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BTOES Insights Official
By
September 21, 2020

BTOES Healthcare Live - SPEAKER SPOTLIGHT : The Real Story of Scaling RPA in Healthcare

 

Courtesy of UiPath's Jason Warrelmann, Change Healthcare's Joseph Peri, HCA Healthcare's Kurt Alexander and  Blue Cross Blue Shield North Carolina's Gary Grena below is a transcript of his speaking session on 'The Real Story of Scaling RPA in Healthcare' to Build a Thriving Enterprise that took place at BTOES Healthcare Live - A Virtual Conference.

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Session Information:

The Real Story of Scaling RPA in Healthcare

Gartner and PWC reports that 50% of Healthcare organizations will adopt RPA and Hyperautomation to transform the Healthcare enterprise over the next 3 years.  However, many Healthcare organizations started their RPA journey early and have learned from their mistakes, challenges and wins to build world class centers of excellence in their respective space.

In this session UiPath will host a panel of COE leaders from different Healthcare spaces to discuss their journey into RPA and how they are tackling difficult challenges around adoption, scale, ROI and the many other transformation aspect of a RPA program.

Session Transcript:

Our next session brings incredible leaders who are using technology to scale excellence, and innovation in healthcare. And I would like to introduce, this is going to be a panel session, and I'm going to introduce the panel moderator, and after that, he will introduce each one of our guests. So, with us and leading and moderating the panel is Jason Warm, and Jason leads Healthcare Life sciences Practice at UI path. Which focuses on transforming the health care, landscaping, and developing capabilities, integrations, and re-usable components that make UI path, a healthcare automation platform, and not just a tool that works in healthcare JSON's, a pleasure to have you with us, very much looking forward to this discussion.

Jason, you're muted right now. Just go make sure that you are unmuted.

About that. We thank you. I really appreciate the invite when vetoes asked for us to attend. You know, we thought we would come and talk live about automation and how it transforms the landscape. As many people know, that 50% of healthcare organizations will invest in RPA over the next two years. And for organizations that are scaling RPA, they're seeing 25 to 45% operational cost out, as well as a four X return. Within two years.

We've seen substantial growth, ink transformation, with automation across the landscape.

I could talk about that for 45 minutes, but what we realized is, no.

What does it take, scale? What does it take to go? from a few use cases? Too many use cases that get that four X return, we talked about. It's not an easy thing.

Recently, in an article and spotlight that class research did, they said that once you get a good base and get a few use cases under your belt, then you take off rapidly. And a lot of the comments I get back from CCS, CFOs, and CTOs, is that's all well and good. But I really want to clear it from the other organizations like myself who are experiencing this. So what I brought to you today is a panel of some of our of our scaling clients. I'd love to introduce you to them. So one is current Alexander, he's the Senior Technology Analyst at ACL. He's leading the efforts there, welcome, Kurt. Gary ..., who is the Digital Process Automation at Blue Cross Blue Shield North Carolina, has been driving that initiative for five years. And his bride almost $7 million of real, tangible outcome to the organization with digital technology.

As well as Joe Perry from Change Health, he's the chief automation officer there. He is a global growing. The enterprise automation program, across business units to each other, of course, is a very large organization, and corralling all those different groups around automation is very difficult. Gentlemen, welcome. Thank you so much for the time today, so I'll drop the screens. So we can put some focus on the team here.

Screenshot - 2020-09-18T211805.107So, Kurt, I would really love to start with you today, and talk about, why now Everything? We're here talking about transformation.

There's a story behind transformation, right? It could be I started just because I had a big problem to solve. So it really be great if you can kick off this panel of explain to the team a little bit about your role in why HCA really invested in their automation program, and really what that holistic vision is and what you're trying to achieve with it today.

Absolutely, first of all, thanks for having us. Really appreciate the topic. I would love talking about automation. But as far as a particular event that kicked us off, I mean, many people are aware of HCA. We're a small healthcare company. We operate about 185 hospitals across the United States, and the UK, and our IT Department, which is where I reside, is anywhere from 5 to 6000 folks on any given day.

These folks are primarily executing digital workloads, which when you think digital, first thing that should come to mind is automation, Right?

These are things, these are often tasks that weekend kick off with a bot if there's, you know, pretty robust logic built within the process. And so last year are we transition CEO?

Sam Hayes is our new CEO upgrade to Healthcare and one of the charts that he made to, Marty CIO, how do we start doing, how did we start doing more with the resources that we have? Right? Age old, operational question, how do we optimize existing resources. And the answer for IT at least, has been, how do we start researching different automation technologies that can take, take a little bit of the burden off of our staff?

Which, I mean every day, that is the case with any, about any other organization listening to this, we're being asked to do more with the same amount of resources, especially with covert right now, everybody's working remotely, so we're having to, we're having to continue servicing all of our customers with an ever changing environment. How do we use technology to augment the processes, to augment the skills that we have?

And that's what this is all about. It's really about doing more with what you have. Like I said, there's not necessarily a particular event. We've been looking at automation. And specifically, RPA for the last 18 months or so, and just over the past three month, we've really gotta. I wouldn't even say dipped our toe in the water, we're kinda dive in headfirst, because we've we've officially got a number of resources dedicated to this effort.

I myself, for example, I was working with Enterprise Technology and Architecture for the past several years and I might just joined the automation official yesterday so we're really, I mean when it rains it pours in so we're, we're, we're going headlong into this is going to be exciting.

Now, that's terrific. Arrive. I appreciate that. It's funny that you say just, you just join. You've been there since the beginning, So this says. And justifies the meetings, I appreciate the insights. So, you know, I really start with any idea in mind it's, you know, jump on the transformation bang bang because you see the 2 to 3 year trajectory. Joey's like very similar conversations, that change Health, but I think your maturity line, where you are, comparing the ACA, is a little bit different for the audience to understand. Really, you know, the change, health, vision, and some of the challenges we've had. Of course, for this, we said, we're very open. Honest conversation, not just the promotion. RPA. So, I know, Change Health has had some, some challenges in the past that you're looking to receive. I mean, next week and focus a little bit on that, but really good to understand your ongoing vision and wide RPA for change.

Yeah, Jason, I want to also echo Kurtz comment about the, I really appreciate being involved and included in this and appreciate the invite and the opportunity to talk a little bit with the group here about what it takes to do automation.

Btog CTAWe're in Chapter three. I call it at Change Healthcare. We've been doing this, puts in only about three years. We've had to, I would say, rough Starks. I came on board about a year and a half ago to start chapter three in and move things forward. And, you know, I think we'll talk a little bit later about some of the obstacles you run into or challenges that you face when you do automation a little later in our talk. But it was pretty obvious to change healthcare, that using automation was the the way to go. And we have 15,000 employees with about 15,000 contractors, do a manual work. and automation is all about transforming that manual work into digital labor force. So, we knew we had the opportunity there. We know, of course, like many companies had have been hearing through the markets.

it, you know, this, this is, this is the thing, this is, this, is what companies are doing the reduced cost. Increase quality and all the benefits that you get with, with automation. And I think the organization just kind of struggled with how to get going with it. It, clearly, our executive team, saw that it wasn't about whether automation tools were ready to do this work. They've been ready for quite some time now. It's more about whether the organization is ready to transform its operations, so that's really what this is. This is not a technology play. This is not an IT play. It's not a finance play, It's It's not, not about that at all.

It really takes the right combination of technology and operations, understanding, and management, in order to combine this, to actually transform that work to a digital workforce, and so, you know, were maturing pretty quickly now. Of course, you know, it's like, most companies are, leadership wants to see results and immediate returns. And even how do you measure that, and when you do, with all that good stuff. But we think, we built a seaweed, centralized co that has representation from different areas of the business that are impacted by this transformation, and rightfully so. Because, ultimately, we're transforming their business operations, so at the end of the day, they still aluminum. But, you know, we've, we've moved pretty far, Down the maturity curve was, by the way, a whole lot more to go. You know, as you start your automation journey, we like to say, the crawl, walk run. But there are actually many more transitions in there than that. It's crawl and then start to walk, but stumble a lot and then stumble a little less.

Then maybe you walk a little bit of trip down the stairs and, you know, and eventually you look back at your, at your past and you go, Wow, we really have moved and come a long way. But then you look at, you know, what it takes to be like a living class athlete and you've got a long way to go, you know, so that's what we're all striving for. So appreciate you having us here today.

I appreciate that, Joe, and I'm very, very similar to how HCA started. Of course, you know, you mentioned transformation a lot, and it is hard, right? Transformation as hiring managers, how change management is a huge piece of adoption for any product, red alone, RPA, Especially when it impacts the human worker. So significantly for the, for the, for the, for the benefit, of course.

But it's combining those two together and proving that out. And Gary ... in our conversation. Especially from a blues perspective, who is no stranger to automation and transformation over many years. We've had a lot of that experience with other products, other types of technology solutions, looking to optimize operations. Be great if you could share with the audience: The Blue, Cross Blue Shield of North Carolina view, and you know, how, how you've been driving this vision to the state?

Yeah, absolutely, Jason. Yeah, and once again, thank you for inviting us.

I won't repeat a lot of the good things occurred.

And Joe talked about, you know, just to sum it up, you know, we've been doing this since late 2017, you know, our goal is we're always to free up employees, We talked about capacity, but free up employees, so they can better serve customers, Get that wrote, work off their plates.

So they can have a better work-life, they can feel more empowered to serve our customers. The second one was then to actually, the whole promise of robots is: to get this development out of IT and actually have our employee subject matter experts, building bots, talk about our ups and downs on that one in a little while.

The third one is, hey, look, if you're gonna do good for people, you still have to give measurable.

Return back to your internal cost investors. Know, you, they're giving you hard dollars, you have to return hard dollars back to your internal investors, those three things. We'll talk more about those later.

You talked about challenges.

I think that's really why a lot of people may have come to this session, is that there are a lot of challenges and not an easy thing. It's not an easy thing, technology, as an easy thing. North Carolina putting the power in the hands of the business group. Instead of relying on IT, that's that's a change in itself. For most organizations, right? So, maybe, Joe, maybe you could start talking a little bit about those challenges that you mentioned, and what you've, what you've witnessed.

So, Yeah, yeah, I'd be happy to There's definitely no shortage of challenges and potholes in the road. I'm quite certain that many of them are common among anybody else, this journey, and there's always some unique ones, too, but, you know. I started when I was just talking with the first question, you know about convincing people that it's, this isn't a technology thing and all you to expand on that more. Because I think the initial mindset is our bonus, you know, a software tool or a or a widget to that will just make life better. It's not that at all. It's, if you think about automation, frankly. It's a tool that you install.

32It does absolutely nothing, until you teach it to do something.

Right. It's, it's like Excel in a way, I use, this analogy is not great, but it's already, but, you know, Excel, you can install Excel. But it doesn't do anything until you put numbers in it until you create spreadsheets, and graphs and things like that to make it deliver value. And it's completely in, within your control to have it, do good stuff, and that you can, you can have it calculate numbers incorrectly. It'll still give you a number.

Automation, is very much the same way, you can, You can make automation or train automation to do things, you know, really well, or not so good, and But I think the core of it is, is really getting across the line. It's not a technology thing.

It's a business process transformation, that, that at the end of the day, the business areas still element processes, no matter how you go about automating things. They are the owners of it. No one else is, and it stays that way. You know, it's really, you know, you run into some things like, you know, you're going to do automation. And some people embrace you and some people, you know, kind of stiff arm you, because they see it as a threat, and again, you know, the analogy I use there is that, that's like back, it wasn't that long ago, guys, that PCs came into the work place, right? And, and I'm sure that the same conversations happened back then. I was like, Why are we bringing this box? And that does all this. You know, stuff for me, my job's gonna go away, we didn't realize it that, well, that really spawned a lot of IT jobs. You know, so created a lot of jobs, and it also made it all businesses more efficient.

In a lot of ways, this is similar to that. It's convincing and getting people to understand that. This, this is, this is the way work is going to be done in the future, and it's it's not about If you're going to do it, it's really a matter of when you're going to do it in and getting your arms around, doing it right. Some of the other quick challenges that I'll pass the baton on, our find qualified resources, highly recommended. In fact, you know, I said this is Chapter three of what we're doing. I highly recommend anybody hidden down this path.

You look very closely at the, at the personnel, especially the initial personnel you put on this, on this type of initiative, because it's a, it's a different animal. It really does take a unique combination of understanding technology and how it can be leveraged to improve business processes through automation. You can standardize through automation so there's a whole lot of disciplines that get poured into this bucket and stirred up that makes up this whole transformation thing. So, make sure you get qualified resources in and out of the out of the gate. If you don't, your, which is, frankly, why I think our first two starts at change healthcare didn't go as as they would have liked. They really thought it was something that wasn't. And I think I'll leave it up again, I'll pass this on, but it's not a project.

I still, internally, have this conversation almost on a daily basis. You know? Whether you're looking at funding or ROI, or delivery of, you know, benefit or whatever, it seems like everybody wants to keep putting this in this box. So, that's a project with a start and an end, and you're finished. And I gave you, you know, $50,000, you give me 150,000 back. It's not how it works. It's a transformation program.

It's ongoing. It constantly, you're constantly building stuff. You're constantly training automation to do more and more and more. You owners of Capitalism's component and an OpEx component to that. And your organization has to look at this a little bit differently because it's not a project. And it's not about an IT or technology tool.

So that's just some of it. I mean, I could go on. And I think Jason, he said, go for 45 minutes and talk about all the war stories around this stuff. But I'll be happy to hand this off and let somebody else throw in some other Grist for the mill.

Perfect job created it, and, you know, when, when you say about, you know, qualified personnel, and who do you start with? It's a common question, right? Do I start with business? Do I start with IT? Do I start with a good way to start with Kurt, and I know in your, in your? journey. Right heavily. Looking at the six Sigma organization, right, the people that even though it's not a project. They own the transformation and the budget For the whole corporation, Not. Every organization is a six sigma organization.

Screenshot (4)Right, but, you know, I think it was built that way, too.

Get around a lot of these adoption challenges. So, maybe for the audience, a little bit about the challenges. You have seen, I know you said you're beginning of the journey Again, the journey has been almost nine months old now to get us to the stage, so maybe a little bit about the challenges that you foresee coming into the next months as you start to scale.

Sure. So if if, if John Chapter three, I kind of made the joke, I'll make the joke that we're kind of in the prolog right now. We're really, really just getting started, not to say that they haven't done automation, quite frankly.

We've been doing automation for 20 or 30 years.

However long any of those technologies have been around, We've been using Boston Workstation for as long as I can remember, but it's been typically executed in silos.

And that that's what's really changing for us right now, is we're trying to consolidate a number of different automation initiatives all happening in different pockets of the organization all providing value. But HCA, as an enterprise, we're, like I said, 185 hospitals, 280,000 employees and want to be advantages that we constantly try and capitalize upon at our scale.

That's what we're trying to do with some of the centralization here. We've got.

And as Joe said, this is not a technology problem. This is not a technology hurdle.

Some of the issues that we saw upfront, things like centralization of infrastructure, as it relates specifically to RPA, we had a couple of different instances, organizations within H C, using RPA.

And, you know, we had to go and say, well, IT, if we had a play on this at all, makes sense. That, you know. We should at least manage the infrastructure, take that burden off of the business, and let them focus on actual development. Let them focus on things that add value. Let's use our IT department to, know, manage the hardware. Fantastic.

If I could go back and deal with those problems, those are so much simpler to solve, because the, the biggest issue, and the biggest thing that has to change our culture, Right? There is, there is an understanding, and I don't think this is necessarily a true understanding, but there is a perception, perhaps, that automation is going to remove people from the process.

That is never the case. That has never been the case, and I say this a lot, especially to some of our more financially minded leaders at that.

If headcount reduction is your goal, you might want to manage expectations a little bit, because that rarely ends up being the case. What you see more often than not is that roles are able to be repurposed. You can have specific people focusing on different tasks that add value, things that the organization think that those teams should be, and would be focusing on, Had David time to do. It has a a little bit more space without having to do a lot of the mundane repetitive tasks.

So, it's a cultural shift that really needs to happen, and that's, that's one thing that we're working on it.

Mean, when I, when I think about a example, something that we would all be familiar with it, it goes back to the people are familiar with the agricultural or the industrial revolutions right?

Right now, we're in the middle of the information revolution. The automation revolution.

People are still going to be working, just like they were before and after the agricultural revolution, The differences we just had left farmers.

Same, same work is being done.

In addition, we now have more high value added work that's being executed. It's going to be a more knowledge centric economy, once that is all said and done. But, again, that's the, that's the kind of conversation that we're having its setting people's minds at ease and letting them know that.

Trust me, having having seen some of the technology.

It is powerful, but it cannot automate an entire person's job with all the intricacies that they have to deal with and all the different exceptions that they have to handle. In some cases, we may be, we may be able to automate part of that, and that's really what we're going for it, to free them up to give them more time back in their day, to do the high value, the critical thinking, the things that people should be doing.

Screenshot - 2020-09-18T211805.107That's the, that's really the big challenge, that I would say, it's culture, Culture as upstream in the progress.

So, what I heard occurred is, it's disruptive, not destructive, which which is the key piece here, right? Yes, of course, disruptive being from a process, evolution, perspective. We're all very familiar with the EMR integration. We're all familiar with claim based processing and business workflows.

These are disruptive, they're not destructive, but they, they make you more efficient. This is truly a disruptive technology as it changes the way the organization works, and everyone moves with, Joe, you talked about Excel, No, computer change the way people worked. Excel workbooks change the way people work. Automation changes the way people work and makes them more efficient.

Of course, there's a lot of challenges. As we were saying, You know, you still have to prove the value. I want to roll over to you, Gary, and talk a little bit about the challenges you're seeing in North Carolina. You've experienced this. And then roll into the next set of questions, which is really around how do we address some of these challenges by proving value? I know you've made that a main initiative at North Carolina, and I think that some of the most mature value Engineering, I've seen out of a lot of the payers, they work with somebody, and you know the line with a little bit of that experience.

Jason, I appreciate that.

Man, you don't understand, the role that I play at a Blue Cross Blue Cross.

Is a very kind blue, Cross north, kind of very kind, very employee centered company.

So, I understand when I'm talking, I'm kind of the operations finance guy.

So, no, I, that's the role I play in this department.

And just like you talked about, just like with a curtain Joe, you know, we've we've, we've had our pain with this program. But we've also had quite a bit of success. We've put in over 40 use cases.

There's robots going on, installed over 700 computers at Blue Cross, North Carolina, Know, we've seen our success, but boy, there has been some pain along the way. For a lot of it has to do with the software, back to where we started with a pair of robotics.

And what we saw with that is it really good developments velocity was just not there.

It was taking way too long to build robots.

Also, we could not, in the first couple of years, of this program, get development out of IT with that software package.

So, now we've had to take the pain of now switching over to you, I pass 1.

one piece of advice is, work with your architects and really make that, make that decision on what package you use, very carefully, because it can really trip you up.

Um.

So now we're working with UI path. We're switching over, and we're very excited too.

Actually, you start bringing this bot development out of IT, I lead the team that's, we're just following the UI path cookbook and develop training, advanced developers.

And this whole idea of taking subject matter are experts in business and teaching them how to build robots and getting out of this hole.

Um, business analysts, writing requirements, writing user stories, handed it over to a developer, we're trying to get out of that very long, very expensive process.

Um, one of the other challenges that we're seeing, and Jason, I'll move into the measurement, is, you need to find high dollar use cases.

Remember, as you're trying to help people, You have to find use cases that are going to payback your internal investors.

And you don't, in my opinion, get these high dollar use cases.

Most of the time, from process owners, a process owner, well, always be looking to you to solve their business pain.

They have problems every day in their business, hey, we're here to help them, But understand that if you're looking for your business, value, your business impact, those use cases, you're not going to get them.

You're going to get, you know, it's, it's purely paredo, 20% of your use cases are going to give you, for us, close to 90% of our heart value.

So, you need to find the larger use cases to then pay for your program, so then you can help people and help customers.

So, you need to find an executive sponsor, you know, both.

the current Joe talked about, culture change.

Well, you know, every so often, you can't know, you don't have the years to change the culture.

You need to go to an executive sponsor who has the view of the Enterprise Mindset, where a Process Owner is kinda looking at their little area, and you need that executive sponsor to help you drive large enterprise impact.

The last one on this, is, never think there's any relationship between the size of the robot and the return on investment.

32You can spend months, three months, building a very complicated robot, get a very tiny invest in tiny return, or you can place a very simple robot in a very strategic place, Very large return.

So, you know, everybody knows about a quad chart, find those easy robots that have very high impact, and really watch your backlog.

Because you can be doing a whole bunch of use cases that you really are helping people and six months turned around, and you got a grand total, 150,000 bucks, that's not going to pay for your program.

Jason, do you want me to go to the the measurement systems?

I think so. I think the next big question I wanted to ask the team is really about value. And it's something that, I think a lot of times, you're talking about those high value use cases, right? How do you measure them transformation running transformation programs, myself, for almost two decades, my biggest issue was, how do I show value?

To a process, we've re-engineered, because there might not be a way to extract value. It could be qualitative, could be quantitative, especially when it doesn't have to do with real headcount reduction.

So a little bit, you're interested in that, and then we'll go through the team.

Do you mind if I add on to something, Gary said? It's something that, I mean, you hit the nail on the head, Gary, with no cost.

Something to really walk away with that I repeat over and over again, change healthcare complexity, drives cost volume drive savings that Simple you know, everybody looks at, Just automate, automate, automate. It's like, OK. Well, you know teak to your point.

It's like if it's an extremely complex thing that you do one time a year Your cost is going to be really high and your returns very low. If it's a really simple thing you do 10000 times a day, right? I mean that's low. Cost to implement very high ROI. It seems really simple, but it's real easy to get lost in the weeds. When you start doing automation, because, you know, it's the, it's that mindset of and some executives feel, this way, and other leaders in the organization, that, go, find the big thing, go find the big fish. And landed, right. And, and, you know my view on it is, that's not how it typically works. What, you're really, What you're really doing, is, you're building a program that can deliver a lot of velocity. And, so, you know, I call it death by one thousand paper cuts. Yeah, we'll get it done. But we're not gonna get it done by land in a whale. We're gonna get it done by landing. You know, 100 million sardines. That's what we're going to do and we need to do it. We need to do it fast.

Of course, if we find some huge volume process that's really simple, we're going to tackle that one because that's a big one, right? So, you go after those. But if that's your mindset, and that's all you see. you're, you're gonna, Honestly, you're gonna fail at doing this, because there aren't that many of those out there.

That's a really good takeaway.

No, as, as we look at any kind of process, no, you know, like Jason was talking about, you know, I do have a Lean six Sigma Engineering process engineering background, like a lot of people.

And every process has at least three measures, koss, Velocity and Quality.

And what you're always going to be tempted to do with automation is try to reduce your cost, the cost of the process.

And usually that's people cost, right? It's ours.

But what you're really has to do to get large impact, is look at the velocity of your process and the quality of your process.

So, what we do at Blue Cross, North Carolina, is we do look at our saved, we track our hours saved, and we report those up and we have goals, but we looked at the hours saved as more of, we don't try to turn that into dollars, some kinda, weird conversion of dollars.

We just say, This is our measure of how we help our internal employees. We're taking wrote, work off their shoulders, and we know they're going to do a good job for customers.

And they're going to have a better work-life where we We also have a measurement that I won't talk about employee experience.

But the one I really want to focus on is where we've made a lot of strides is what I call realized value creation.

And this, I wrote down one of the first I'm an engineer, so you have to write an operational definition to these things, so everybody realizes what this is.

So, our definition of a realized value creation is an auditable annualized financial impact on operating income from DPA financed automation.

So, there's a big word in there.

Operating income.

So, what I would highly stress is: get to know your income statement of your organization.

You know, this is, maybe for a lot of people who are more IT focus, they don't really think about this, but if you can, if you can build a bot, you can share, learn an income statement and a cash flow statement.

So, right at the top, you got, you have revenue, and what we found at Blue Cross is that we're able to, by increasing our velocity, we're able to increase our margin from revenue growth.

So, we're able to speed up our, um, our underwriting to quote cycle for alternative quotes.

And that had a very large impact on our top line revenue growth. Did we try to cut out Underwriter's or cut the number of people in the process? No, we didn't.

We wanted that velocity increase. We didn't care about the number of people in that process.

Once again what I always call the cost part of this process is small balls.

You will work like the dickens to get two people out of a out of a process and those people cost the company $50,000 apiece.

So you will kill yourself and fight with a manager to kick people out of a budget. And when it's all over, you got $100,000.

What I'm suggesting here and what we've done is go after financial wast instead.

So we increase revenue growth.

The other one we do for velocity is in our cash cycle.

So, look at your cash flow statement, one thing we did know in anybody that knows cash flow knows that you want to speed up your receivables and you want to slow down your payables.

Screenshot (4)And that increases your current account balance. That's real money in the bank.

So that's a chunk of money that's in your current account.

And it's also driving now marginal investment income, or at the very least, interest on your current account, your checking account.

So how are some of the ways you can do this?

Well, one thing we did, we sped up our, our check writing process to the hospitals.

And what the reason, the reason we were able to do, we did that.

And what that did is it actually allowed us to hold on to not pay our claims for an extra two days.

So we're able to hold on to our claims, paying the clients for two extra days, which dramatically increased our current account balance in millions of dollars.

So we did that by, we're holten, we're paying our claim is out pretty fast so that we would make it within 30 days.

We sped it up. So we could hold onto that money faster.

I didn't say that very well. But really, look at your cash flow.

And, finally, no. We're looking at payment integrity. Are we paying our claims correctly?

The other one is risk revenue, anybody who does anything with obama-care and Medicare, But the federal government gives you risk revenue.

Well, how can you make sure that you are very accurately reflecting your risk in your your risk pool to the federal government, so you can increase your risk revenue?

There's millions of dollars sitting: So, you know, just to conclude this, No.

You have to be able in this business.

To talk to your finance folks in their language, you have to create a strong, very good reputation to continue to get this investment.

Now, we've all been through these investments, where, hey, you can get money for a first couple of years, by just being the new kid on the block, and the new exciting thing, but you know what?

If you're going to have a year, over year investment, you have to be able to show return, and have this reputation that you, the return you are showing, is actually a hard, dollar cost savings.

That was the long talk, I apologize for the length, I think it needs to be said, Gary, right? You're right, a lot of organizations do focus on the cost out, the headcount reduction. It's, it's how RPA typically sold initially and your message is that, you know, you'll kill yourself trying to get there. You need to really understand the big numbers and how automation impacts that. Because that's how that's how operations looks at it with the people, right? People are just a number. They impact the bottom line somewhere, so we always talk about impacting the bottom line. You want to transformation? and be successful.

You need to impact the bottom line numbers, not the small, and where you find, You know, it's easy to have a manager tell you where their pain is, because they can speak to you.

But The enterprise's a whole can't speak to you.

So you need to go find where you can figure out the enterprise. And the way you learn where enterprise pain is, is through the cash flow statement, statement, and the income statement. That's how they're talking to you.

And, you know, I always say black belts and bank robbers.

Go to where the money is, and, like, which is, like what Joe ... talked about, high volume.

Go to your income statement, get to be best friends with some of your finance people, because they know where the financial waste is, and then start looking, where they're pointing you to and your income statement.

That's where you put automation. You ask where you pay off your internal investors.

That fantastic feedback, Gary, and I think, definitely needed to be said in the conversation just for aspects of time, will accelerate this a little bit.

And I just wanna coin on something that, you know, and, oh, I heard from both of you and, Joe, you throw it in there, which is, you'd have to look at a lot of things that are standardized, and we do a lot of them. Because, sometimes, the more complex ones will increase the cost and the long term, right. I'm always looking at your Year one, there's always an investment. Any project that you want to maximize your return in year, three and year for this, isn't a one and done. it. Transformation with automation never ends, because you wouldn't say, I'm gonna hire employee. And they're always going to do the same job.

Every year, right, no employees need to be trained, they need to learn new skills, They need to be enhanced, Right, We all do that, and our career automation is no different.

But then getting it across everyone. So they can enhance their own skills, while the robots are enhanced, is really the difficult part going back to your change. So I wanted to bring the conversation back to a little more transformative, which is automate, automate, automation robotics for everyone. Right, for every person would call a rep. And I know, so let's all three of your organizations. It's something that we're heavily looking at. I mean, Kurt, it's something you're looking at heavily. And ACA now.

You're just starting on the enterprise, which is now where a lot of the automations, he's talking about, really automate the backend. Server side.

But what if I give a robot, or a digital assistant to a person, right? To all my employees, to, all, 60, 60,000 ACA employees, at a string of automations that they now manage on a daily basis. It might not be the high complex ones, but if they're all doing low complex automations, that all add up an impacts those hours spent by can take three hours off of a clinician's time in the evening so they can spend it with the family. Everyone would appreciate, right? If I can reduce the administrative work upfront, no scanning and document, make it real time. I think everyone would appreciate that. It's maybe a little bit. You know, maybe start with you on what your, what your thoughts are there and how you see that potentially playing out for the for the long term and ETA.

You saw me nodding emphatically because you said the magic word clinicians are our lifeblood at HCA and really, healthcare more broadly is, nurses, physicians. We've got about 90,000 clinicians.

And so, when you think about opportunity, the opportunity with the opportunity to benefit gained from automating even a minute of their day, that multiplied by nearly 100,000.

Not only do we realize the financial benefits from that, but, guess what? That clinician now get to spend more time in front of a patient, which, let's be perfectly honest to your clinicians, didn't go to med. They didn't go to nursing school, they didn't go study for years and years, so they could spend time in front of a computer documenting all of their effort and their money. Learning to become a clinician, because they wanted to help patients. And, frankly, that the patient one as well. That's why you go to a hospital. That's why you go to a healthcare facility, is to receive care. Whether it be from clinicians or physicians.

So, I have no doubt, in my mind, that, in the future, something like that is necessary, that we have clinician to have something. You have a digital assistant at their fingertips, with a robust library of different automations.

That our EMR, Agnostic, that are kind of solution agnostic, but that know how to operate the ins and outs of their workflow, and can pick the intent after the clinician, interact with the patient. And then they go back to the digital side of their workflow. And they have to enter information. They have to transfer things around that input, you know, ABC into this system. How do we automate that piece?

Again, if we talk about automation, vision, I would love to maintenance, let's just go big.

I'd love to double the time that clinicians spend in front of patients, right? And one of the biggest barriers to that, is all the digital, all of the documentation work that are required, that are regulated, that are there for a reason, that don't necessarily need to be performed by that clinician. If we can automate it with a robot.

Long term, I think that's absolutely where we need to be.

But just to make a long story, marginally less long, I would say that, initially, we look at, a lot of unattained use cases that we can tackle, end to end, write processes, where we can entirely remove the person from the equation and let them focus on other things.

Once we get, you know, once we get artsy legs down at that point, then we can start introducing automation, the proxies, where we can drop the ball A to Z, right? We can tackle a little chunks. And so, we introduced the digital assistant at that point, and again, that, the longer term goal, but certainly somewhere that we're going to get.

I know we're a few minutes here, Mary Jo. You can cycle up before I start to take questions on that. Same a rep concept, I know being a Heavy Service provider. All right. You see the other side, which are all, these transactional automations, right? That fit, perfectly into this desktop automation. Maybe a viewpoint. A little bit from your side Where you see automation for everyone setting.

Yeah, no, thanks, Oh, yeah. We are a little bit different where the same industry, but, you know, we're mostly mid back, office type services and so, we look at a couple of primary things to what Gary was talking about. Which, by the way, could be a whole nother session about how you measure stuff because we found within finance, there's even different different definitions of handicap the money, but we focus on cost per transaction, right? You know, how do we deliver value through greater accuracy, greater speed, lower cost per transaction? And then, of course, within our own walls, you know, how, how does that transform itself into something like revenue uplift or you know better cash flow?

And so, in order to do that, there's, there's really two basic approaches with your automation tools. one is centralized automation or unintended automation, which is, really, hey, you know, you do this process all the time, I can just build a bot, put it on a server, and it pulls it whenever it's available and that does the work and you really don't need an interaction with the person. The second time is this concept of assisted automation, which is really like a digital assistant. It's like having your own, you know, digital employee, sit next to you, that you can work over two and say, Can you, can you take care of these? You know, thousand transactions, 500 transactions? For me, all of that is good stuff. I mean, it allows people to be faster, better, cheaper, and get more things done. And I think there's, there's a piece of this that, that I think is also really important to understand.

And a lot of organizations, and I can't speak for the other gentlemen on this call, but lot of organizations start with a centralized model, right, That we, we know the automation tools, and they know the business. And so, we work together. We automate things. Reality is, most of the knowledge is in the business users, Not in the How do you train automation to do something, I can teach a business user, would be pretty darn dangerous with automation at about half a day. They get really good in a few, couple few weeks, maybe a few months. They get, you know, really, really good at it.

It's, it's actually better to train people, to use automation, to build it themselves, to use a concept called citizen builders, citizen developers. Because that's how you really get scale. If you, as long as you centralize your build model, you're restricted, your, your resource constrained by that model. Once you open it up to all your employees, that's when you can really scale and grow. And again, use a bad analogy of Excel. If only a centralized team could put the numbers in Excel and hand it back to you, you can only get so much work done in Excel. But if you teach people how to use Excel and you put a, you know, 100 copies of 500 copies out there, all of a sudden the scale. And the leverage you can get using a tool like Excel grows exponentially. And so our vision that change health care is to decentralize the model by and large and use a citizen builder citizen developer method going forward.

Good, gentlemen. What a fascinating reveal of robotics process automation, in real life practitioners, who are implementing significant, positive change that creates value. So, thank you so much. We have run out of time on this session, because it's such a, such an interesting topic. There were several questions that were posed. and I want to thank Lisa Weber for from UI Path directly, answering several of those questions. There may be additional questions that we're asking people to go onto the page that we have created for. this, for this event. And you can look under My Name Post, your questions in there, and we'll have Jason, and others come in, and provide answers to some of those questions. But I want to take the time. And thanks Jason, Kurt, Gary, and Joe, for sharing your wisdom and expertise. Not theoretically, but practically on how you make these things work. We really appreciate you taking the time to share your insights with the global audience today.

Appreciate Jose, and thank you very much for having us. Thank you so much. Thank you for having us.

Thank you, gentlemen.

Ladies and gentlemen, this concludes our segment. This segment of Beetles Healthcare Lies will will be wrapping up the first day with a terrific presentation from Tina Wilson. Tina with Wilson is the Executive Change Management Leader for the Joint Commission Center, for Transforming Health Care, and Tina is going to talk to us about leaders, transforming, healthcare, inactivating, operational excellence, through trust, and change management. As you can. As you have seen today, we, we are bringing their varied perspectives into healthcare, transformation and operational excellence. Somewhat perspectives are cultural. Some perspectives are on the, on business and digital transformation, and, and some of these perspectives are very tactical, so, we hope you enjoy that.

At the top of the hour, we'll see you again with Tina Wilson and talking to us about transforming health care by activating operational excellence. So, see you back at the top of the hour. Thank you very much.

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About the Author

more-Sep-21-2020-11-07-23-74-AMJason Warrelmann,
Global Healthcare Practice Lead,
UiPath.

Jason Warrelmann has been transforming healthcare operations for over 15 years  with some of the largest healthcare provider, payer, and pharmacy organizations. He is a certified Six Sigma Black Belt, Change Manager, and Agile coach, which gives him a unique view into what works in a healthcare environment.

Currently, he leads the Healthcare and Life Sciences Practice at UiPath, which focuses on transforming the Healthcare landscape and developing capabilities, integrations, and reusable components that make UiPath a healthcare automation platform and not just a tool that works in healthcare.

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About the Author

more 121-1Joseph Peri,
Chief Automation Officer,
Change Healthcare.

Recruited to build an enterprise wide automation CoE to deliver and enable efficiency improvements for business operations and customers. Change Healthcare supports 5.5k hospitals, 900k physicians, 118k dentists, and 600 laboratories with $14B transactions, $1T claims and 2.2k payer connections. Change healthcare touches 1 in 3 US patient records. Achieved $5mm savings in the first year and achieved annualized savings of $18mm in 18 months with 7 direct reports and 50 contractors.

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About the Author

more..-1Kurt Alexander,
Senior Technology Analyst,
HCA Healthcare.

Kurt Alexander, HCA - My entire career has been focused on healthcare in various capacities. I have worked in data informatics, finance, and most recently information technology as part of HCA’s Enterprise Technology and Architecture team.

I am passionate about technology and understanding how we leverage both existing and upcoming tech to improve the care we provide to our patients. As it relates to automation, the name of the game is delegation. Machines are capable of performing much of the tedious (but necessary) work it takes to keep the lights on. My goal is empowering the myriad teams of HCA with the tools they need to work smart, deliver results quickly, and love the work they do.  

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About the Author

more (3)-2Gary Grena,
Principal Consultant, Digital Process Automation,
Blue Cross Blue Shield North Carolina.

Gary Grena BCBS NC - Gary began his career with Caterpillar, Inc. where he worked while completing his engineering degree.  After graduation, he progressed thru many supervisory and management positions in Operations and Planning where he helped build some of the biggest construction machines in the world.  After moving to a project leadership role, he was on the team that created the construction Industry's first Internet build and quote configurator.  Gary earned his Lean 6 Sigma certification in 2005 after leading over a dozen successful continuous improvement projects that produced over $2MM in SOX-compliant savings.

After earning his MBA from the University of North Carolina, Gary was recruited to become a Partner at a startup focusing on high-temperature plasma applications.  Gary directed the accounting and financial investment functions for the firm where he worked to raise over $5MM in investment capital.  Gary gained an expensive education in the necessity of driving hard-dollar value and cash flow during his 5 years working at this eventually unsuccessful venture.

Gary has worked at Blue Cross, North Carolina for the last 5 years where he has been part of the team that launched the Digital Process automation program at BCNC in 2017.  This program has delivered over $7MM in annual hard-dollar, auditable value.  Gary has created a financial reporting framework that accurately communicates the financial value of automation to executive leaders.  This framework has been instrumental in gaining our internal investor support for continued year-over-year investment.  Gary is currently leading a team to expand and accelerate robotic development beyond IT by developing our employees to become Citizen Developers who can build their own robots.

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