Paging Doctor Bot

DOCTOR B

AUTOMATION IN HEALTHCARE

et’s turn back the dial to the peak of the pandemic. As the world fought back against COVID-19, hospitals were reliant on oxygen machines to keep a segment of the infected population alive. Each patient in this situation required a certain millilitre per second of oxygen solution, drawing from delivery devices on a colossal scale. If the calculations were inaccurate, and machines ran out, the results were nothing short of catastrophic, with death tolls rocketing.

At Northampton General Hospital NHS Trust (NGH NHS Trust), experts gathered to develop a solution, and in just six hours, ‘Oxybot’, a robotic process automation (RPA) bot, was born amidst the turmoil.

“In a few hospitals around the world, the oxygen stopped because of this challenge, and every single patient died because of an oxygen crisis,” explains Tremaine Richard-Noel, head of emerging technology and RPA director at NGH. “Here was something repetitive and about data, as oxygen amounts needed to be checked hourly. It was the first time I’d ever sat down with engineers at the hospital, and together with clinical staff, we built a system, factoring in calculations like the conversion rates and sublimation of liquid to gas, the types of patients, the capacity and ICUs, and it was powerfully simple.” The bot, created using the Automation Anywhere (AA) platform, monitored oxygen levels 24 hours a day without human intervention and with 100 percent data accuracy, and it enabled the hospital to repurpose over 1,500 hours of staff time in 2020. Despite a long line of technology failures in the healthcare sector as a whole, the NHS started to imagine the possibility of an entire healthcare revolution due to Oxybot’s success.

By January 2021, NHSX, an NHS unit responsible for setting national policy and developing best practice for NHS technology, had selected NGH to become an NHS RPA Centre of Excellence (CoE). Here, experts like Richard-Noel led the charge to create an army of software bots to bolster the deficit in NHS resources and support the workflows of employees.

Neeti Mehta Shukla, co-founder and social impact officer at AA, helps to explain the uptake: “Seeing the world from a technology lens, the best innovations come at a time of crisis, because the need is so much. It pushes the solutions to meet that need. And that’s what we’ve seen in healthcare. It’s that lightbulb moment, where you think, ‘Oh my god, this technology actually exists, imagine what I can do now’. That is why you get goosebumps and why you continue coding.”

Despite being the tenth largest employer in the world, the NHS is struggling with pressures striking at every area of operations; the past few years have seen hiring and workforce challenges, with nearly 40,000 nursing vacancies alone pre-pandemic. There are also dramatic service demand

IT’S THAT LIGHTBULB

MOMENT, WHERE YOU THINK, ‘OH MY GOD, THIS TECHNOLOGY ACTUALLY EXISTS, IMAGINE WHAT I CAN DO NOW’

NEETI MEHTA SHUKLA / AA

THE CHALLENGE

ISN’T WHAT TO AUTOMATE. IT’S WHEN TO AUTOMATE IT

TREMAINE RICHARD-NOEL / NGH

increases and backlogged cases, and cascading supply chain delays and shortages to boot.

“Everything needs to be automated because, realistically, there’s too much work to do,” Richard-Noel explains. “The challenge isn’t what to automate. It’s when to automate it. There is a backlog that is really difficult to recover when we could only just deal with what it had at the time. Now we’re at a point where we have to be innovative because we’ve got to suddenly find more capacity, particularly with workforce challenges at the minute. There’s a huge burnout. The only way we can deal with these challenges is to do something quite dramatic.”

However, there is a history of technology implementation flops in the healthcare sector, whether due to non-adoption, scale-up failure or else sustainability concerns and eventual abandonment. Therefore, how will RPA technology hope to break the mould? What will the picture look like for employees, end users and the NHS as a whole?

REIMAGINING HEALTHCARE - THE NHS RPA REVOLUTION

The past attempts of Google, Amazon, and others have, if anything, taught the healthcare industry to be incredibly reluctant to undertake new technology projects. But Richard-Noel explains that the flexibility of intelligent automation technology specifically, and its potential to enable team members throughout the organisation (whether developers or non-developers, administrative employees or front-line clinicians, porters and domestics) is key to its successful uptake at scale.

“We could start small and build up together,” he explains, “and we’ve been able to work and shape this product around our problems with an ability to glue things end-to-end across multiple organisations.”

Thus far, the NGH’s RPA CoE, encompassing business analysts, developers, clinical safety governance, principal medical officers, outreach and engagement, has enrolled more than 28 NHS organisations across the UK in their automation accelerator programme. This has seen 50 employees per month targeted to complete training, and over 500 automation opportunities already identified.

With a CoE in place to manage the governance of each bot, the control is placed directly into the hands of the NHS teams to create endless amounts of resource-saving initiatives, as Richard-Noel explains: “Giving automation to the hands of the organisation, because we’re a heavily regulated environment, is creating an option for individuals to sandbox before submitting it to the CoE. Even if you just have 10,000 staff out of 1.7 million trained and producing one automation each a year, that just becomes astronomical in terms of value.”

SORRY, DOCTOR - IT’S CHANGING AGAIN

From Richard-Noel’s estimations, one could argue that the fear of technology is morphing into an opportunity mindset as the awareness of RPA capabilities grows. Rather than taking jobs or introducing yet more procedure changes, automation is starting to be imagined as the very reason that burnt-out and overworked employees can hope to continue in these fastpaced and heavy-workload professions.

The key, then, is to use the ecosystem of knowledge readily available to the NHS, and present technology concepts that are both governanceready and free from forms, and which are designed internally to save time and effort from the start with minimal training and processes required. For NHS staff whose working days are ruled by countless procedures and best practice, the last conversation they want to have, on top of updated policies or new medications, is the ‘sorry, it’s changed again’ chat.

“Healthcare is almost all logicbased,” Richard-Noel continues. “So, there are clinicians looking at something and choosing which rule set to follow. Their specialty is being able to