Using Automation and Outsourcing to Improve Hospital Margins and Patient Care

Jul. 2 2019, Alyssa Rapp, CEO

Blog post

Health care providers sometimes see words like “big data,” “automation” and “outsourcing” as threats to their goals of spending time with patients and providing excellent care. In fact, investing in new technologies empowers hospitals and clinicians to improve care even as they reduce administrative costs and malpractice risks.

If you are a healthcare executive, you know about shrinking margins. According to data from Moody’s Investor Service cited by CNBC, the average hospital operating cash flow margin dropped to 8.1 percent in 2017 from 9.5 percent in 2016 — a drop of 17%.

How can hospitals reverse that trend? Try these three ideas:

Data drives profitability

Clinical decision support (CDS) systems allow providers to diagnose patients more quickly and accurately. They also save money by reducing unnecessary testing.

CDS systems combine biomedical data, individual medical histories, and computational analysis to help physicians diagnose and treat illnesses. Many of today’s CDS systems work with information derived from electronic health records (EHRs) and use data mining techniques to examine patients’ symptoms by tapping relevant clinical research. According to the Office of the National Coordinator for Health IT, CDS systems are expected to “significantly impact improvements in quality, safety, efficiency, and effectiveness of healthcare.”

CDS tools also alert providers to dangerous drug interactions and reduce unnecessary testing that can hinder treatment and trigger insurance claim denials. When equipped with artificial intelligence capabilities, CDS systems scan the latest research and guide doctors toward the best way to test and treat patients with specific symptoms.

CDC systems can nudge patients toward preventive care as well. A patient at risk of cardiovascular disease, for example, might get reminders through the hospital’s patient portal that it’s time to schedule blood pressure and cholesterol screenings.

Finally, CDS systems can increase operational efficiency by helping overloaded providers interpret ever-growing volumes of patient and clinical data, protecting patients from dangerous medical errors. One study published by the NIH found that CDS systems can reduce the risk of malpractice by more than half.

Go Digital

Administrative costs account for one-quarter of hospital expenditures in the United States, according to a study published in Health Affairs. Hospitals that make smart use of automation can cut those costs dramatically.

One way to automate without investing in brand new systems is by enhancing current systems with robotic process automation (RPA). These software bots efficiently perform the repetitive work of billing, ordering medications, and admitting patients. That frees hospital staff to focus on duties that require face-to-face communication and specialized training.

And how about those insurance claims? Most health care facilities still handle them manually, which not only gobbles up time but also increases the chances of administrative errors and delays. Many billing and insurance functions can now be automated, with big payoffs. According to Ernst & Young, automation can reduce insurance claim turnaround times by as much as 85 percent.

Smart Outsourcing

There were 750 million doctor’s visits in 2016, up from 380 million in 1994, according to the American Hospital Association. There are simply not enough providers to handle the current influx of patients, a problem that will only expand as the population ages.

Staff shortages contribute not only to burnout and turnover among existing hospital workers but also make it tough to attract new hires. One way that hospitals can free up money for critical staffing needs is by using strategic outsourcing to cut overhead costs.

Outsourcing non-clinical work, such as financial services, IT, and equipment maintenance, can ease the burden on budgets and full-time workers. As the CEO of Surgical Solutions, I have also seen hospitals save money by outsourcing highly specialized tasks in the operating room environment, with the added flexibility of scaling services up or down depending on patient volume.

Using big data and automation also helps, by reducing the time and cost associated with administrative tasks and freeing up physicians, nurses and other hospital staff members to focus on high quality patient care.

Clinical decision support (CDS) systems allow providers to diagnose patients more quickly and accurately and save money by reducing unnecessary testing. CDS systems combine biomedical data, individual medical histories, and computational analysis to help physicians diagnose and treat illnesses.

Many of today’s CDS systems work with information derived from electronic health records (EHRs) and use data mining techniques to examine patients’ symptoms by tapping relevant clinical research. According to the Office of the National Coordinator for Health IT, CDS systems are expected to “significantly impact improvements in quality, safety, efficiency, and effectiveness of healthcare.”

CDS tools also alert providers to dangerous drug interactions and reduce unnecessary testing that can hinder treatment and trigger insurance claim denials. And one study published by the NIH found that CDS systems can also reduce the risk of malpractice by more than half.

Administrative costs account for one-quarter of hospital expenditures in the United States, according to a study published in Health Affairs. Hospitals that make smart use of automation can cut those costs dramatically.

One way to automate without investing in brand new systems is by enhancing current systems with robotic process automation (RPA). These software bots efficiently perform the repetitive work of billing, ordering medications, and admitting patients.

Automating billing and insurance functions can also produce big payoffs. According to Ernst & Young, automation can reduce turnaround times for insurance claims by as much as 85 percent.

Want to know more about these or other ways to cut costs and improve care? My staff and I at Surgical Solutions are here to help.

These are derivatives from the Originally Published Byline: Live Link.