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Forward-thinking leaders are exploring and adopting intelligent automation solutions to drive transformation for their Revenue Cycle Management operations. Innovations such as Robotic Process Automation (RPA) and Machine Learning (ML) can be combined to digitize and automate even the most complex end-to-end processes and functions, allowing organizations to drive value to the bottom-line while scaling resources to focus on complex, value-added activities.
At SYNERGEN Health, we have developed a robust RPA Use Case Evaluation Framework. In this document, we explain how to use the framework as a decision support tool so organizations can choose the most efficient pathway to automation.
An RPA use case should primarily focus on routine tasks suited for automation. The given task is currently handled by manual efforts and RPA can automate it.
All tasks involving high levels of human input are prone to error. Errors can be costly and go undetected in a workflow for a sustained period of time, compounding issues downstream.
A good RPA use case must be concurrently repetitive and frequent. A task that repeats weekly should be prioritized over monthly or quarterly tasks.
Business rules may not always be formally documented. But, for a use case to be a high potential RPA use case, the business rules underpinning the workflow must be clearly defined, documented, and available first.
Before you prioritize a use case for implementation, it is important to first confirm that the data needed to accomplish the task effectively is or can be made readily available to your RPA software.
If you have 2 use cases that you are considering - one for an isolated workflow and the other for a workflow that can have enterprise-wide impact, the latter will deliver greater value and should be prioritized higher.
Volume fluctuations often impact RCM workflows. Businesses have traditionally relied on overtime and/or seasonal workers. This approach can be expensive and amplify data security concerns. An RPA use case that can eliminate and/or reduce dependence on overtime workforce is highly valuable.
If the task you are considering for RPA involves working with data elements that are governed by compliance and regulations, e.g., HIPAA, then it should be considered a high value use case. Automation can solve for the access management policies to increase security compliance.
RPA is best suited for processing structured data. For quick wins, prioritize use cases that leverage structured data. As your automation competencies develop, you may consider combining multiple technologies like RPA, Artificial Intelligence (Al) and Data Science to solve for the complexities of unstructured information.
If the use case being considered for RPA can take advantage of the 24 hour time cycle, it is a valuable use case. Multiple benefits like cost optimization, speed, and high asset utilization accrue when automation is paired with 24/7/365 operations.
Audit trails manage the who, what, and when of a given transaction. They are key indicators of robust internal business controls. Automated audit trails are more accurate. So, if the use case being considered for automation requires detailed audit trails, it is a good use case for RPA.
If the use case being considered for RPA needs to eliminate or optimize the level of human involvement from a compliance and auditability perspective, then the use case is optimal for automation.
If the use case being considered for RPA has a well-defined Standard Operating Procedure (SoP), then it is a use case worth prioritizing. Alternatively, first build the SoP and then consider automating the task.
