24 minute read
Deploying RPA in the Health Service Executive
Deploying RPA in the HSE
Ciarán Galway speaks with Kevin Kelly, RPA Lead with HSE Shared Services and Philip McGrath, Public Service Innovation Policy Lead with the Reform and Innovation Division at the Department of Public Expenditure and Reform (DPER) about the rollout of robotic process automation (RPA) across the Health Service Executive (HSE).
Philip McGrath
The key drivers of RPA in the HSE are the same as the drivers of RPA in any of our public service bodies; we need to automate processes that are time consuming and laborious to make organisations more efficient. These processes follow a particular pattern; they generally involve several different systems, and they involve rules. RPA frees up staff to be transferred to do more value-added work and undertake more cerebral tasks, while simultaneously speeding up processes. Moreover, RPA assists in performing a type of audit on an organisation’s processes. It helps to identify areas where processes really aren’t contributing to desired outcomes, other processes that lean methodology can be applied to, as well as processes that might not need to be undertaken at all. This improves the service delivered to citizens, making it better, easier to use and quicker.
Kevin Kelly
In many of the areas where we have deployed RPA, it has enabled those already stretched teams to absorb more work with the same headcount. Although traditionally a good fit in the areas of administration and particularly within HR and finance, we are observing interest from both administrative and frontline areas and through the conversations we are having right across the health sector, use cases are emerging that positively impact frontline services directly. For instance, nurses who have been relieved of administrative tasks through RPA and surveillance scientists who have handed over their administrative tasks to a robot or virtual worker, thereby allowing them to analyse infectious disease data rather than having to process it first.
What are the advantages of the HSE/DPER collaboration on RPA?
Kevin Kelly
Having DPER’s stamp of approval on this technology and on the approach that we were taking has been invaluable. From the HSE’s perspective, DPER came on board at an early opportunity and supported us to identify suitable areas to conduct a number of pilots. Since then, the decisions we have taken to invest in the establishment of our Centre of Excellence and in the operating and delivery model we have subsequently adopted have been validated by DPER. This instilled a high degree of confidence that our approach is correctly aligned with broader public sector policy.
Philip McGrath
DPER has been involved in research, testing, piloting, and growing RPA since the end of 2016. Our collaboration with the HSE has confirmed that RPA can be gamechanger in terms of how we administer our services to the citizen. The health sector is the largest and, arguably, the most complex component of the public sector and we know that there are several systems that would be prohibitively expensive and difficult to integrate using conventional automation methods. That’s why driving RPA’s success in this particular sector will pave the way for other centres of excellence to embed RPA across government.
While we have centres of excellence in Revenue, the National Shared Services Office and the Department of Social Protection is working through its options at the moment, what the HSE has done is showcase how RPA can be successful in terms of changing how we do work. This ranges from the back office and the work done in relation to Garda vetting to the Mater Hospital, where nurses have been
assisted in their administrative duties, and to the work on positive Covid test cases in the Health Protection Surveillance Centre. It has confirmed and validated DPER’s planned direction of travel and it has shown the enormous savings that can be made if people commit at a strategic level. The Centre of Excellence that Kevin is building is very much strategically focused and incorporates the virtual worker into the future of the health service. Overall, the collaboration acts as a blueprint for us in moving forward across government.
What are the most significant challenges on this journey?
Kevin Kelly
While the deployment of RPA within the HSE was a year or two in the making, it suddenly became an overnight success because we were fortunate to land RPA
Philip McGrath
The most significant challenge since we began embedding the pilots was the Covid-19 pandemic and the associated challenges that working remotely has presented. However, this has also acted as a catalyst. Organisations will now very quickly move to digital inputs which then more easily enable the deployment of RPA. In terms of the challenge, projects across the HSE have, out of necessity, been required to take a backseat while our health service staff focus on protecting the public and the vaccination programme. As much as we would love to be pursuing every single pipeline of processes, there are other priorities for Kevin and his team. While the deployment of RPA is very important in terms of the future of the health service and ensuring the most efficient service possible, it is clear that the health and wellbeing of the citizen takes precedence.
technology into the right areas at the right time in the very early stages of the Covid19 response and it made a significant difference. However, the challenge that presents now is the expectation to keep delivering, while simultaneously building an enterprise technology platform and embedding an appropriate delivery methodology and support structure. So, it is a balancing act at the moment between doing this correctly while simultaneously meeting demand.
Another challenge that we have encountered is a skills deficit. RPA is a relatively new and niche technology, so we’re cognisant of the challenge of attracting appropriately skilled people who are in high demand. For that reason, we’re keen to upskill our own staff to become proficient in RPA technology so we have developed staff training opportunities through our Digital Academy and are exploring other initiatives that will create a pipeline of talent through apprenticeships and internships that we will then tap into.
Kevin Kelly
That’s correct. Many of my team have been involved in the Covid-19 response to some degree over the last 12 months, firstly in contact tracing and more recently the vaccination programme. Simultaneously, however, the HSE has undergone a rate of digitalisation during that timeframe that might otherwise have taken years. As such, staff have become more aware of new and innovative ways of working than they were perhaps 12 or 18 months ago. They are scanning for more efficient approaches to work and can now envisage how automation might occur in their respective part of the health service. The crisis has brought about an opportunity for us in that digital transformation has accelerated. But we’re in the early stages of our RPA journey and there is a substantial volume of work ahead of us to firmly establish the Centre of Excellence and embed a federated model of local delivery and self-sufficiency across the organisation.
Philip McGrath
We found it particularly difficult to identify projects over a number of years, in part at least due to a misunderstanding about what RPA is and how it can be applied. Covid has inadvertently put processes under a microscope and enabled people to understand that what they previously thought were subjective decisions were in fact a series of rules-based decisions, usually bundled together. There has been something of a cultural shift as a result of the Covid-19 pandemic.
How has the application of RPA supported the health service’s Covid-19 response?
Kevin Kelly
This is where the RPA has already proven its worth for the HSE. One of the areas in which we had piloted RPA was a process around Garda vetting and fortunately, we had it automated by the end of February 2020 just prior to the first positive Covid19 cases in Ireland. That particular Garda vetting process previously took over three weeks for a team in Dublin to complete and the implementation of RPA reduced that time to six hours. As such, a process that was occurring monthly could now be completed weekly. In the context of the Covid emergency, at a time when we were hiring new interns and nursing graduates at pace, the streamlining and automation of this process meant that these new health service staff had their HR records updated with their vetting outcomes more rapidly enabling them to be deployed into frontline posts more quickly.
In March 2020, we then engaged with the Director of the Health Protection Surveillance Centre and, over the past year, we have implemented an RPA solution which has effectively reduced a previously manual process from 26 minutes to just over three minutes. In effect, for every 100 positive Covid cases, we are now saving public health staff 38 hours of administrative workload. When you consider the context of hundreds, or at times thousands of positive daily cases, that’s a significant number of hours of manual data entry being saved each day. By early December, we had scaled the solution by
cloning our RPA virtual agents to manage up to 10,000 cases per day based on predicted models. HSE data scientists have been instilled with such confidence that they are now discussing the automation of additional processes relating to vaccination data, genome sequencing and antigen testing notifications. We would simply not have been capable of managing the workload that was emerging from the daily positive Covid figures, so it is a good news story.
Philip McGrath
I was almost shocked by the level of support that RPA provided to the Health Protection Surveillance Centre. It was a very proud moment for the people who had been working on RPA when we saw how much assistance this provided during a national crisis and how it enabled our medical scientists to do what they do best; protect public health. RPA, in this instance has really validated itself and has shown that we can have a future where our human workforce is supported by virtual or robot workforce.
What is your vision for the future of RPA across the health service?
Kevin Kelly
Our plan is to develop a high degree of self-sufficiency in RPA skillsets, right across the organisation. We will do this by establishing a central technology platform, a governance structure and a series of methodologies which will support and encourage all elements of the health sector to adopt virtual workers into their respective areas to perform repetitive, mechanical tasks, and ultimately free up our staff to focus on delivering better health outcomes for our service users.
For now, we’re focused on driving RPA based automation across this very large organisation, but we are keeping our finger on the pulse on new developments, such as chatbot technology or other cognitive AI technologies, which can then knit into what we’re already doing.
Philip McGrath
I’d love to see the Centre of Excellence that Kevin and the team have developed being available to all the bodies in the health sector and potentially making this platform accessible to other public service bodies in the future. If that is possible from a technical, logistical and governance perspective, that would be very welcome. There is a lot of valuable time, whether in clinician, data management or back office, being spent on processes which are not adding value. As Kevin said, what we need to do is find ways to return that time to the frontline, rendering our services better, cheaper, and faster for the user. We can do that by investing in our people who can then automate their own processes and become self-sufficient in automation. We can then look at incorporating additional intelligent automation platforms and move into more advanced areas, such as cognitive computing and artificial intelligence.
Kevin Kelly
Kevin Kelly has 30 years of experience working within technology, the first half of which was spent in the private sector before he joined the HSE in the latter half. Predominantly, Kevin worked within ICT infrastructure, but six years ago, he moved into the HSE’s Shared Services Division initially as a Business Relationship Manager but more recently leading on digital innovation across health shared services.
Kevin Kelly
One of the most pleasing and surprising aspects of this is the manner in which our colleagues have been so eager to embrace RPA. We haven’t met any resistance and people have recognised the benefit to them, the work they do and the service they deliver to their service users. It has been a positive experience for us in exploring the opportunities which exist with every section we have engaged with. People are genuinely excited about what they hear about RPA and when we present the evidence from within the HSE, there is a clamour for this technology to be applied.
Philip McGrath
That sentiment has been mirrored elsewhere. Previously, when we rolled out RPA within the National Shared Services Office, there was initially a lot of suspicion around RPA. However, when people saw that it worked and removed challenging processes that staff had to spend hours each day working on, they sought to improve their processes to get them to the point whereby they could be automated. While they can offload much of the mundane, repetitive, and timeconsuming aspects of their work to a virtual worker, staff retain ownership of the processes, and that is important.
Philip McGrath
Philip McGrath worked within the Department of Justice for 12 years, undertaking a variety of different roles ranging from processing asylum seeker claims to antimoney laundering. Philip joined the Department of Public Expenditure and Reform in 2014 and was allocated to the Reform and Innovation Division where he now leads public service innovation policy. While he began piloting RPA in 2016, the majority of his work relates to driving innovation across the wider public service, including responsibility for coordinating the recent Public Service Innovation Strategy.
Global minimum corporation tax
The Biden presidency has reinvigorated efforts to reform the international corporate tax regime which could have significant repercussions for Ireland.
Addressing the Chicago Council on Global Affairs in early April 2021, US Secretary of the Treasury Janet Yellen asserted that efforts to agree a global minimum corporate tax rate of 21 per cent could halt the “thirty-year race to the bottom on corporate tax rates”.
Yellen’s remarks on international priorities referred to efforts on behalf of some countries to use reduced rates of corporate tax as a tool of economic competitiveness in an effort to attract FDI.
“We are working with G20 nations to agree to a global minimum corporate tax rate that can stop the race to the bottom. Together we can use a global minimum tax to make sure the global economy thrives based on a more level playing field in the taxation of multinational corporations, and spurs innovation, growth, and prosperity,” Yellen said.
Writing in the Wall Street Journal in the same week, Yellen outlined: “This is the rock bottom of the race to the bottom: By choosing to compete on taxes, we’ve neglected to compete on the skill of our workers and the strength of our infrastructure. It’s a self-defeating competition, and neither President Biden nor I am interested in participating in it anymore. We want to change the game.”
Under Biden’s proposals, which have been shared with the 135 countries involved in the OECD BEPS negotiations, the taxes paid by multinationals would be based on their sales in each of the countries within which they operate. It is intended that this would inhibit tax avoidance and profit shifting. Meanwhile, the minimum global rate of 21 per cent could prevent the US from being undercut, stemming further losses to its tax revenue.
Speaking at a virtual meeting of the G20’s finance ministers in February, Yellen endorsed the OECD negotiations to reform the international corporate tax system. Two months later, the Treasury Secretary reiterated her support for an agreed OECD global minimum rate. “Destructive tax competition will only end when enough major economies stop undercutting one another and agree to a global minimum tax. Through the Organization for Economic Cooperation and Development, we have been engaged in productive negotiations to achieve this,” she wrote.
This has revitalised the OECD Base Erosion and Profit Shifting (BEPS) project which seeks to mitigate the shifting of profits from high-tax to low-tax jurisdictions by determining where tax is paid and setting a minimum rate. Pascal Saint-Amans, Director of the OECD Centre for Tax Policy and Administration, suggested that the US proposals will “reboot” the stalled OECD negotiations.
GILTI
Domestically, the Biden administration intends to increase corporation tax to 28 per cent to provide revenue for a massive $2.3 trillion capital spending programme as the spearhead of the post-Covid recovery in the US.
Introduced under the previous Trump administration, the global intangible lowtaxed income (GILTI) system taxes income that is earned outside of the US by US controlled foreign corporations. Intended to discourage US companies from offshoring business to low-tax jurisdictions, it is now recognised that 10.5 per cent was insufficient rate in disincentivising these companies. Biden’s proposals would increase the GILTI from minimum of 10.5 per cent to a minimum of 21 per cent.
If the Biden administration’s proposed changes to tax levying were implemented, it would mean that any company paying tax at a rate below the global minimum would be required to pay additional tax in each jurisdiction it operates in, in order to reach the 21 per cent threshold. Consequently, Ireland’s advantageous tax regime could be destabilised.
Although yet to progress through the House of Congress, the minimum tax rates set within the US will inevitably have repercussions for the OECD and Ireland.
While highlighting the fact that Ireland’s corporation tax rate has not changed since it was reduced from 32 per cent to 12.5 per cent in the 1999 Finance Act, Finance Minister Paschal Donohoe TD recognises that the context of the debate on corporate tax policy has now changed.
“What Ireland and other countries will do is put forward their case within with the OECD, and we’ll work inside that process to try and influence an outcome that recognises the role of small economies in the global economy,” he insists.
Intelligent automation: Enabling your operations
Digital transformation can help enhance our public services by improving back office operations to better serve the needs of citizens, businesses, and employees through the innovative use of design, operations and new technology, write Shane Mohan and Louise McEntee of Deloitte.
Robotic Process Automation (RPA) is a practical and pragmatic approach to move towards digital transformation that is within reach for all organisations and business areas. Our experience with a range of public bodies is that they can implement automations that deliver material efficiencies, time and cost savings in a very short time – a few months, and even weeks in some cases.
RPA is here to stay
In the past few years, we have seen organisations embrace digital ways of working, and many have incorporated robotic process automation as part of their transformation journey, to support their people and enable their operational efficiency.
We are working with organisations across the public sector to:
• Help them to imagine the possibility intelligent automation presents for their organisation;
• Deliver their vision for automation and release immediate value from basic RPA through to intelligent automation;
• Transform their operations by exploring how they can redesign their service model and operations to really get the best from both people and their digital workforce; and
• Build new automation capabilities in their organisation, to support them to sustain these new automations and manage their digital workforce.
Delivering real benefit from the outset
Robotic process automation is already delivering significant benefit across the Irish public sector. In the past year alone, we have partnered with multiple departments and agencies to deliver:
• Increased efficiency by reducing processing time/lapsed time for completion of processes, and removing handover delays;
• Improved employee experience: Staff have been able to move away from repetitive rule-based tasks associated with manual processes and to focus on more challenging and value adding activities;
• Increased Quality: Increased data completeness, quality and security;
• Improved Accuracy: Reduction in human error reduction in time required for QA/human review;
• Automation re-configurability:
Automations and business-objects developed for automated processes can be easily reconfigured for other processes;
• 24/7 Operations: Scheduling processing to run outside working hours will increase capacity of your teams, while also improving accuracy and efficiency; and
• Standardised process: The robot will carry out the process in the same way every time it is run, so that reliable results are produced every time. For most organisations the initial focus will be on substitution; organisations take processes or fragments of processes as they are performed by humans and simply automate those processes by replicating them exactly.
As an organisation’s understanding of automation increases the trend is to move to shifting work, redesigning processes to shift elements of work from human workers to digital workers to reduce backlogs, process duration, and remove bottlenecks, and remove lapsed time when handing processes between teams and accelerate overall processing time.
The next evolution is to supersede existing processes. Organisations are moving to redesign their processes and operations to allow people and technology to truly collaborate. This means that we do not just shift work over to our digital workforce but actually redesign work to deliver new, different and better results for citizens, businesses and employees.
How do I spot a good opportunity for automation?
Pre-Requisites: Digital/Computerbased Rules bases
Case Enhancers: High volume Low variability Error prone
Why should you automate?
Your RPA Deployment Checklist
When preparing to adopt RPA within your organisation there are some key areas to focus on:
• Check for leadership alignment: Not just official sign-off but actual agreement on the goals of your implementation (quantified by a business case/payback period), timelines and resources.
• Identify change champions: You will need leaders who will be the face of the transformation within your organisation and can advocate for your transformation. Empowering your teams, who know their business best, on process selection, process, operation or organisation design, and to shape key messages around the change can really help to avoid pitfalls and risks down the road.
• Clearly articulate alignment between automation and your organisation’s priorities: Disruption to the way things have always been done and transition is rarely easy, but if your teams and stakeholders understand how these initiatives link to your overall priorities (e.g., better service, improved efficiency, reduction of backlogs) and how they will benefit, they will be more inclined to commit to a project and support it.
• Clearly define the changes that automation will bring: This will include supporting your teams to redesign their operations and processes to work in partnership with your digital workforce. You will need to think through your training approach to foster continuous improvement and also focus on the skills to embed your changes (e.g., change management, programme/project management and automation management) to support your teams to evolve those roles and build skills for the future.
Getting started on your automation journey?
Start small
Start with a pilot project. Building a production ready bot from the outset rather than a proof of concept means that your automation will deliver real benefit to your organisation straight away. You can also start to build the skills required to continue to implement automation within your organisation.
But think big
Be prepared that once you introduce automation to a team, they will be considering what they will want to automate next before your first project is finished. It will be important to consider how you are going to build skills, manage your digital workforce and maintain momentum around your programme of automation beyond that first pilot.
Louise McEntee Louise leads our Government & Public Services Intelligent Automation Team. She is a specialist in the delivery of digital operations & transformation. She with our partners in DPER and OGP to support clients through the RPA Framework.
Office of Government Procurement RPA Framework is there to support you
The OGP Framework for the provision of RPA services, training, and support makes it very easy to get started on your automation journey. To learn more about RPA and other automation technologies, or to discuss how to get started with RPA, contact the Deloitte or Department of Public Expenditure and Reform teams:
E: IE_GPS_RPA@deloitte.ie E: rpa@per.gov.ie W: https://bit.ly/3dcH79L
Shane Mohan Shane leads Deloitte’s Government & Public Services practice. He works with clients across National and Local Government, Justice, Health and Education sectors.
Brexit: Progress and process
The EU Commission will continue its legal action against the UK over its unilateral action on the Northern Ireland Protocol but away from the spotlight, the European Parliament has moved closer to ratifying the EU-UK trade deal.
As intensive talks were underway in London in mid-April over implementation of the Northern Ireland Protocol, MEPs in Brussels moved a step closer to ratifying the trade deal which has been provisionally implemented since January.
Foreign Affairs Minister Simon Coveney TD was in London on the 14 April for a series of meetings with British cabinet ministers to discuss the management of the Protocol and the impact of its implementation.
Coveney’s visit to London coincided with a meeting between European Commission Vice-President Maroš Šefčovič and UK Minister for EU relations, David Frost, in Brussels, with the pair seeking to keep communication open over differences around the implementation of the Protocol.
Both parties described the informal meeting as positive, with Šefčovič stating that officials had been given a “political steer” for discussions to intensify in the coming weeks.
However, while a statement from the UK also described a “constructive atmosphere” and the establishment of positive momentum, the spokesperson added: “But a number of difficult issues remained, and it was important to continue to discuss them. [Mr Frost] agreed there should be intensified contacts at all levels in the coming weeks.”
Despite the positive development, Šefčovič has indicated that the EU will pursue legal proceedings against the UK’s decision to unilaterally extend grace periods for the Irish Sea border.
In early March 2021, Frost announced the extension of grace periods for goods coming from Great Britain into Northern Ireland, set to end in March, until October. However, he failed to consult the EU’s Šefčovič on the move. Despite attempts to play down the move, pointing to “operational reasons”, Šefčovič said the move amounted to “a violation of the relevant substantive provisions” of the Protocol.
Brussels has said it is ready to find “swift, pragmatic solutions” within the framework, something Coveney has repeatedly stressed. “We need to talk seriously about how the Protocol is being managed, how it can be implemented in a way that listens to the concerns many in Northern Ireland have and what flexibilities are possible,” he said in London.
While the Protocol, as part of the 2019 divorce treaty, is legally separate from the EU-UK trade deal, the two have been consistently linked politically. Earlier this year, the European Parliament paused the ratification process of the trade deal in response to the UK’s grace period extension.
However, it would appear that MEPs are now more contented with progress in the negotiations over the Protocol and could soon move to officially ratify the trade deal.
In mid-April, the EU’s foreign affairs and trade committees backed the trade and cooperation agreement by 108 votes to one, a move which paves the way for a future final ratification vote by the assembly. MEPs waited to be briefed on Šefčovič’s meeting with Frost before setting a date for a final ratification vote, but Parliament faces an end of April deadline to either extend the provisional application of the agreement or ratify the agreement in full to avoid the trade deal ceasing to apply and a revert to WTO terms.
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