Building Your Digital Workforce: Launching and Sustaining Your Intelligent Automation Journey

Realizing the Potential of Intelligent Automation

Building a digital workforce involves integrating a team of human agents and bots working together seamlessly through the process efficiencies and predictive analytics of AI agents.

Bots excel in managing repetitive tasks, freeing up human agents to focus on complex activities that require human intelligence. For example, bots can efficiently manage tasks such as claim status checks or prior authorizations while human staff dedicate their efforts to high-value work like analyzing denial codes for appeals. This well-orchestrated collaboration not only enhances process standardization and data management practices but also sets the stage for more strategic operations.

Despite the healthcare industry’s growing familiarity with intelligent automation, its adoption in key functions across revenue cycle management (RCM) is inconsistent. The current state is a fragmented industry with a lack of uniformity in interactions across payers, clearinghouses, and other systems or companies.

While RPA and other automation tools are gaining traction in revenue cycle management, the adoption of AI-based logic systems has been limited. As a result, few healthcare organizations are truly realizing the full potential of intelligent automation. The ability to harness this potential exists only at the intersection of AI, bots, and human-in-the-loop services. In fully integrating these resources, healthcare organizations can pave the way for a more efficient and effective workforce capable of handling exceptionally higher workloads with minimal effort.

Embracing Transformation

To fully leverage the capabilities of intelligent automation, healthcare organizations must move their focus from simply automating existing tasks to designing and building digital worker-first processes.

Embedding automation within inefficient processes only institutionalizes and perpetuates those inefficiencies. Conversely, creating new digital-first processes requires a willingness to depart from existing human-oriented workflows towards advanced solutions that leverage the full capabilities of RPA and AI.

Effective change management, aimed at fostering a culture of continuous improvement, is critical for redefining automation's role in revenue cycle workflows and workforce. This involves stakeholder engagement, communicating the advantages of RPA, and ensuring employees are well-prepared to collaborate with bots. Recognizing the factors that foster adoption and framing them from an empathetic point of view is crucial, especially in addressing concerns related to job security and the impact of innovation on existing roles.

Most importantly, it is critical to understand that reconfiguring deeply engrained processes does not bring overnight success. In fact, there may be short-term consequences as team members adjust to new operating procedures. However, implementing digital-first processes is necessary to raise the bar in the long term.

Building a Metrics-Driven Digital Workforce

Incorporating RPA and AI into RCM can significantly improve operational efficiency and financial outcomes. However, despite the prevalence of fully centralized revenue cycle metrics tracking among health systems, pinpointing the right metrics, monitoring them effectively, and measuring intelligent automation's impact on outcomes remains a challenge.

For RCM leaders, this underscores the need to integrate RPA and AI solutions with meaningful metrics from the beginning. The challenge lies not in selecting metrics but in demonstrating the value of technology investments, particularly to senior management and stakeholders. By understanding existing metrics, communicating their significance and differences, and adapting organizational processes accordingly, leaders can effectively advocate for the technology's benefits.

Given time is required to observe meaningful trends in RCM business cycles, patience is essential for accurately evaluating impact. RCM leaders must be prepared to continually review data to observe trends and generate hypotheses that can be shared among stakeholders. Strategic alignment with organizational goals enables more informed decision-making and optimizes revenue cycle operations, enhancing process accuracy and efficiency while measuring financial improvements.

Preparing for the Future

For revenue cycle leaders, future investments in intelligent automation technologies involve not only financials but also cultivating a culture of readiness for innovation. As the line between operations and technology continues to blur, delivering value requires a proactive approach to developing a clear strategy and roadmap. Successful healthcare organizations will proactively identify areas that can benefit from automation, select the right technology partners, and establish a strong governance framework.

Looking toward a future where human agents will work alongside digital counterparts, revenue cycle leaders must invest in training and configure the workforce for effective collaboration. This involves transitioning from a few power users utilizing advanced technologies to a culture where everyone is empowered to leverage automation. Investing in both technology and in people's ability to manage data and create solutions empowers the workforce to harness tools effectively, translating the investment in technology into an investment in people.