Proponents of government-provided healthcare often tout the benefits of low cost and expanded access to services. But in countries where governments and the provision of healthcare services collide, it can result in organizations that are even larger than private healthcare companies, working with fewer resources.
Most healthcare in Canada is publicly funded and delivered through provincial systems. Alberta Health Services (AHS) is the largest in the country, directly employing more than 112,000 people and providing health services to more than 4.4 million people in Western Canada through more than 900 hospitals, continuing care facilities, cancer centers, mental health facilities and community care locations. It is an enormous organization and just the kind that can reap outsized benefits from RPA and intelligent automation.
Taking the First Step
In its IT department alone, the organization employs 2,700 people dedicated to implementing and maintaining the technology systems enabling AHS to function on a daily basis. The company is in the midst of a $1.6 billion implementation of Epic—a well-known electronic medical records software application that touches all aspects of a healthcare system’s business from registration and scheduling to patient management to billing.
It was leading the IT Analytics, AI, and Automation CoE at AHS—measuring the performance of IT and the Epic program—that Jesse Tutt began to see where and how RPA might benefit the organization. His team built a data warehouse with data from more than 300 of AHS’s enterprise systems and began to unearth trends in different parts of the organization that pointed to inefficiencies.
Concurrently, Alberta Health hired global consulting firm Ernst & Young (EY) to review its financials. Their analysis identified even more opportunities, including the need for a broader automation program.
“The Alberta Health review’s recommendation to setup an AHS Automation Program supported the work we had already done and provided the seed funding to kick start the Intelligent Automation team,” Tutt explained.
AHS engaged EY to help setup the Intelligent Automation team and an RFP resulted in a contract awarded to SS&C Blue Prism for their suite of Intelligent Automation software and services.
“BP is currently embedded in my team so much so that they answer my team’s questions immediately, even attending my team’s scrum meetings, which adds a lot of value,” he said.
According to Tutt, AHS has 19 automations in production that have freed 21 FTE of capacity annually. He hopes to expand that to 55 by April of 2023. The automations implemented to date support HR, Finance, Supply Chain Management, and IT, and connect to systems like Epic, Ivanti, PeopleSoft, ServiceNow, Taleo, Active Directory and many others.
Growth of the AHS Automation Program wouldn’t be possible if AHS wasn’t able to monitor and quantify the impact of automations already in place. Tutt said that is accomplished by assigning a human processing time to each automation and then reporting on the time saved in a real-time benefit reporting dashboard, which is updated every 15 minutes. The key values in this dashboard are updated through each stage of every automation.
“We record the amount of time each process takes manually along with the number of queue items at the intake process, then update it through the design stage and, finally, three months into the monitoring stage. The number of queue items times the duration equals the amount of time that’s saved,” he explained. “We also have durations calculated for the system exceptions and the business exceptions. System exceptions to date have been zero minutes of freed capacity, business exceptions often result in a savings of up to two minutes and successful queue items typically save more than five minutes each. All queue items are tracked in real time and down to the minute, enabling us to prove our value to leadership and management every step of the way.”
Easing the Onboarding of Doctors and Nurses
A recent report from Bartleby Research outlined some of the concerns Canadians have about their healthcare system—concerns Tutt said intelligent automation is working to address and improve.
“Most Canadians are very proud of their health care because it provides citizens universal coverage on the basis of need,” the report’s authors wrote. “However, due to COVID-19 Canadians have observed some deterioration in the quality of the system regarding waiting times which has pushed the need for innovation, investment in technology, and recruitment of 1,000s of clinicians.”
In the end, the most important facet of quality healthcare comes down to the interaction between medical professionals and their patients. Nurses and doctors of all kinds, lab workers, physical therapists and more are the most visible representatives of the healthcare ecosystem and make the biggest impact on people who go there to get well. AHS directly employs approximately 26,000 registered nurses and 9,000 physicians, and that total represents only a portion of the vital clinical staff. In an organization as large as Alberta Health Services, that makes the HR function, which onboards medical staff, vital. As a result, one of the most important projects Tutt’s department has undertaken with SS&C Blue Prism is implementing automations in the HR department.
Tutt said automations supporting the hiring, onboarding and retaining of clinical personnel has had an enormous impact on the quality of care. This is a direct result of these functions ensuring clinical staff are in the right place at the right locations. Fortunately, as the Bartleby report notes, consumers of AHS’s services are taking notice.
“Making sure the units are staffed appropriately is one area we’ve been focusing on,” he said. “We have one automation going live in the next couple of weeks that’ll help free up 12 FTE of capacity.”
Managing position changes, sending offer letters, scheduling resources and other formerly manual tasks involved in the human resources function, which historically have caused delays, are now automated, freeing those professionals to find, interview and fill mostly clinical open positions faster, Tutt noted.
“I think there’s a direct patient benefit to every automation, even those in corporate areas,” he said. “Business processes on the corporate side really do impact clinical care directly. As a health organization, automation is always a win.”
Nearly two years into the project, Tutt said there are definitely things he would have done differently. He would have leveraged the value of real-time benefit reporting much sooner and developed stronger relationships with the privacy and risk functions of the organization sooner. These are areas Tutt said would benefit any organization.
Another area worth investing in early is Organizational Change Management. Often staff are wary of Intelligent Automation programs because they feel they could be automated out of a job. Tutt said AHS employees have generally embraced RPA, Process Mining, and other intelligent automation technologies, however, due to hundreds of awareness campaigns at the staff, management and leadership level.
“From a resistance perspective, you might think our employees would feel it is a risk,” he explained. “But I found the opposite. Most of the things we automate are things people hate doing. So our slogan has become, ‘if you hate it, automate it’.”
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