Electronic Health Reporter

By Ben Manning, director of product management, ETHERFAX. 

Despite significant progress in health information technology (HIT) and artificial intelligence (AI), many healthcare processes remain inefficient. Administrative workflows are cumbersome and error-prone, and they can lead to serious repercussions, including delayed patient care, clinician burnout, and mounting costs.

Generative AI (Gen AI) is a type of artificial intelligence that creates new content—such as text, images, or even insights—by learning from large datasets. In healthcare technology, Gen AI has transformative potential. It can automate tasks like generating medical summaries, assisting with diagnostic image analysis, or even suggesting personalized treatment plans, thereby saving time for healthcare providers and improving accuracy in patient care.

Additionally, Gen AI can streamline administrative tasks and data analysis, helping organizations manage records, optimize workflows, and enhance decision-making. However, realizing this potential requires a deep understanding of existing challenges in healthcare workflows and a strategic approach to integrating automation into day-to-day operations.

The Ripple Effect of Inefficiencies

Inefficiencies in healthcare workflows are not isolated incidents; they affect a wide range of stakeholders, each of whom bears the brunt in different ways.

Clinicians find themselves overwhelmed by administrative tasks such as charting, billing, and data entry. These tasks, though essential, are contributing to clinician burnout—a significant issue in the healthcare industry. Dealing with inefficient workflows is also leading to lower job satisfaction and higher turnover rates among medical professionals.

For administrative staff, inefficient workflows translate into an overwhelming volume of paperwork and repetitive manual tasks. This not only lowers productivity but also increases the likelihood of errors, which can have cascading effects throughout the healthcare system. The repetitiveness of data entry workflows, compounded by often inadequate compensation, makes it difficult to attract and retain qualified administrative staff.

For patients, inefficient workflows can manifest as longer wait times, delayed diagnoses, and poor patient experience. When administrative or clinical processes are bogged down by inefficiency, patients experience frustration and dissatisfaction. Worse, their health outcomes may be negatively affected by delays in receiving necessary care.

Digitizing workflows without automation tools often perpetuates existing inefficiencies. Too often these workflows fail to optimize and streamline administrative processes, limiting the potential benefits of health information technology. The push to digitize workflows often means repeating the same paper process, but in a digital format; which doesn’t make the process more efficient.

Tackling Administrative Expenses

Administrative tasks represent a significant portion of healthcare operating budgets, yet they are often mundane and repetitive—perfect candidates for automation. A study focused on Medicaid revealed that administrative expenses account for 15% to 30% of total healthcare spending, largely due to non-clinical costs such as billing, insurance processing, and documentation.

It’s estimated that administrative expenses cost the healthcare industry around $1 trillion annually. These costs are driven by routine tasks that, while necessary, do not always require human intervention and can often be automated. Automating administrative tasks using AI and related technologies could save between $200 billion and $360 billion over the next five years. These savings could be redirected towards initiatives that directly improve patient care, such as hiring more clinical staff or investing in advanced medical equipment.

Though AI technology has not yet reached the point where it can operate without human oversight, tools like Gen AI are already making a difference by automating tasks such as document classification, information summarization, and data indexing. This allows healthcare providers to significantly reduce wasted time and enhance operational efficiency. Automation frees up clinical teams to focus on patient care, leading to a more streamlined and effective healthcare system and better patient outcomes.

Enhancing Compliance and Reducing Regulatory Risk

Keeping up with the ever-changing regulatory environment in healthcare is a daunting task. Regulations are continually updated, and hospitals and clinics must remain in compliance to avoid penalties and ensure quality care. Workflow automation offers a robust solution to these challenges by:

• Streamlining Document Management: Automation can manage the review, approval, and tracking of documents, ensuring that teams always use the most recent versions. This reduces the risk of human error and enhances compliance with regulatory requirements.
• Creating Audit Trails: Automated workflows generate comprehensive audit trails that are invaluable during regulatory audits. These trails provide a clear history of actions taken, ensuring transparency and accountability.
• Proactive Alerts and Notifications: Automated systems can send real-time notifications to relevant stakeholders whenever a document is created, modified, or approved, ensuring no critical action is overlooked.

By incorporating automation tools, healthcare organizations can not only meet regulatory requirements more effectively but also reduce the likelihood of errors, saving time and resources.

Transforming Healthcare Efficiency

Workflow automation is a critical step towards building a more efficient healthcare system. By automating routine tasks, healthcare organizations can reduce the burden on clinical and administrative staff, lower costs, and enhance the quality of patient care.

• Reduced Administrative Burden: Automation can take over routine administrative tasks such as document classification, patient indexing, medical record management, referral coordination, appointment scheduling, prior authorizations, and billing. This reduces the time spent on these tasks and minimizes the risk of errors, allowing administrative staff to focus on more strategic activities.
• Cost Savings: By decreasing administrative expenses and minimizing errors, automation delivers significant cost reductions. A key component to the cost savings is eliminating the downstream impacts incorrectly entered data, such as prior authorization denials or rejected claims. Downstream issues require additional administrative time to resolve, and the savings generated can be reinvested in patient care, expanding services, or enhancing organizational operations.
• Accelerated Referral Processes: In the U.S., more than 100 million specialist referrals are made each year, but many are delayed or incomplete due to communication breakdowns and missing information. Workflow automation, especially when powered by AI, can address these issues by automating tasks like document classification and routing, ensuring timely and accurate referral processing. Faster referral processes also allow patients to receive care faster, which can significantly improve their health outcomes and satisfaction.

Adopting workflow automation is not just about improving efficiency; it represents a fundamental shift in how healthcare is delivered. By reducing administrative burdens, healthcare providers can focus on what truly matters—creating better patient outcomes.

The Future of Workflow Automation in Healthcare

Overall, AI powered solutions. are poised to be the future of administrative healthcare operations. By automating administrative processes, enhancing decision-making, and improving administrative workflows, AI-driven systems enable healthcare organizations to focus on delivering higher quality patient care. Here’s how Generative AI will drive administrative efficiency:

• Intelligent Document Processing: AI-powered tools can automate the manual workflows being done today to classify a document, summarize its content, and extract patient demographics.
• Enhanced Claims and Billing Automation: By recognizing patterns in claims data, AI can automatically flag potential issues, reducing claim rejections and speeding up reimbursement processes.
• Virtual Assistants for Administrative Tasks: Gen AI-powered assistants can handle routine queries, task prioritization, and task reminders, allowing human teams to focus on higher-value tasks.

Ultimately, AI’s ability to streamline workflows, identify bottlenecks, and recommend enhancements further contributes to a smoother, more efficient administrative processes. This shift enables healthcare providers to achieve better patient outcomes and satisfaction across the board.