Understanding the Importance of Workflow Management in Healthcare

Timely interventions in the healthcare industry are crucial in saving lives. Likewise, quick and efficient healthcare processes save a significant amount of money for the healthcare industry. Millions of healthcare transactions that occur daily are costly and tedious administrative processes.

According to the Council for Affordable Quality Healthcare 2020 Index, the US healthcare industry is missing out on saving billions of dollars by conducting key business transactions manually. The report goes on to say that out of the 39 billion USD spent by the healthcare industry, a whopping 16.3 billion USD could be saved by migrating to fully digital transactions. Workflow automation in healthcare improves the efficiency and accuracy of transactions.

What ails the Healthcare System?

Ironic indeed – What ails the healthcare system! From billing to discharge to admission in hospitals – each of these processes is paper-based. So, what is wrong with a paper-based hospital? For starters, paper-based processes are inefficient and prone to errors and duplications.

The medical industry is already burdened with the pressure of having to do more with less, the errors and inefficiencies of following archaic paper-based processes only add to their woes.

According to a statistic, 32% of healthcare workers spend more than 20 hours a week on administrative work. Every second counts in the healthcare industry that strives to save lives. Imagine if all these hours could actually be spent on patient care.

It would make a world of difference in the productivity and quality of healthcare delivered by the organization. In a nutshell, outdated healthcare workflows need to be replaced by digital workflows that are quick and efficient. 

Relying on human resources for mundane admin tasks is another factor that is holding back healthcare providers from delivering quality healthcare. Admin tasks do not require intelligent decision-making or analytical thinking – they only require keen observation and errorless data validation.

You don’t have to waste precious resources on such tasks, we have bots to take care of that! Admissions, insurance claims processing, discharge, medical coding and billing, appointment scheduling and management, and insurance pre-authorization are examples of healthcare workflows that require minimal to nil human intervention. Automating such tasks saves a huge chunk of time for human resources. 

So, how to improve medical workflows?

The cornerstones of a healthcare workflow management system are – streamlined workflows, quality patient care, and regulatory compliance. Healthcare workflow automation empowers hospitals and healthcare providers to overcome all the limitations of archaic systems and deliver top-notch patient care. 

By combining advanced technologies like AI, machine learning, and computer vision in healthcare workflow management, the scope of automation in healthcare is greatly increased. 

Simple automation was limited to simple tasks that could be handled by RPA. But, with computer vision and ML, AI-based automation can perform more sophisticated data recognition and even learn and improve processes based on historical data.

The powerful combination of AI, ML, and CV has expanded the scope of healthcare automation to include revenue cycle management, patient scheduling, inventory management, human resource management, supply chain management, and even IT request management. As these technologies advance further, more entities will be added to the list.

Improving Healthcare Workflows

Healthcare workflows are complex processes ridden with workflow variations and transitions. What is a workflow? The workflow may be defined as a sequence of repeatable administrative, mental, or physical tasks that are performed by employees.

To ensure the delivery of quality healthcare, workflows need to be streamlined. From patient registration to medical reports to insurance documentation – all medical workflows involve several repetitive admin steps.

Manual healthcare workflows are characterized by paperwork. Paperwork is like a necessary evil – as much as it is important to maintain healthcare records, it is equally important to ensure the accuracy and consistency of paperwork. Not just being consistent, healthcare records also need to be compliant with HIPAA regulations.

From a business perspective, the key to improving profitability is to improve the efficiency of key clinical workflows. How do we improve healthcare workflows?

Here are key focus points for improving hospital workflows:

1. Reduce wastage

The wastage in the healthcare industry is humongous. Resource underutilization is a main source of wastage. The first step is to study existing workflows in-depth and identify areas for change/improvement. Scrutiny of existing workflows helps eliminate repetitive and redundant steps.

Using technology to improve the efficiency of workflows is an effective way to reduce the wastage of resources. Electronic health records (EHRs) help healthcare providers deliver high-quality healthcare by digitizing patient information updates and maintenance. Streamlining clinical workflows enables clinicians to reduce the wait time and communicate and collaborate better.

2. Communicate seamlessly

Outdated communication systems like a pager, faxes, emails, and landlines can bring down productivity drastically. Both medical personnel and patients are frustrated with the use of such outdated systems. Most healthcare systems work in silos with broken communication chains. These outdated systems must be replaced with modern integrated systems for seamless communication.

3. Collaboration systems

Communication and collaboration systems are critical to improving clinical workflow efficiency. Using mobile communication devices compliant with HIPAA texting standards improves collaboration between disparate clinical teams and systems.

Modern Clinical Communication and Collaboration (CC&C) solutions minimize wait times and ease communication bottlenecks, accelerating admissions and discharges, improving patient safety, and enabling faster clinical decisions.

Efficient workflow management in healthcare can be brought about through healthcare workflow automation.

What are the Prerequisites for Healthcare Workflow Automation?

So, how does one decide that a medical workflow is the right candidate for automation? A general baseline would be any process that involves excessive paperwork, consumes a lot of the Doctor’s time, or is ridden with data errors. In a healthcare environment when several appointments are missed or wrongly scheduled, it means that the admin team or manager has to consider automating some or all of the appointment scheduling and management workflow. 

When it comes to claims processing, inordinate delays or wrong payments, or high volumes of denied claims, are some of the telltale signs that the process needs to be reviewed and streamlined via workflow automation. Automating the claims processing and insurance preauthorization process drastically brings down the processing cycle time and also the error margins in claims processing. 

Automating repetitive tasks in healthcare improves patient outcomes by supporting technological advancements that make processes more efficient and effective. Automation could be as simple as sending automated messages to patients reminding them of upcoming appointments, or as complex as warning clinicians of known contraindications and interactions for drugs by referring data from a central database. 

When is it Time to Automate Healthcare Workflows?

To derive maximum benefits from healthcare workflow automation, one must choose the right workflow and automate it at the right time. We have covered how to choose the right workflow for automation in the above section. Now, we have to decide the right time to automate. 

Hospital administrators often see their staff slog over appointment schedules by going through the waitlist. Sometimes, the staff simply bypasses the waitlist due to the time it takes to go through and update it. Bypassing the waitlist is more of a stop-gap arrangement, which can boomerang sometimes in the way of missed or overlapped appointments. So if you are seeing way too many cases of missed appointments or the appointment waitlist not being managed properly – it is time for automating the appointment scheduling and management workflow. 

The medical coding and billing process is among the most important medical workflows. It has a direct bearing on the bottom line of the healthcare organization. Even a minor oversight or mismatch in the codes used in the billing cycle could prove disastrous for the organization. When you are seeing way too many errors in billing, most of which are due to human negligence, it is time to consider automating the process. 

What is Workflow Automation in Healthcare?

Automating workflows is particularly useful in healthcare because they have several programs, disparate systems, and data requirements that need to collaborate daily. A single clinical process relies on several disparate systems.

Although existing systems have worked well so far, the lack of accuracy, labor-intensiveness, and siloed working model of these systems do not work in their favor. Automated medical workflow management is focused on improving process efficiencies and effectiveness, increasing productivity, and cutting costs.

Workflow automation for healthcare is a dependable way to improve patient safety and quality of healthcare. A streamlined hospital workflow enables healthcare providers to improve compliance, accountability, and accuracy. Workflow automation in healthcare focuses on streamlining the healthcare process workflows by eliminating redundant steps.

The first step is to map out existing workflows to identify areas for improvement. The next step is to involve all the stakeholders to plan out a new workflow that is in sync with process requirements and expectations. The new workflow must achieve the end goal of the process through optimal resource utilization.

Once the new workflow is run by the team, the next step is to implement the new changes. All the stakeholders must be informed about operational the new changes and their impact on the workflow. Post-implementation the workflow performance must be reviewed. The feedback from the review process helps fine-tune the workflow as per user expectations. The success of healthcare workflow solutions is measured based on key metrics.

Benefits of Automating Healthcare Workflows

Automating the healthcare workflow process brings several benefits to clinical processes. Healthcare providers are bogged down by inefficient, disparate processes that bring down work efficiency and productivity. Healthcare providers that have automated their key workflows swear by their benefits.

The key benefits of automating healthcare processes are listed below:

1. Centralizes and simplifies business operations

Automated workflows provide a single source of truth for all healthcare-related information. Centralized access to data saves a lot of time for the users.

2. Manages capital and operational expense processes

Workflow automation in healthcare helps healthcare professionals manage capital and overhead expenses efficiently.

3. Standardizes admission and discharge processes

A workflow automation solution standardizes the patient admission and discharge process. Speedy admission and discharge of patients help improve the brand image of the hospital.

4. Ensures compliance with HIPAA regulations

A healthcare workflow automation solution ensures that patient information records are maintained as per HIPAA regulations.

5. Ensures a compliant vendor approval process

Only compliant vendors are to be admitted into the healthcare system when they come through the workflow automation solution.

6. Manage incident reporting and management

Incident reporting and management are managed efficiently through healthcare process workflows.

Examples of Workflow Automation in Healthcare

An efficient healthcare workflow is one that is devoid of any redundancies or bottlenecks. Organizations that go for healthcare workflow automation enjoy several benefits like reduced errors, accelerated approvals, and consistent data processing. Workflow automation for healthcare is used for automating and streamlining tasks like appointment scheduling, report generation, and medical records updation.

Here are a few workflow examples in healthcare:

1. Capital and operational expenditure

Healthcare organizations receive large volumes of capital expense requests that must be managed efficiently. Handling these requests manually is prone to delays, errors, lack of visibility, and lack of compliance. Deploying a consistent and compliant workflow via automation brings down the risk of mishandling and errors and increases the speed of returns on capital spending. Audit trails can be standardized for internal purposes and external compliance.

2. Vendor qualification

Healthcare companies are responsible for ensuring that processes are in place for the proper qualification of external vendors and contractors. A workflow management system helps assess the accountability, consistency, and risk of inconsistency while vetting new vendors. Consistent screening of vendors and their approval can be standardized by the workflow management solution.

3. Hospital facilities management

Efficient facility management is vital in a healthcare environment. Top-notch levels of hygiene need to be maintained in a clinical environment and managing ambulance service efficiently is critical for healthcare providers. From managing building security access to fixing the HVAC issues to maintaining hospital rooms automated hospital workflow management systems enable centralized, consistent facilities management.

4. Health information management

Efficient management of patient health information is essential for a smooth admission and discharge process. Forms requests and approvals, audit management, pharmacy recall notices, pharmacy drug tracing, and many such activities involved in patient information management can be effectively automated by workflow management.

Not just the above examples, there are several healthcare processes that can be effectively automated. Workflow management in healthcare helps improve the accuracy and consistency of operations. Workflow automation eases the burden of expense management.

The success of workflow automation in healthcare depends on the automation solution that is chosen. Cflow is a workflow automation solution that automates key business workflows easily. Visual form builders enable users to create workflows within minutes.

5. Appointment scheduling and management 

More often than not, we spend more time waiting for appointments at the physician’s office than on discussing health issues with the physician. Manual appointment scheduling by the physician’s assistant or the nurse is prone to overlap of dates/times, inefficient rescheduling, and inadequate follow-up on appointments. A clinical workflow automation system can take care of appointment scheduling and management like a pro. From appointment scheduling to rescheduling to updating appointment schedules – this system takes care of all the tasks related to the scheduling and management of healthcare appointments.

6. Insurance pre-authorization 

Insurance pre-authorization is an extremely important workflow in healthcare. What exactly is insurance preauthorization? As per medical and prescription drug plans, certain treatments and medications need to be authorized by the insurance provider before medical care is received by the insured. Pre-authorization may be required for complex treatments or prescriptions. Such treatments or prescriptions may not get covered by insurance without the due preauthorization. Automating the preauthorization process minimizes the delay in claims processing and also ensures that due diligence is carried out before authorizing the treatment or prescription. 

7. Insurance claims processing 

Waiting endlessly for your medical claim to be processed and approved can be quite a pain, especially, when you are recovering from a health setback. There are several entities that the insurance provider needs to verify and validate before approving the insurance claim. This can take a while, especially, when claims are processed using archaic manual methods. Medical workflow management can ease out claims processing by automating rote processes like data verification and validation, or credit history checks of the insurer. 

8. Medical coding and billing 

Hospitals and healthcare organizations process thousands of bills on a daily basis. Going through each bill and matching the code against the list of approved medical codes is a laborious and exhausting proposition. Automating the medical coding and billing process not only speeds up the billing process but also eliminates errors in the process. 

9. Revenue Cycle management 

Revenue cycle management in healthcare is the process that facilities use to manage the administrative and clinical functions associated with claims processing, payment, and revenue generation. Identification, management, and collection of patient service revenue are all part of this process.

The revenue cycle management begins when a patient seeks an appointment for the medical services, and ends when the hospital/healthcare organization has collected all the claims and patient payments. Optimizing this cycle is a top priority for hospitals and healthcare providers. Workflow automation is considered the most effective way to optimize the revenue cycle in healthcare. This way all the rote tasks like patient statement creation, eligibility verification, and claim status follow-up can be automated for accurate and quick processing. 

With the claim denial rates increasing steadily from 2016 to 2020, organizations are hunting for effective ways to deal with this issue. One way is to train staff on coding and billing processes and educate patients about medical costs. The most effective and fool-proof way however is to invest in a medical workflow management system that automates coding and insurance verification. 

FAQs

Adopting workflow automation in healthcare is a significant decision for healthcare organizations. Migrating from manual to automated work environments may seem like a daunting task for healthcare providers. Healthcare organizations have several queries in their mind when considering the automation of their operations.

Here are a few FAQs that may help decision-makers-

1. What is a workflow?

A- workflow is a sequence of physical and operational tasks that are performed by various people within and between work environments. For example, the workflow for ordering medication includes several tasks between the provider and the patient.

2. Why should we analyze workflows?

Ans – Analysis of workflows is important for identifying process loopholes and redundancies. Once these redundancies and bottlenecks are identified, necessary process improvements can be made to improve process efficiencies.

3. What does workflow automation entail?

Ans – Automating clinical processes involves sound planning and execution. All the stakeholders must be involved in the planning process to ensure that the workflows are in sync with the requirements of the business. Once the new workflow is created, it is implemented and reviewed regularly to ensure that goals are met.

4. When should I assess workflows?

Ans – The need for workflows arises when existing systems do not perform at optimal levels and expected results are not achieved. At this stage, existing workflows must be assessed to improve process outcomes.

5. How do medical staff access messages and data from the automation platform?

Ans – Each authorized user can simply download messages and data from the automation platform onto their devices. Whenever the app receives a message from the platform, the corresponding user is alerted via push notification. The user may have to log into the automation platform to read and reply to the message. 

6. Are these automation platforms HIPAA compliant?

Ans – Yes, healthcare workflow automation platforms are designed to comply with HIPAA regulations. Most automation platforms make the processes audit ready by accurate documentation, which is not only a requirement by HIPAA, but also improves the accountability of the healthcare workflow management system. 

Workflow automation in healthcare is essential to ensure that top-notch healthcare is provided to patients. A workflow automation solution like Cflow can turn the tables around for healthcare providers. Signup for a free trial to explore Cflow.