Rehabilitating Healthcare Processes
Increasing the efficiency of fundamental information processes is imperative for many organizations. Improving the flow of information in customer service, accounts payable, patient records, insurance claims, loan origination, and in the mail room can bring advantages in cost reduction, productivity and customer satisfaction. And increasingly, the expectation of users, both employees and customers, is for better, faster access to accurate and consistent information.
Healthcare processes are a good case in point.
According to a recent McKinsey study of healthcare systems in three very different geographies over the last year, more than 75 percent of patients used digital communication services such as websites or email.1
The study goes on to say that what patients want is not necessarily innovative applications and advanced features, but the “surprisingly mundane: efficiency, better access to information, integration with other channels, and the availability of a real person if the digital service doesn’t give them what they need.” For example, simply having help finding and scheduling appointments was cited most often by respondents from all three regions.
Pain Relievers – Digitisation and Automation
For most people, modern healthcare still involves filling out lots of forms and documents, whether this be with a public (government funded) healthcare provider or a private insurance company. Frequently, this involves inputting much of the same information again and again. From the patient’s point of view, this is extremely frustrating. And for providers and insurers, their operations become less efficient, more costly and prone to error.
Like all industries, healthcare providers and insurance organisations are looking to manage these costs and increase their efficiency. In many regions of the world, consolidation in healthcare continues, putting pressure on less productive organisations. And governments, frequently the biggest “customers” of healthcare providers, are looking more closely at their subsidies and spending.
Optimising information flow to capture more data up front and integrating this data across key business processes is a good place to start. Capturing information digitally as soon as possible, whether it’s patient information or insurance forms, is important to improve access to information and reduce downstream inefficiencies and costs.
One regional healthcare provider, encompassing hospitals, ambulatory care units, care homes and training centers, implemented one-touch buttons on their multi-function devices to scan paper documents at point of contact and process them according to pre-determined rules. For example, referral letters are captured immediately, indexed and automatically appended to the patient’s electronic health record. This eliminates time spent searching for documentation in subsequent billing processes. Clinicians throughout the organization also save time and make better informed decisions with secure access to more complete, up-to-date electronic records of patient care.
Making the Rounds
Another example: a Fortune 500 global healthcare insurer recently outsourced its claims data processing activities to the tune of 2 million claims a year. This means that paper-based claims and the more than 100,000 claims received by e-mail and fax are captured and automatically validated before being passed to the adjudication process. The validation is done in accordance with a fully auditable process. Digital copies are securely encrypted and uploaded to a cloud-based processing system, where metadata is automatically extracted from the document and validated against the insurer’s policy database excerpts.
Validating paper-based claims used to be an inefficient, time-consuming process which tied up valuable resources. Now the insurer’s claims adjudication teams can access fully validated claims within hours of receipt. These business process services have improved response times, reduced local administration and minimized physical document management costs, saving time and money. It also makes for happier customers.
The company is also now better positioned to take the next step towards re-engineering their claims processes, introducing technologies to migrate customers to a web-based system which will significantly accelerate claim payment turnaround times and further reduce operational costs.
It can be difficult for organisations caught up in the day-to-day delivery of services to step back and gain the perspective required to transform fundamental business processes. Both the healthcare provider and the global insurer took advantage of Ricoh’s managed services experience to help them fundamentally change their operational activities. Working in partnership with Ricoh, they have been able to optimise their business processes to reduce operational costs, better meet patient needs, and lay the groundwork for further innovation and growth.
1 Biesdorf, Stefan and Florian Niedermann, “Healthcare’s Digital Future,” McKinsey & Company, July 2014.