In this article, Sheldon A. Pink, CEO of Krystal Rock Innovation Group, highlights the profound impact automation is having on the healthcare industry. Organizations are increasingly looking to invest in Robotic Process Automation (RPA), Machine Learning (ML), or Artificial Intelligence (AI), reflecting a trend that began around 2012.
Initially, automation was used for basic functions like managing work queues, logging into applications, and data collection. However, the approach was limited as it required several computers to perform each function.
The emergence of RPAs, ML and AI has created a buzz in the industry, but also confusion given the distinct differences between each technology. Concerns have grown as some individuals have invested in the wrong tool for a perceived outcome, leading to skepticism around healthcare innovation. However, the changing industry dynamics and pressing needs have necessitated a shift towards automation. This includes addressing inaccurate responses from payors, minor claim edit rejections, and staffing shortages amid increased work volumes.
RPA, the most basic form of automation, offers scalability and the ability to perform more tasks, which potentially brings cost savings. However, it requires constant attention to rule changes that may impact the bot’s operations.
ML, on the other hand, is an advanced form of automation. It enables a bot to remember previous actions and adjust its programming for desired outcomes. However, it comes with challenges when majority action cannot be generalized or standardized.
AI, while promising, has its share of skeptics. The inconsistency and lack of standardization in healthcare-adjudicated claims may limit the advancements in AI. Pink suggests separating clinical and financial AI objectives. He sees potential in predicting patient outcomes based on historical data. However, he warns that AI could only accurately predict financial outcomes, such as how long an account will take to achieve a zero balance, rather than how it got there.
In conclusion, Pink emphasizes the need for innovation and effective management in healthcare amidst the current challenges. Regardless of skepticism or obstacles, embracing these technologies is crucial for improving productivity and efficiency within healthcare organizations.
