Adrienne Moore, VP of Revenue Cycle at Banner Health, discusses the significance of automation in healthcare, particularly in revenue cycle operations. She points out that introduction of automation technology follows a well-known innovation curve, starting with innovators and early adopters, followed by the majority and finally late adopters.
Banner Health has a robust automation system in place, including tools that enable the transformation and modification of data, manage large transaction volumes and create rules for billing and coding.
She notes that robotic process automation (RPA), or bots, are the next wave in automation. These bots follow pre-set directions, performing specific tasks. However, they are not always a long-term solution and require continuous monitoring and assessment of their value.
Application Program Interfaces (APIs) have become crucial where bots have limitations, offering a more reliable form of information transfer. For instance, should a dataset’s structure change unexpectedly without updating the bot, the data transfer may be incorrect. APIs, on the other hand, ensure data integrity during transfers.
Predictive analytics using machine learning (ML) or AI will become common in the near future. Through algorithm-driven models, ML can prevent actions that don’t yield results, thereby increasing efficiency.
Moore talks about potential bias in ML models, advising that they be heavily audited and continuously trained to ensure accuracy. This involves treating each dataset as a separate implementation and working with a variety of stakeholders to set model accuracy thresholds.
Generative AI is mentioned as a valuable tool for creating new content, with the ability to generate more empathetic responses than human efforts, as demonstrated in AI chatbot interactions. Its role in patient communications and clinical documentation has potential for growth in the near future, particularly in clinical documentation improvement or denial appeals.
Bots sometimes behave unexpectedly, advocating for considering bots as components of an automation process rather than the primary driver. It aids in task reversal and reduces bottlenecks.
Moore highlights that while automation is more prevalent among payers than providers, this puts medical providers in a unique position. They must adopt automation to keep up, but they also see the legal scrutiny being applied to the practice. Therefore, health systems need to be careful about their approach to automation, mindful of its emerging governance and regulation.
Overall, automation has a transformative impact on the healthcare industry, easing the administrative and operational processes while increasing efficiency and accuracy. Despite the potential difficulties, health organizations must develop their automation capabilities to keep pace with a rapidly evolving industry.
