stories from other hospitals and start the conversation about the reality of using a digital workforce to supplement the human workforce. There should not be the goal to eliminate workers, rather a gradual transition through attrition and utilization of that digital workforce. Once leaders understand what can be done, they can start re-thinking job duty allocation. Over time, this may reduce the workforce a bit, but the real goal is to improve operations and be better positioned in a very competitive environment.

If hospitals want to stay ahead of their competitors, they need to embrace all that technology can offer. Many times, this means a culture change and possibly expanding the IT structure to bring in the required talent and technology. There is a lot of buzz around becoming a data-driven organization. I think that same drive needs to be applied to RPA. Hospitals also need to be an automation-driven organizations. RPA is a good lead into machine learning and even artificial intelligence – all of which can be done in-house. The entire RPA space is so very competitive that the platforms are positioned to explode with new capabilities. It is a very exciting time to be in IT and especially IT in healthcare. I cannot think of a worthier industry to work in.

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The Appian Low-Code Platform: Taking Healthcare to New Heights https://www.healthtechmagazines.com/the-appian-low-code-platform-taking-healthcare-to-new-heights/ Wed, 24 Nov 2021 14:39:42 +0000 https://www.healthtechmagazines.com/?p=5598 Before the COVID-19 pandemic, the concept of an e-visit was merely aspirational in healthcare—the industry had a long way to

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Before the COVID-19 pandemic, the concept of an e-visit was merely aspirational in healthcare—the industry had a long way to go to catch up with the world’s consumer-driven technology trends and expectations and embed them within its delivery models. Providers and payers faced pressure to become more technology-forward in order to increase patient and member confidence in their policies, procedures, accessibility, and storing of sensitive clinical data. Organizations attempted to address this pressure by building code-heavy platforms and complex tech stacks, but this only served to fragment the healthcare ecosystem.

In today’s climate, healthcare constituents are readily implementing robotic process automation (RPA), machine learning (ML), process mining, and artificial intelligence (AI) to offer a top-notch, tech-enabled experience for all—enter the Appian Low-Code Platform. Appian uses low-code technology to speed application development, automate workflows, and ease integrations to empower healthcare teams and other stakeholders to function seamlessly in the virtual world. Appian has been demonstrating its unique ability to bridge the technical, clinical, and financial dimensions of healthcare since long before the pandemic, and it will continue to do so into the future.

Over the last 30 years, innumerable healthcare IT platforms and system implementations have emerged, creating the ‘accidental architecture’ of today. For our clients and partners, being able to stitch together the various aspects of their ecosystem through Appian is a major benefit.

“Pre-pandemic . . . dealing with workflows around revenue cycle optimization, biomedical device asset management, and physician quality assessments was the norm,” recalls Fritz Haimberger, Global Industry Lead for Healthcare at Appian. “Post-crisis level of the pandemic and beyond, there have been significant increases in magnitude for these same use cases, however, the patient journey management and care coordination applications are coming into their own.” Not surprisingly, the backbone of patient engagement applications is a robust technology platform that is easily accessible to all patients. The Appian Low-Code Platform is a great tool to simplify the process—for both patient and clinician—of bringing together disparate technologies like EMRs, 3rd party adjuncts, IoT wearables, and remote patient monitoring devices. Appian is a global leader within the enterprise technology market, including digital process automation (DPA), intelligent business process management (iBPM) and dynamic case management. Appian has extensive experience transitioning from legacy systems to cutting-edge, electronic medical records with low-code. “Over the last 30 years, innumerable healthcare IT platforms and system implementations have emerged, creating the ‘accidental architecture’ of today. For our clients and partners, being able to stitch together the various aspects of their ecosystem through Appian is a major benefit,” explains Haimberger.

Reusable components and automation speed app development and streamline complex healthcare workflows.

“When a client purchases Appian, they get the entirety of the platform—reusable components, drag-and-drop process mapping, pre-built smart services, intelligent automation capabilities including RPA and intelligent document processing—all without the need for multiple modules to deliver on a single use case.” The reusability of the components accelerates application development time, allowing healthcare organizations to rapidly build solutions that reduce the burden on clinicians and patients alike.

It is evident that automation solutions really do make a difference. “Taking an enterprise workflow like clinician onboarding, biomedical device asset management, or even home health servicing and bolstering it with intelligent automation truly takes those applications to the next level,” adds Haimberger, citing a customer success story of a healthcare client that continues to realize over $1 million in savings per month after integrating digital capabilities to assist clinicians in call centers, freeing them up to take on an additional 25% patient caseload.

In another instance, a large, academically-renowned, oncology-focused provider approached Appian seeking to improve the onboarding process for newly-affiliated entities. Providing top-notch service to physicians and their patients across the US is paramount for this provider. The more quickly clinicians can be brought into the organization, the faster patients can access world-class cancer care protocols and clinical trials. Within a matter of weeks, Appian helped the client implement a system that automated and increased the throughput with which physician quality assessments were undertaken and completed. To date, multiple weeks have been shaved off the timeline for getting a physician into the organization and operationally viable, and patients are able to get the life-saving care they need more quickly than ever before.

No more working in silos.

Ignyte Group’s Mental Health Management solution is another flagship offering that is built on the Appian platform. The solution helps connect patients readily and rapidly with their caregivers anytime, anywhere. It tracks personal qualitative and quantitative trends through remote patient monitoring tools, allowing patients to be intimately involved in their care continuum. And the solution is automatically mobile-ready. Having access to these tools on a computer or in an Android- or iOS-based mobile environment facilitates instant communication between provider and patient for emergencies.

Even situations as non-acute and simple as medication or appointment adherence can be managed with gentle, automated nudges to the patient through their preferred method of communication. Using intelligent automation (like workflow, RPA, AI, and ML) to stitch together existing EMRs and other clinical adjuncts with the Appian platform gives Ignyte’s Mental Health Management solution a true 360-degree view of a patient. And it presents all this data to a provider in a clean, unified way that allows them to make the best treatment decisions possible and take actions from within a single interface.

Appian is tech-agnostic—giving clients the power of choice.

As an open platform, Appian supports organizations’ freedom to choose the solutions that work best for them. If a health system has made investments in other technologies, Appian can easily integrate with them, extending their value and usable lifespan. Appian does not lock organizations into proprietary data structures and systems. For example, the company has demonstrated exceptional value across clinician onboarding, as the workflows for recruiting, onboarding, licensing, credentialing, and payer contracting necessitate various departments and systems working in harmony. By bringing the siloed entities together for a seamless hiring experience, Appian has enabled many healthcare systems to mitigate the challenge of pandemic-induced employee attrition. “The natural stress of the job was causing early burnout long before anyone had heard of COVID-19; the pandemic has put such added strain on these clinicians that we’re struggling to replace the holes left behind when these valuable employees depart,” says Haimberger.

Creating a patient-first culture through technology.

A significant portion of the success of Appian is attributable to the four founders’ vision and culture. “They have no qualms about jumping in the trenches with the troops on the ground, and I’m proud to be part of the leadership team that is cut from that same cloth,” reminisces Haimberger of his journey since 2015 and his hand in helping to take Appian public in 2017. “The ‘All for one and one for all’ mentality that is so pervasive here is infectious, and I love celebrating the greatest and the smallest of wins with our broader team.” 

Appian emphasizes collaborative relationships among employees and healthcare partners, with the goal of putting patients first. “It humbles me every day to be able to spend time with my fellow Appian employees who truly ‘get it’ when it comes to healthcare—there is a higher calling afoot here, and we’re appreciative of being given the opportunity to be even a small cog in that continuum,” emphasizes Haimberger. Appian is continuously looking for opportunities to invest in technology partnerships that facilitate patient-first outcomes. In fact, the company recently acquired a leading process mining organization, Lana Labs, to help healthcare providers and payers better understand their current processes so they can optimize them or discover new ones to better serve patients and member constituents.

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Is RPA a Good Fit for Your Organization? https://www.healthtechmagazines.com/is-rpa-a-good-fit-for-your-organization/ Mon, 22 Nov 2021 17:56:06 +0000 https://www.healthtechmagazines.com/?p=5592 By Dr. Lauren Vivian, CHIO, Pacific Medical Group Over the last 30 years, robots have played an integral part in

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By Dr. Lauren Vivian, CHIO, Pacific Medical Group

Over the last 30 years, robots have played an integral part in the healthcare ecosystem. Whether by aiding a surgeon in a complex procedure or executing simple tasks on their own, robots have dramatically enhanced care delivery. Today as healthcare organizations face COVID-related staff shortages, clinician and staff burnout, and overall decreased productivity, they are looking for robust solutions.  

Robotic Process Automation (RPA), the hottest digital trend, is a user-friendly option that automates specific redundant tasks that lead to overall efficiency and employee satisfaction. Hence, the rapid adoption of RPA over these last few months. Yet, a study found that 30 – 50% of initial RPA projects fail, which may explain why several companies have not made the transition. For those organizations contemplating RPA for their infrastructure, there are some things you must consider before leaping into the process.

What is RPA?

RPA is often confused with another emerging technology, artificial intelligence (AI). While both AI and RPA are two forms of automation that often work in concert, they approach tasks quite differently. AI uses machines to simulate human intelligence. In contrast, RPA uses software robots to emulate human behavior. These robots complete repetitive mundane tasks with increased speed and accuracy compared to that of a human. In simplest terms, AI is the brain of an operation, but it cannot get tasks done without the representative hands and feet, RPA. Several companies are harnessing the synergistic effect of pairing AI with RPA, but as you can imagine, this collaboration comes at a hefty price tag.

Benefits of RPA

Since its inaugural phase, RPA underwent several iterations to evolve into a system that delivers end-to-end processes that reduce healthcare inefficiencies. By replacing human input in areas that add little value but consume considerable time and resources, RPA can provide an ROI less than six months after launching. It’s impressive considering traditional automated IT solutions, which are costly and time-consuming to implement, do not generate the same returns as quickly. All these features combined with the ease with which RPA is integrated into existing systems without disturbing essential functions is one of the many reasons adoption is expected to increase by 72% within the next five years. With a reduced cost and timeframe to that previously required by other digital tools, RPA is transforming workflows and facilitating the emergence of new roles.

Some of the top benefits of RPA in healthcare are eliminating human errors, improved patient experience, reduced costs, increased employee productivity and satisfaction, and improved compliance.

Is RPA a Good Fit for Your Organization?

RPA uses in healthcare include streamlining claim management, improving revenue cycles, and simplifying patient appointment scheduling. Before your organization deploys RPA, it must identify its goals with automation. With so many technological innovations in healthcare ending up in the IT graveyard, it is critical not to overinflate the capabilities of RPA.

To determine whether RPA is a good fit for your organization, start by answering the following questions:

  • Are there clearly defined processes that your company would like to automate?
  • Can the associated workflow for those processes be reduced to a few clearly defined steps?
  • Do the steps involve a significant number of repetitions?
  • Can the steps be performed without applying critical thinking?
  • Are the processes scalable across the entire organization?  

If you answered no to any of those questions, RPA is not a good fit for your organization. There is no question that RPA is a powerful digital tool, but it can also cause long-term detriment to your business if misused.

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Technology and Pharmacy: Continued expansion of pharmacist role in patient care utilizing technology https://www.healthtechmagazines.com/technology-and-pharmacy-continued-expansion-of-pharmacist-role-in-patient-care-utilizing-technology/ Thu, 09 Sep 2021 14:44:01 +0000 https://www.healthtechmagazines.com/?p=5428 By Madeline Camejo, Pharm.D., VP of Pharmacy Services & Chief Pharmacy Officer, and Sara Panella, Pharm.D., Clinical Manager, Baptist Health

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By Madeline Camejo, Pharm.D., VP of Pharmacy Services & Chief Pharmacy Officer, and Sara Panella, Pharm.D., Clinical Manager, Baptist Health South Florida

In the current state of the world and the COVID-19 pandemic, many healthcare providers have turned to virtual platforms to care for their patients. What about pharmacy services and pharmacists? Considered the most accessible healthcare provider, pharmacists’ skills often tend to be undervalued and underutilized in the ever-growing evolution of technological delivery of healthcare. Although there has been an exponential growth of pharmacists based in ambulatory settings, such as clinics and physician’s offices, there is still an opportunity to include pharmacy services into current practices. Pharmacists at every point of the patient journey can harness technology to positively impact patient outcomes.

Sara Panella, Pharm.D., Clinical Manager, Baptist Health South Florida
Sara Panella, Pharm.D., Clinical Manager, Baptist Health South Florida

Pharmacists are the medication experts and should be utilized in telehealth to provide clinical services surrounding medication management. Medication management requires engagement by the patient and/or caregivers to ensure that patients are on the most appropriate and accurate medications. This includes evaluations of the patient’s current disease states and how well controlled by their current medication regimen. This includes an assessment of how adherent the patient is to their medications. Pharmacists have the ability to review and optimize therapies and identify duplications and omissions of medications.

The COVID-19 pandemic has created more opportunities and growth for pharmacists. The Coronavirus Preparedness and Response Supplemental Appropriation Act opened up telehealth regulations to enhance patient access to care, including expansion of technologies and flexibility in billing opportunities. Pharmacists, considered “auxiliary staff,” are able to bill through incident-to a Medicare-eligible provider, and “direct supervision” of this encounter can be done virtually, which has created more flexibility in workflow.

Pharmacist and pharmacies role is not limited to the conventional video-telehealth platform. There are several other platforms available to have pharmacy staff to aid in the continuum of care.

Pharmacists are leveraging all types of technologies to enhance both direct and indirect patient care. For example, clinical pharmacists have successfully utilized video telehealth services to discuss and review medications with patients. Patients are able to virtually display their medication to the pharmacists, perform medication reconciliation, enforce education surrounding medication regimens and adherence, especially around medications delivered through a device such as insulin pens and inhalers. Since these visits by pharmacists are billable, it allows extension of Medicare-eligible provider services and enhanced patient care. Services could include, but not limited to wellness visits, chronic care management and transitions of care.

Transitions of care is a crucial point in a patient’s care that a pharmacist can be involved in through telehealth. Pharmacists are able to follow up with patients post-discharge, as this is typically a time that is overwhelming for patients and/or their caregivers. Pharmacists are able to educate patients on their new medications, review any changes made in their regimens, and assist them in obtaining new medications that they may have cost or transportation barriers to. The pharmacist uses this opportunity to link their patients back into their primary care doctors and aid in transferring medical information to them. Technologies exist to assess if a patient was able to pick up medications post-discharge and overall adherence to medications that the patients have been on previously. It is also an opportunity to ensure that the care plan placed for the patient on discharge is continued appropriately. For example, prior to admission, medication may have been changed or discontinued due to an issue identified during the hospitalization. The patient may not have been aware of those changes, and they may have picked that medication up from the pharmacy with the rest of their new medications.

In addition to ambulatory care management, pharmacists in the acute care setting can also use telehealth to provide medication management services. For example, remote monitoring of pertinent labs for disease management can allow the pharmacist to provide insight on enhancements of medication management, including, but not limited to glucose monitoring, blood pressure, anticoagulation, and even vasopressor management for patients in the Intensive Care Unit.

Pharmacist and pharmacies role is not limited to the conventional video-telehealth platform. There are several other platforms available to have pharmacy staff to aid in the continuum of care. For example, platforms are available to support refill management that pharmacy staff is able to manage and maintain for the providers and their patients. This helps alleviate the burden from the providers’ offices and their staff and allows for centralized services. As this is protocol-driven, pharmacist extenders like pharmacy technicians and interns can be utilized in this space.

In addition, a pharmacy can provide background support in urgent care telehealth visits. Issues arise such as failure of the prescription transmission and/or lack of access to the medication due to coverage issues or not being in stock. The pharmacist can play an integral role in aiding these programs in resolving these issues, which includes clinically discussing opportunities with the providers on alternative therapies that may be better suited for the patient. Pharmacists can also be utilized to provide additional medication education to these patients.

Overall, the COVID-19 pandemic has driven healthcare to re-evaluate and expand the use of telehealth services, as well as many different technology platforms. Artificial intelligence (AI) and machine learning will likely play a bigger role in health care in the years to come. Robotic Process Automation (RPA) is a software-based automation service that uses AI, relying on robotic software to perform daily repetitive tasks and processes with higher accuracy and speed, allowing the person to focus on higher clinical decisions and tasks. By reducing human errors, pharmacists can harness the power of this technology to address pharmacy revenue cycle, 340B tasks, Clinical Documentation, enhance financial outcomes and improve the patient care experience and quality outcomes.

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