IT Automation in Healthcare May 2014
IT Automation Still in Nascent Stage; Large Scope for Adoption Increasing competition in the healthcare market, coupled with greater regulatory oversight, is driving healthcare organizations to operate under increasing cost pressure and work more efficiently. In an effort to maintain or increase their operating margins, many organizations are turning to technology, including hardware and software, which are providing greater efficiencies than manual systems. Overall, the healthcare industry has traditionally been behind other industries such as retail and manufacturing when leveraging automation because of infrastructure and technical issues. However, emerging technologies such as cloud computing and automated software that require lower investment and availability of related expertise could further increase usage of IT automation in healthcare. IT automation requires minimal or zero human intervention and is driven mostly by software that manages routine tasks. IT process automation usually involves tasks that are time consuming, administrative in nature, and resource intensive. As the healthcare industry increasingly shifts from paper-based records to digital records and online information sharing, it is clear that healthcare organizations cannot afford to have any downtime, interruptions, or errors in their workflow. Due to this, organizations need to reduce or abolish traditional manual processes and invest in IT automation solutions to efficiently perform daily and complex tasks.
Adoption of IT Automation in Healthcare For health providers, revenue cycle management (RCM) is a prime area where IT automation can be leveraged to increase efficiency and minimize errors. The mandatory transition to the International Classification of Disease tenth revision (ICD-10) system can have a major impact on providers’ RCM. The ICD-10 is a coding system developed for noting various medical records by the World Health Organization in 1992. Until hospitals and practices become well versed with this new code system, it may take longer for them to submit claims, correct rejections, and appeal denials. As such, health providers need to identify which processes are manual and which could be automated to minimize risk and gain efficiency. Denials – IT tools offering denial tracking and correction can help prevent recurrences and keep the revenue cycle robust. Implementing these tools will allow providers to understand their denials pre-ICD-10 and help with seamless transition. Appeals – Providers handling appeals manually could consider tools with pre-developed letters that populate patient and denial information. This will lead appeals to be completed quickly. Eligibility – Automated verification technology helps in reducing denials and supplying eligibility information before actual treatment services are provided.
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With the influx of new members and expansion of Medicaid population, healthcare payers are under pressure to reduce costs and improve claims payment speed and accuracy. Payers can leverage claims processing automation solutions to eliminate the costly, labor-intensive manual interventions, which have long been associated with claims processing, and to improve customer service delivery. Automated claims automate and replace work performed by a person, such as a claims examiner, on a claims system. This is leading to faster turnaround, lower headcounts, and greater customer satisfaction.
Outlook RCM and claims processing are just a couple of examples of IT automation in healthcare. From automating data entry to multi-step processes involving decision making, automation can make a huge difference to healthcare organizations in optimizing workforce, streamlining processes, and responding faster to their customers.
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