Healthcare payers and providers aim toward a common pinnacle goal: to promote better health outcomes. The steps toward this achievement require efficiency and insights. In this blog, I explore how intelligent automation (or IA) and advanced analytics intersect to support healthcare’s aims.
Triple Aim? Quadruple Aim?
First, a brief history lesson. In 2007, the Institute of Healthcare Improvement created a three-pronged objective for health care systems. Seven years later, the Annals of Family Medicine introduced a fourth objective – thus creating the Quadruple Aim, which prioritizes the following tenants:
- Improve the health of populations,
- Reduce the per capita costs of healthcare,
- Improve the patient experience, and
- Improve provider experience.
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The goal is an optimized intersection of all four objectives at a time where U.S. per capita healthcare spend is double that of the average of any industrialized nation. Consider these stark differences in per capital health care costs, as of 2019:
- United States: $10,200
- Netherlands & France: < $6000
- United Kingdom: $4,000
But healthcare costs are only one motivating factor.
Physician Burnout Crisis
The fourth point of healthcare’s Quadruple Aim recognizes the concerning rate of provider burnout. It was prioritized to improve the work life of healthcare clinicians and staff and to enhance the overall caregiver experience.
This fourth aim – improve provider experience – remains a top priority. Just this year, the American Medical Association reported that approximately 44% of US physicians exhibit at least one symptom of burnout. And this burnout leads to downstream problems:
- Physicians share less one-on-one time with patients, impacting patient experience.
- Physicians leave their practice, impacting continuity of patient care – again impacting patient experience. This often leads to different providers ordering repeat or additional diagnostic tests, driving up healthcare costs.
- Exhausted physicians may make medical errors putting patients’ health or safety at risk and negatively impacting overall quality of care.
Intelligent Automation Supports the Quadruple Aim
Much of the “busy work” in healthcare is grounded in repetition. Ever-increasing administrative work is required to support non-clinical tasks. And many of these tasks can be done more quickly and more accurately with intelligent automation (IA).
IA combines artificial intelligence (AI), robotic process automation (RPA), and digital process automation (DPA) to automate and enrich tasks. This automation drives efficiencies and creates capacity to address higher-level issues – the parts of the job that healthcare teams enjoy and that lead to better outcomes.
IA can be used in support of:
- scheduling patient appointments,
- simplifying the billing and claims process,
- improving revenue cycle management functions,
- extracting and optimizing patient data, and
- optimizing data collection and analytics.
Analytics Support the Quadruple Aim
Going back to that quadruple aim, we have traditionally developed and used both DESCRIPTIVE and PREDICTIVE analytics to evaluate, address, and to monitor the state of affairs of each tenant.
DESCRIPTIVE analytics evaluate what has happened. For instance…
- Using HEDIS, AHRQ, or STARS health care quality measures, we are able to see how each member is receiving care and how each provider or facility is providing such care.
- Through cost and utilization reporting, we can measure and monitor healthcare spend.
- Patient surveys, provider wait times, proximity and availability of specialist providers, and other proxies for a patient’s experience with the healthcare system provide additional dimensions of potential understanding via analytics and reporting.
PREDICTIVE analytics help us understand why something has happened. Statistical models help determine the causal factors (or correlated coefficients) that lead to certain outcomes. These predictive models can then extrapolate what will happen in the future, given certain conditions. For instance…
- We predict the relative risk of individuals being readmitted for care based on specific activities, adherences, and preventive measures.
- We forecast health care costs given the population size, people’s ages, genders, and the health severity (or case mix) of a population.
DESCRIPTIVE and PREDICTIVE analytics have helped us to understand and to start to control the outcomes of the Quadruple Aim objectives.
Intelligent Automation + Analytics = Power Combo
Actionable insights simply aren’t attainable without quality data. And automation processes can help fuel that data quality pipeline.
If we are going to determine what happened and why it happened, the source data must be complete, consistent, timely, valid, and match the precision of its expectations. In other words, it must be “analytically ready.” Intelligent automations support the important prep steps and follow-on, data-informed touchpoints.
Prescriptive analytics and automation help lighten the load.
- For Caregivers. Automate guided advice on what services to offer patients, offering guidance for next best actions at the clinical point of service.
- For Patients. Automate care management guidance and follow-up, providing advice on what services and diagnostic testing a patient or member should receive and when, medication guidance, and next best actions.
These intelligent automation and analytics functions support cost optimization – a consistently recurring theme among healthcare organizations – and can help elevate patient and member outcomes.
Additionally, IA and analytics can help declutter care teams’ task lists by intelligently automating time-consuming processes and optimizing data pipelines. Together, IA and analytics streamline and illuminate paths toward better care experiences.
LEARN MORE: Enhance Efficiency and Value in Healthcare With Intelligent Automation
An End-to-End Partner
We blend healthcare, analytics, and automation expertise to help you build stronger teams and establish optimal processes. Our experts will help you identify how work is performed today and how you can optimize for tomorrow.
We work with partners that address the key elements of intelligent automation with their best-in-class product offerings. Your needs are unique, and we can help you determine the product or system for your particular use case. We also provide readiness evaluations, business case development, implementation and migration services, and rapid development and pilots.
We are recognized by Modern Healthcare as a key healthcare consulting leader. Additionally, Perficient was cited as a “Contender” in The Forrester Wave™: Digital Process Automation Service Providers, Q3 2020 report.
Have questions? Let’s talk.
