Hoverstate Blog

The Role of Intelligent Automation in Unlocking the Quadruple Aim in Healthcare

Since it was first proposed in 2014, the Quadruple Aim has played an important role in guiding strategic decisions for healthcare organizations. Specifically, the quadruple aim establishes four areas in which hospitals, clinics, and physician practices should be continually working to improve: Patient outcomes, cost reductions, patient experience, and providers’ experience / work-life balance. The final aim was added in 2014, transforming the triple aim into the fourfold goals that we have today.

These are lofty goals that are not easy to achieve. In fact, many might argue that they are contradictory — how can an organization improve outcomes and provider work-life balance while also cutting costs? But it is possible, especially with the assistance of intelligent automation, a key facet of the digital transformation that so many healthcare organizations are seeking. Through the proper application of intelligent automation, clinics, practices, and hospitals will be able to achieve all four goals of the Quadruple Aim.

What is intelligent automation? Unlike traditional automation, which requires human guidance and primarily addresses repetitive tasks, intelligent automation incorporates artificial intelligence, which makes it much more autonomous and able to handle more complex functions. Four Key Elements of the Quadruple Aim

The original “triple aim” came out of a HIMSS conference in 2009. The fourth aim — ensuring providers have a good work experience that doesn’t prevent them from having a life outside of work — was first suggested in a 2014 journal article, and it quickly expanded the three aims to four.

The quadruple aim was adopted in part as a response to the then-recent government mandate that providers adopt electronic health records (EHR) as a requirement for getting paid by Medicare and Medicaid. The adoption of EHR significantly changed the provider-patient relationship. From then on, there’s almost always a computer in between the doctor or nurse and the patient, accompanied by a barrage of the same questions over and over again about medications, treatments, and symptoms.

It was hard on providers, as well, who would end their day at the clinic or hospital and then spend another three hours of documentation at home. It’s an enormous irony because EHR was supposed to make the process of tracking, maintaining, and accessing patient health records more effective and efficient. And to some degree, it did. But with the adoption of any new technology, there will be growing pains — EHR definitely brought them to all aspects of the healthcare system.

As noted above, intelligent automation can help organizations achieve each of the four goals of the Quadruple Aim. So, let’s go through each, one by one.

Improving the Patient Experience

Patients have a very different expectation for healthcare services than they did even ten years ago. In the past, patients were very much guided by their providers. Today, patients are far more educated (or miseducated, unfortunately) thanks to the ubiquity of healthcare information online, and, so, they often already know what they’re looking for.

But instead of seeing their provider and getting to the point of their visit, every time they come in they have to update their medication list and answer a litany of other questions about their health history. And that’s just one of the many irritations and annoyances they face. They often have to fill out a lengthy form before they can even begin to think about scheduling an appointment, and then when they arrive, they find they have to wait for 30, 60, or even 90 minutes before they can be seen.

With intelligent automation, a patient’s current medications can be fed directly into their electronic health record with the assistance of services like CoverMyMeds and Surescripts, both of which interface with every EHR on the market today and pull information on every prescription that the patient has filled.

And while it’s not possible to know exactly whether a patient is taking the medication as directed, some pill boxes are connected to the Internet, enabling these applications to keep track of when the medications’ containers were opened and a pill was removed. Intelligent automation can also consolidate information from many sources to provide a complete and updated EHR, so all a patient needs to do is select an open appointment, making scheduling an effortless process.

The end result is a happy patient who gets the care they need quickly and without hassle. They’ll be much more likely to return and work with other providers within the same system.

Population health

The Federal government, as well as the public health and private health communities, are very interested in identifying the barriers that prevent people from getting the medical attention that they need. After all, if you don’t have a roof over your head or don’t have access to good food, you’re not going to the doctor or getting your colonoscopy after 50.

So, healthcare providers have a financial interest in identifying and removing these barriers. For example, if they know of a patient on the Medicare Advantage plan who has transportation issues but needs to see a physician, they’d do well to send a rideshare to bring them in. That $10 to $20 rideshare can bring in a $165 Medicare reimbursement, plus referrals.

Intelligent automation can help providers identify these gaps in care in a number of ways. For instance, it can create a list from their patient database of every woman over 40 who hasn’t had a mammogram and every man over 50 who hasn’t had a prostate exam. Now while that’s not particularly impressive – creating this kind of list is easy — gathering additional information on whether the practice has contacted them, whether they’ve responded to outreach and if they have an appointment is far harder. Intelligent automation can make this a reality.

Reducing costs

A substantial part of the problem with costs is simply a lack of information, such as not knowing which providers are in the network when making a referral or not having data on which radiology center provides the best images at the lowest price.

This data exists. Insurers, of course, keep records of which providers are in their network, and healthcare providers know which insurers with whom they have contracts. The Centers for Medicare and Medicaid Services have a lot of data on both costs and quality of service.

Intelligent automation can gather this information and present it in a form that enables providers and patients to make educated choices about the care that maximizes quality while minimizing cost.

Improving the work-life balance of clinicians and providers

By automating the collection of data into EHR, providers save so much time that would otherwise be spent updating patient information. This is the most obvious benefit. But intelligent automation can do much more.

Pulling all of the pharmacy information about a patient’s current medications saves both patient and provider the aggravation and wasted time asking once again about their prescriptions. And imagine how nice it would be for a provider to simply walk up to a terminal and be logged in thanks to a smart card? This is already a reality for many cardiologists, but there’s no reason it couldn’t be expanded to all physicians and nurses.

Finally, imagine putting a dashboard that shows not only each of the 25 patients that a physician is seeing, but also what the physician needs to focus on for each, so the provider can immediately start focusing on the patient’s specific issue. It would save time and enable providers to make the best use of their skills instead of asking intake questions that have almost certainly already been asked at one point or another in the process.

Why Intelligent Automation & Why Now

Intelligent automation can enable healthcare organizations to achieve the quadruple aim, which confers strong business benefits to healthcare organizations. Happy patients get the high-quality care that they need without the hassles of repetitive questioning and endless forms. That’s good for word-of-mouth referrals and keeps patients coming back when they need additional care.

Providers are happier because they’re better equipped to focus all of their attention on addressing patients’ health issues instead of the minutia of updating records and rote, repetitive questions. And, because providers are better able to identify gaps in care, not only are they able to bring in patients – and revenue – that would have otherwise been overlooked and left out, but they also improve health outcomes for the community at large. Intelligent automation is a powerful tool that benefits all stakeholders within a healthcare system. If you’d like to learn more about how to apply it within your organization, contact us today.

Technology | Healthcare

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