Despite being pinned down by ballooning costs, fluctuating demand, regulatory pressures, and staff shortages, many US Hospitals and healthcare systems have stayed afloat primarily through the availability of cost-effective, skilled, and reliable healthcare talent in India and The Philippines. Access Healthcare, one of India’s fastest growing and largest Healthcare BPO companies, utilizes global delivery, automation, and analytics to deliver meaningful financial results to its customers. The company’s highly advanced, intelligent, and comprehensive Robotic Process Automation platform, echo, and its technology ecosystem is helping healthcare organizations. We sat down with Prabhakar Munuswamy, Senior Vice President and Head of Application Services, Access Healthcare, to understand what the future holds for this industry.
- How are Indian healthcare BPO companies helping US healthcare organizations tide through the tough times?
Hospitals and Health Systems in the US are facing tough times with multiple headwinds. The pandemic phase was challenging for them with the underutilization of medical facilities due to the large-scale postponement of elective surgeries. The cost of hospital supplies went up by over 20% in the last two years, and the nation has been facing the highest inflation ever in the previous two decades. Compounding this is the massive labor shortage in clinical and administrative roles. That’s where we come in.
By enabling access to trained and certified healthcare administrative labor from locations in India and The Philippines, we are lowering their costs significantly. Additionally, we apply technology (workflow, robotic process automation using AI and ML, and knowledge management systems) and analytics to help them improve clinical, administrative, and financial outcomes. The savings we bring to the healthcare organizations helps them as multiple headwinds threaten their financial survival.
2. Could you tell us a bit about Access Healthcare and its operations
Since 2011, Access Healthcare has been a trusted partner to healthcare institutions by providing Revenue Cycle solutions to enhance clinical outcomes, improve financial performance and optimize operations. We apply our revenue cycle expertise, technology solutions, automation platform, analytics, and best practices to deliver market-leading results. In short, we manage the business of healthcare for our clients.
Access Healthcare provides business process outsourcing, applications services, and robotic process automation tools to hospitals, health systems, providers, payers, and related service providers. The company operates from 18 global delivery centers in the US, India, and the Philippines. Their 25,000+ staff is committed to bringing revenue cycle excellence to clients by leveraging technology, emerging best practices, and global delivery. Based in Dallas, TX, the company supports over 400,000 healthcare providers through 85+ clients, serving 80+ specialties, processing over $70 billion of A/R annually, and ascribing medical codes to over 30 million charts annually.
3. What is the impact of robotic process automation on productivity, efficiency, and quality of BPO service delivery?
We look at productivity holistically. The first step is to improve human productivity. We do this by improving digital governance and automated workflows. Our systems sensitize our team members on improving productive time, and the automated workflows keep them focused. Our automatic rewards program credits Stardust Points, giving them the rewards they have for excelling in their work area. The next step is to utilize intelligent machine learning and AI-driven robotic process automation systems. We decided to avoid investing in costly RPA systems and built our echo platform.
echo is a purpose-built suite of automation solutions that can automate processes across the revenue cycle continuum. By leveraging machine learning and artificial intelligence capabilities, echo, offers multiple use cases for automating eligibility verification, data entry, medical coding, payment posting, accounts receivable management, denial management, and appeals.
While human productivity improves costs by about 12-15%, RPA can deliver additional cost savings of 15-45%, depending on the process type. With echo’s inbuilt designer studio, we can quickly onboard new processes to our RPA platform.
4. What are some of the misconceptions or myths that people have about RPA? Can you help clarify some of them for our readers?
Most people do not realize that automation requires ongoing maintenance. Bot obsolescence is a real problem. Changes in the underlying environment can lead to broken bots that require IT to reconfigure or change the bot. Meanwhile, you have a considerable backlog volume building up, which can significantly impact your organization’s financial health. Let us remember that DevOps (non-technical) resources are now implementing bots. The onus of infusing modularity, scalability, design studios, information security, and compliance elements is in the hands of the innovation team.
With enterprises adopting Robotic process automation at a dramatic pace, broken bots can completely ruin a business function’s performance. So, on one side, there is the issue of bots losing relevance due to changing business process rules; on the other side, there are constantly evolving automation frameworks that automation engineers can use to reduce human work efforts.
Innovation team members must contend with the issue of designing bots for scale and change. Therefore, they need to quickly develop bots for monitoring, alerting, and managing the change process. In addition, bot control centers must be able to provide insights into the efficacy of bots. When analyzed by technology and process experts, such trend data of bot failures can help identify issues and address bot obsolescence. However, RPA solution designers must design automation solutions that allow them to make quick changes to bot configuration to get better yield and not cause any issues due to broken bots.
Another issue is about expensive costs of implementing off-the-shelf automation platforms. Service providers do not have healthcare process knowledge, and hence, the implementation is slow. Typically, the cost of implementing these solutions is prohibitive due to expensive process consulting, upfront license fees, and monitoring and ongoing support costs. With such high-cost structures, the value of automation solutions implementation is lost. For our echo implementations, we are taking a differentiated approach of contracting for actual outcomes rather than the mechanics of implementation. Our pre-built stack accelerates implementations and value realization.
5. Tell us about the echo RPA suite and your vision for how it will impact the BPO industry. What is the timeline for this impact?
The echo RPA Suite is different that it has been conceptualized by practitioners and built by techies, and not the other way around. As practitioners, we understand the pain of building automation solutions and not being able to use them efficiently. So, we decided to create an architecture that future-proofs the bots. We did this through a microservices architecture, allowing rapid changes in the underlying workflow and technology frameworks to align with process changes. This increases bot usability and life span.
We have already launched many solutions on the echo platform and have taken the offering to our customers. The solutions include:
- echobotis the mother engine on which we have built the echo suite. With a library of pre-configured process activities and a design studio, echobot system integrators can build automation use cases quickly.
- echopayis an automated tool for payment posting, delivering high accuracy (over 99%) and improving productivity by 220%.
- echorevis an AI/ML-based call volume segregation engine providing decision support capabilities to contact center agents. It is a collection of tools for accelerating claims status checks, denials review, and appeals filing.
- echosmrtis a predictive analytics tool for creating customizable dashboards on top of the underlying hospital and physician revenue cycle systems.
- echolockis a productivity improvement and security solution that monitors resources in a non-intrusive manner and provides insights to improve time spent on productive activities and tasks.
- echoc3is an integrated platform for productivity monitoring, assimilating call center switch data, revenue cycle systems data, and internal workflow information to create customizable dashboards.
6. Access Healthcare has extensively deployed technology in recruitment, people management, etc. Tell us about the origins and evolution of this ecosystem and what is your roadmap for the future.
Our mantra is to digitalize the technologies to provide a seamless collaborative experience for all stakeholders and reduce the time spent in interactions. We started with a workflow application to improve human efficiency. As the data of our entire workforce was digitized, we started adding employee engagement, self-service tools for transportation and support, employee communication, and even tools for quality and audit management. Quickly this evolved to a set of 16 tools under the brand “arc.in”.
Recruitment automation resulted from the pioneering vision of our vice chairman, Vardhman Jain. His observation that candidates waste a lot of time in the interview process and do not have transparency to the stages of the interview process mandated us to create a 45 min hiring experience for the candidates walking into the facility. As soon as they fill in the profile information, the time starts ticking and ends with the issuance of an offer letter if the candidate gets selected. When the pandemic struck, we realized that we had to do more and then took this entire process to the app with an automated recruitment app for one can download off the App Store or the Play Store and commence the hiring process.
In the future, we will continue to invest in testing the frontiers of human and machine productivity. A lot of technology innovation is happening in echo labs, and different products and solutions are at varying levels of development.
7. How did you develop this ecosystem of technologies
Our technologies have been developed ground up organically. Initially focused on creating baseline systems to run enterprise BPO operations, we have evolved into robotic process automation and analytics over the last six years. Our teams are structured to develop new products and solutions, implement them, and support them. These are three different teams, and the roles are very clearly defined. We will invest more in innovation and developing market-leading solutions as we move further.
8. Could you tell us what some of the changes are in the US healthcare system and how your technology helps you deliver value today and will continue to do so in the future?
The US healthcare system is in a constant state of evolution. The headwinds of labor and cost pressures create opportunities for Access Healthcare to provide tech-enabled and tech-led solutions to ease these pressures and put them on the path to profitability. Further, as the current fee for service gets its due criticism for being costly and ineffective, it is paving the way for value-based care services. As the name suggests, this is a fundamental shift in the model and requires a robust analytics backbone for managing the population’s health, creating innovative plans based on the outcomes delivered, and developing a new line of services to provide data in the requisite formats.
Our tech and people architecture thrive on constant learning and ongoing innovation. We are making significant investments in both these areas. Our learning systems are nearly 80% automated today, and the products development ecosystem is bringing out better solutions each month. We will also acquire for niche expertise to give further impetus to our solutions. In the future, stakeholders will exchange data through technologies such as EDI, FHIR, and other secure information processing and interchange standards. We will build interfaces with various stakeholders and utilize these technologies for developing solutions.