August 25, 2022

RPA in the Healthcare Industry - Best Use Cases

By using RPA in the healthcare industry, you can get several added benefits & speed up many processes. Read on to know more.

The healthcare industry is undergoing a transformation. Hospital executives are focused on reducing costs and increasing patient satisfaction. To achieve this, hospitals are investing in new technology to streamline their processes and cut back on manual labor. The role of robotics process automation (RPA) is growing in the healthcare industry because it can be used to automate many routine tasks that human workers have previously done manually. This results in efficiency improvements, cost savings, and happier patients. In this article, you will learn about the benefits of RPA in healthcare, potential use cases for RPA in the industry, technical considerations when implementing RPA, case studies of companies using RPA, and resources to help you get started with RPA in your organization.

What is Robotic Process Automation (RPA)?

Robotic process automation (RPA) is an emerging technology that is being increasingly adopted in various industries, including healthcare. It automates business processes using metaphorical software robots (bots) or artificial intelligence (AI). It is also referred to as "software robotics." In classic workflow automation systems, a software developer creates a list of steps to automate a process and interfaces with the back-end system using application programming interfaces (APIs). On the other hand, RPA systems automate operations by watching the user perform them directly in the GUI of the application. This way, products that do not otherwise have APIs for automation can be made more accessible.

RPA is a form of artificial intelligence (AI) that can automate repetitive, rule-based tasks. RPA can automate a wide range of functions in healthcare, from administrative tasks such as data entry and claims processing to more clinical tasks such as appointment scheduling and laboratory results management.

What makes RPA better than Traditional IT Automation?

There is a razor-thin line between RPA-based and IT-based business process automation. Although the two approaches may appear similar to the untrained eye, they are quite different in reality. Below you will find some characteristics that make RPA better than traditional IT-based process automation.

In Terms of Goal Perspective:

Automation based on RPA and traditional IT targets different aspects of the business and achieves other objectives. Automating operational processes leads to the optimization of processes, whereas IT-based process automation aims to improve end-user delivery times while lowering costs. From accounting to marketing, robotic process automation (RPA) simplifies and streamlines end-user tasks far beyond the IT department in many aspects of a business.  As far as ITPA is concerned, the company's complex information technology infrastructure is more important than the system's requirements.

User Interfaces and User Experiences: 

A significant advantage of RPA is the user-friendliness of its tools and applications, which offer improved user interfaces and user experiences.  As a result, users can use every interface with a basic understanding of IT that is clear, simple, and tailored to meet their needs. In traditional IT-based automation, user interfaces and user experiences appeal less to end users. Because of this, conventional IT-based process automation applications are complex and require advanced IT skills.  So, programming knowledge may be required to use most ITPA applications.


RPA tools don't disrupt underlying systems because they are designed for light IT requirements. As a result, robotic process automation can access computer systems using established interfaces and access control mechanisms. Therefore, any changes to the underlying system do not need to be made. In traditional  IT-based automation, the focus is on automating the existing processes and procedures. Due to this, the current IT architecture will constantly be disrupted.

An Overview of RPA in Healthcare

Healthcare is one of the most critical industries in any country regarding revenue generation and employment. These include medical devices, clinical trials, health insurance, and medical equipment. Healthcare systems face the challenge of managing and processing information from multiple internal and external sources, including clinical applications, laboratory information systems, third-party portals, insurance portals, radiology information systems, scheduling applications, enterprise resource planning, and human resources applications. Due to the difficulty of integrating these systems, healthcare companies must rely on humans to perform manual, labor-intensive operations.

Healthcare is dominated by patients, doctors, and insurance companies.  Establishing a more efficient and accurate back office process to handle the growing number of patients and paperwork required for follow-up and insurance claims is imperative. As a result, medical organizations can increase operational efficiency, decrease costs, and limit human error by implementing advanced automation solutions like Robotic Process Automation (RPA).  In addition, RPAs can be used to process physician credentials and enrollee eligibility, schedule patients, code, administer claims, manage clinical documentation, billing, and compliance for Medicare, manage secondary claims, and handle receivables and payables.

The Importance of Robotic Process Automation in Healthcare Organizations

A healthcare organization operates in real-time, so any error-prone processes have an impact on everything from the cost structure to compliance to patient experience. In order to avoid this problem, RPA software automates operational processes, improving data quality and speeding up decision-making. Using business rules engines, RPA automates structured data operations and logic. Its software can also manage unstructured data sources and convert them into structured data with the help of natural language processing (NLP) and optical character recognition (OCR). This equates to cost reductions, which implies that resources may be used where they are most needed.

Benefits of Robotic Process Automation in Health Care

As healthcare organizations are becoming more digitized and automated, RPA offers new opportunities for business transformation. Here are a few benefits of RPA in the healthcare industry: 


Increased Efficiency in Key Business Processes:  RPA reduces workload and frees up resources to focus on more important, value-added activities such as providing better customer service and developing new products. 


Reduced Operational Costs: By eliminating manual work, RPA can help organizations cut down on operational costs. 


Improved Patient Satisfaction: Automation of repetitive tasks can help improve the efficiency of patient-facing processes such as scheduling appointments, collecting payments, and releasing records. 


New Opportunities for Innovation: With RPA, organizations can design new ways to deliver care, manage their operations, and interact with patients. 


Competitive Advantage:  Hospitals that implement RPA can gain a competitive advantage over their peers by reducing costs, increasing efficiency, and improving the patient experience. 


Business Transformation:  RPA can transform how organizations operate and provide services. For example, it can be used to automate manual tasks, integrate systems and data, and improve customer service. 


Technology Transformation: With RPA, organizations can transform their technology environment by reducing the number of technologies and systems. -


Process Transformation: RPA can be used to transform business processes by improving the way organizations perform their key tasks and operate. RPA can be leveraged to transform the organization by enabling new ways of working. Social organizations can benefit from social transformation by using RPA to improve ways of working and engaging with customers. RPA can be used to transform organizational culture by enabling new ways of working.

Use Cases of RPA in the Healthcare Industry 

According to Deloitte's third annual RPA survey, robotic process automation (RPA) will be universally accepted within five years. RPA is a technology that automates business activities by using structured inputs and business logic. Using RPA tools, any firm can configure a robot or software to comprehend and capture applications in order to execute a transaction, trigger a reaction, interface with other digital systems, and alter data. The following are some use cases of how RPA is being used in the healthcare industry.

RPA Simplifies the Appointment Schedules:

Patients often book appointments online. During the registration, healthcare institutions must collect personal information, medical diagnoses, and insurance information. Depending on the information provided by the patient, scheduling appointments can be challenging. Moreover, patient visits need to be coordinated with the schedules and availability of the various doctors in the hospital. Therefore, it may be difficult to schedule appointments for patients.

It is possible to solve these problems by implementing RPA in healthcare. Depending on the patient's diagnosis, location, availability of doctors, and other variables, RPA bots can schedule appointments. Using an RPA system, patient data can be scanned to produce a report that can be emailed to a referral management employee. The bots can call if a patient's doctor cannot attend an appointment.

RPA Improves Account Settlements: 

Healthcare organizations must track, quantify, and evaluate each patient's diagnosis and treatment costs. It can take a long time to manually process this type of data. To correctly calculate bills for each patient, it is also necessary to keep records of tests, medications, doctor's fees, ward costs, and other services. This can result in a lengthy process for medical employees. RPA bots can correctly calculate the bill amount by considering the cost of tests, drugs, ward, food, and doctor's fees. By deploying RPA in the sector, healthcare providers can decrease payment delays and billing errors. As a result, implementing RPA in healthcare services can dramatically accelerate account settlements.

 RPA Implements Instructions: 

Healthcare companies have a difficult time monitoring whether patients follow discharge guidelines. These cases may require medications and follow-up appointments with doctors. Healthcare facilities have difficulty monitoring and ensuring that such discharge criteria are followed. By using RPA bots, discharge guidelines can be validated and prescription pick-up reminders can be sent to patients. RPA in healthcare can also be reminded of medical testing and doctor's appointments. It is also possible for RPA bots to alert healthcare providers if a patient's condition requires further attention. By implementing this method, healthcare workers can provide better care to their patients, reduce readmissions, and improve their patients' experiences.

Using RPA to Speed Up Claim Processing:

Some processes for managing insurance claims are data input, processing, evaluation, and dealing with appeals. It is possible for the entire process to be inefficient and error-prone when it is carried out manually or with generic software. In insurance claims, outdated procedures can significantly affect cash flow. In addition, 30-40% of health insurance claims may be denied if regulations are not followed. Thus, maintaining regulatory compliance may be challenging.

Health insurance claims can be managed more efficiently with RPA in healthcare. Using RPA bots, insurance claim data can be processed faster and errors can be avoided. Thus, RPA bots make it possible to track the entire process and prevent delays. Additionally, these bots can help you avoid legal pitfalls by detecting compliance-related exceptions. The automation of complex insurance claims administration procedures can be improved through RPA in healthcare.

Technical Considerations When Implementing RPA

When implementing RPA, organizations should consider various technical considerations. Before you start automating your processes with RPA, you should make sure that the technology is right for you. Make sure to consider these technical considerations when implementing RPA: 


System Design - Before implementing RPA, it’s important to understand the existing systems that are being used in the organization. You should know which systems are critical for your business and which ones can be automated using RPA. 


Process Identification - The next step is to identify the processes that can be automated using RPA. Make sure to consider both manual and digital processes. Choose processes that are repetitive and can be done without having to use advanced skills. 


Process Flow Diagram - Once you’ve identified the processes that can be automated, you should create a process flow diagram to determine the best way to automate each process. 


System Mapping - Next, you should map all the systems that are connected to the processes that you want to automate. You should look for the data sources and processing systems that are connected to the identified processes. 


Data Mapping - Once you’ve mapped the systems and data, you should identify the data that is relevant for your processes. You should determine which data fields are necessary for your systems and which data fields are available for use in the systems. 


Data Preparation - When implementing RPA, you should prepare the data for use in the systems. This means collecting the data from various sources and putting it in a format that is ready for use in the systems. - 


System Integration - Next, you should integrate the systems that will host the RPA and the systems that will be automated. You should also integrate the data sources and put the prepared data in the systems that are connected to the RPA. 


Testing and Training - Before you implement RPA, you should test the systems to identify any issues and then integrate the systems. Once you’ve integrated the systems, you should test them again to identify any issues. Additionally, you should train the staff on how to use the RPA system and the new workflows.

Additional Benefits of the RPA in the Healthcare Industry 

In healthcare and medicine, RPA has many applications, and it produces some extremely promising results. Moreover, it offers a reasonably unobtrusive technical implementation with a small learning curve for those who depend on it, eliminating tedious work across a very broad range of roles, functions, and departments. It is important to note that different firms implement RPA in different ways, ranging from enterprise-wide settings that include all functions to smaller deployments with narrower scopes. Through RPA, the hospital can gain these benefits and more: 


Appointment Management - With RPA, hospitals can be able to automate the task of scheduling appointments, rescheduling appointments, and sending out notifications about the appointments. 


Billing and Revenue Cycle Management -  With RPA, hospitals can automate the tasks of receiving patients’ insurance information, processing payments, and sending out bills. 


Clinical Documentation - With RPA, hospitals can automate clinical documentation and improve the overall documentation process


Discharge and Transfer Management - With RPA, hospitals can automate the tasks of creating discharge summaries and transferring patients to other facilities.


Front-Desk Customer Service - With RPA, hospitals can automate the tasks associated with greeting customers and answering basic questions. 


Clinical Service - With RPA,  hospitals were able to automate the tasks related to clinical services, such as managing member appointments, scheduling, and tracking services. 


Claim Process Management -  Hospitals can manage more claims with AI computer vision than they can with manual workers. This results in an increase in the efficiency of claim process management.



Healthcare is an industry ripe for automation. RPA can help to streamline processes and reduce costs across a variety of health sector applications, from patient data entry to insurance claims processing. With the right tools and partners in place, RPA can be a powerful tool for transforming healthcare delivery.


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