How To | Revenue Cycle Technology

How to prepare your revenue cycle and your employees for a digital workforce

How To | Revenue Cycle Technology

How to prepare your revenue cycle and your employees for a digital workforce

  • As healthcare organizations are tasked with lowering costs and improving performance, it’s no surprise many are considering automating the revenue cycle operation with robotic process automation (RPA) technology.
  • An integrated plan to implement the RPA server-based software solution includes a well-organized governance structure, integrated plan and a workforce management strategy.
  • Many organizations are moving their freed-up human workers to higher-valued tasks.

As healthcare organizations are tasked with lowering costs and improving performance, it’s no surprise many are considering automating the repetitive, error-prone functions of revenue cycle operations with robotic process automation (RPA) technology.

An RPA server-based software solution implementation includes a well-organized governance structure, integrated plan and a workforce management strategy that will accomplish the following:

1. Maximize the effectiveness of the new “digital employees,” software “robots” or “bots.”

2.  Decrease the stress of the human workforce with an information campaign about redeployment to higher-value tasks and other opportunities within the health system.

3.  Prepare the organization to reskill and upskill legacy employees on new non-robotic responsibilities. Much of the RPA solutions value comes from the ability to redeploy an organization’s most valuable resource — it’s people.

4. Avoid negative publicity sometimes associated with replacing human workers with digital employees by developing a strategy to transition, reskill and upskill impacted resources as an initial focus, not an afterthought.

5.  The most prevalent digital employee in the market is derived by RPA technology, a server-based software solution (i.e., a software robot, bot or digital employee) that uses existing system interfaces to automate repetitive, mundane and error-prone work previously performed by humans.

Unfortunately, with the low barriers to RPA implementation, there can be a tendency to implement with haste and without structure and planning, resulting in confusion with terms of policies, change management and execution. Furthermore, utilizing this type of technology can be deemed as a threat to the purpose or literal roles of the current human workforce, causing anxiety and apprehension. Because redeployment of the human workforce to higher value tasks is a major element of the RPA ROI, executives should manage this area carefully. Therefore, creating the right governance with an integrated plan, for both digital and human employees, is crucial to maximizing your new digital workforce without alienating your best resources.

Governing a new digital workforce

Although successful deployment of digital employees requires speed and scale of adoption as well as nimble decision-making leadership engagement, the key is a well-organized governance structure aligned with organizational strategic priorities.

For example, if patient experience is an organization-wide initiative, it is logical to prioritize a series of bots to rapidly process appointment requests and financially clear and/or complete pre-registration activities to allow for quicker and more accurate patient-intake processes. 

Organizations will need a participative, multi-disciplinary governance committee to help prioritize, organize and quickly drive bot ideation to implementation. Ensuring a smooth transition requires healthcare organizations to carefully consider the following questions:

When do you launch? Standing up the RPA governance structure at the right time is critical to ensuring team members stay engaged and willingly support the initiative. Organizations don’t want a group of talented, busy leaders attending meetings with no meaningful actions.

The most successful programs have developed a vision and a solid business case for an RPA program before formally activating a full governance structure. The best time to begin activating elements of the governance structure is soon after funds are allocated and the greenlight is given to proceed with RPA deployment. Identifying executive sponsors, steering committee members and team leaders should happen early on as their input is needed to develop program guiding principles, success factors and a charter.

What type of governing body is needed? The intended level of RPA deployment will likely drive the answer. Those seeking to pilot RPA in select areas might initially leverage an appropriate committee that already exists, preferably a strategic or innovations group. Conversely, organizations choosing to implement significant RPA solutions that overhaul entire business units may consider establishing a more robust Center of Excellence (COE) model to help initiate, prioritize and execute RPA initiatives with an enterprise-level vantage point.

Regardless of the chosen model, organizations seeking to deploy RPA governance need to be capable of making quick and collaborative decisions to enable both speed and breadth of adoption (Enterprise RPA Adoption Pinnacle Model Assessment, Everest Research Group, March 2018).

Who is needed to create a digital workforce? RPA governance should be comprised of well-respected and progressive leaders from a variety of departments. The chair/sponsor of the committee should be a senior financial and/or operational leader. Other contributors include:

  • Human resources leaders who can help navigate and process potential changes to position descriptions, paygrades and employee movement.
  • Training, communication and change management representatives to help support the changes to human employee activities.
  • Although RPA initiatives are frequently led by business teams, it is IT that owns and manages the tools, security access and infrastructure knowledge necessary to safely implement RPA (How to scale RPA: in six slides, by UiPath’s Guy Kirkwood). Therefore, RPA governance should include IT stakeholders from end-to-end to establish good communication and to confirm cultural alignment between IT and the business units (Enterprise RPA Adoption Pinnacle Model).

Integrate both digital and human workforce plans

There is significant media scrutiny over bots replacing humans in the workplace; however, this position appears to be overstated. There are widely circulated articles that state 38% of jobs are at risk of being automated (Suarez, D., “Will AI and Robotics Replace People in Healthcare?” Pwc, August 2018). In addition, 45% of human activities could be replaced today, yet, research groups that surveyed companies with RPA currently deployed are not reporting large lay-off numbers (Chui, M., et al., “Where machines could replace humans — and where they can’t (yet),” McKinsey Quarterly, July 2016).

Instead, there appears to be efforts to move their freed-up human workers to higher-valued tasks. For example, a recent study showed that only 11% of RPA-impacted employees were indeed laid off.  The other 89% were redeployed, reskilled and upskilled to other jobs within their company (Enterprise RPA Adoption Pinnacle Model). 

How to best integrate a strategic human workforce plan with a digital workforce plan while also managing employee anxiety and apprehension is the challenge.

To determine the amount of capacity created by the new digital employees and serve as the foundation for a transitioning human workforce plan, consider the following:

What is left of an FTE job after automation? What cannot be automated? What is the new number of FTEs needed for that position group? Have you automated parts of a job that were complex or high risk, thus lowering the skill level needed to perform the non-automated parts of the job?

Decide where you need smiling faces. If you had more human resources where would you deploy them? Think about the “gaps,” “nice-to-haves,” or the “how have we survived without people” areas. Every healthcare institution has these areas.

For example, with patients now representing the third largest payer group, behind Medicare and Medicaid, hospitals need more professionals to help patients in need of financial advice to navigate their options for assistance (Sanborn, B.J., “Hospital bad debt rises in tandem with growing share of patient financial responsibility,” Healthcare Finance, June 2018, and Kneller, S., “Innovators Wanted: Mounting Patient Financial Responsibility Driving Provider Demand for Positive Disruption and Change [Part 1 in a 3 Part Series],” TripleTree Holdings, December 2015).

Having reassuring staff trained in patient  financial options, with the ability to compassionately and professionally counsel, benefits healthcare institutions.

Develop a plan to reskill and upskill human employees. As you take the automated processes out of your talent’s job descriptions and redeploy them to non-robotic jobs, where their talent is better showcased, you will need infrastructure in place to train legacy employees on their new responsibilities. Most institutions have training infrastructures already in place and should leverage those resources. However, a well-structured training plan is needed with training resources ready to take on potential mass reskilling and upskilling. 

Have a transition/cutover plan ready. The go-live day for your new digital worker is most likely not the same day you should transition many employees to their new responsibilities. How much overlap is needed? Should this be a scaled transition? The answers are dependent on the size of the automation and the level of patient-experience risk or provider-experience risk. Most prudent automation installers will err on the side of caution and plan for a slow but deliberate transition plan that allows for continuity through any potential issues early in the digital worker’s life.

Communicate well or suffer consequences. As mentioned earlier, the media hype around robots replacing human workers is prevalent, and an RPA initiative can produce anxiety and concern. This may lead to low morale, untimely attrition, slow implementation and generally put the initiative at risk. To combat this outcome, a complete communication plan is needed that does the following:

  • Informs stakeholders of RPA’s purpose.
  • Answers the “what’s in it for me” question.
  • Illustrates the transition plan for robot and human.
  • Provides an avenue to ask questions and get answers.

Healthcare organizations interested in implementing RPA solutions are likely to realize much more value from that journey if they establish governance structures and develop workforce management strategies. A well thought out governance structure ensures the right stakeholders are involved and empowers them to make decisions in an efficient manner so that RPA can be adopted quickly and broadly. 

About the Authors

Prashant Karamchandani

is a principal with The Chartis Group and is a leader in the firm’s Revenue Cycle Practice (pkaramchandani@chartis.com).

Steve Wood

is an engagement manager with The Chartis Group (swood@chartis.com).

Travis Ish

is an associate consultant with The Chartis Group (tish@chartis.com). 

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