How Automation Helped Weather the Pandemic and Beyond

By Matt Phillion

When Geisinger Health System’s innovation operations department wanted to help staff perform higher-value work that better used their skills, the department sought out automation options that could create “bots” for the completion of tedious tasks, taking that work off employees’ plates and letting them spend more time practicing at the top of their licenses.

“In 2019, we started having conversations around the technology of automation,” says Emily LaFeir Fry, vice president of innovation operations at Geisinger. “The innovation team is constantly assessing the market for technologies that can further our digital footprint and create efficiencies.”

To that end, Geisinger operationalized an intelligent automation hub at the Geisinger Steele Institute for Healthcare Innovation using automation technology from UiPath.

“What caught my eye was the versatility of it,” she says. “We didn’t have just one specific problem it could solve, but a number of diverse opportunities across the healthcare system we knew we needed to connect.”

The organization had existing technologies that could make those connections, but the hub offered a way to add automation to Geisinger’s toolkit.

“We asked: How can we solve the fragmentation, and do it in a quicker manner?” says LaFeir Fry. “We really [wanted] to solve it in a way that improves the patient, employee, and member experience. And the market moves fast; we wanted to keep up with that.”

Innovation as a core value

Innovation is one of the core values of the Steele Institute. “When I got here, innovation was already instilled in the culture,” says LaFeir Fry. “We weren’t starting an innovation group for Geisinger; we [assembled] a vehicle to accelerate innovation. We leveraged preexisting departments to do this but also created new ones, which included a new vertical with automation.”

Automation leans into the concept of value-based care, where the patient comes first rather than the number of visits. This kind of automation is intended to take routine, repetitive business tasks out of the hands of humans and allow the technology to handle them instead.

The Steele Institute’s automation team focuses on delivering business processes that offer measurable benefits for partners, constant improvement, and a scalable platform that consistently decreases delivery times.

There are plenty of hurdles when introducing a new technology, particularly one involving automation—and one of those hurdles is how to best utilize the technology. “It’s a diverse tool, and when you have a health plan, a clinical enterprise, and back office services, you have great problems to solve, but [the challenge is] finding traction for proving value and education across the organization,” says LaFeir Fry. “Where do we use this over a native solution or new technology or software?”

The team spent several months building a strategy for an automation hub, selecting the technology, and determining how best to use it. Their first bot went live in 2019, but not on the clinical side—rather, it helped the HR department handle employee tax allocations. “We were switching over to a new HR system, and there were no plans to have this as a feature, so it was something we could overlay with automation,” says LaFeir Fry.

COVID-19 and innovation

Of course, the innovation’s introduction in 2019 was followed by the start of the COVID-19 pandemic soon afterward. Geisinger was unbowed, figuring out how to leverage the technology for the organization’s emergent needs.

“We really pivoted our focus on COVID,” says LaFeir Fry. “It became a hyperfocus. We had one problem to solve: How do we help the operational teams achieve the needs that COVID has put into place for us?”

Even during a once-in-a-lifetime healthcare event, there were rote, repetitive tasks where automation could be leveraged. Patients needed to have symptoms checked; they needed to be screened at the door; they needed vaccine appointments scheduled. “COVID wasn’t in the budget,” says LaFeir Fry. “All of those things had to happen, and COVID challenged us to leverage technology through chatbots and automation to really scale to a massive population.”

Automation was one solution among many, and LaFeir Fry explains that it was a people, process, and technology solution. “We had 25 nursing staff members calling patients with test results, and especially for positive results, we wanted to turn them around quickly,” she says.

But Geisinger encountered the same challenge as every other healthcare organization during the pandemic: the increased need for nurses in the inpatient setting. With the influx of ED visits and patients to care for, they needed to find ways to let nurses focus on care delivery.

“We recognized the delivery of results could be done in an automated fashion without taking away the human interface. We could route you to a nurse for more direct patient care,” says LaFeir Fry. “Our bots took care of some of that outpatient service need and then routed [patients] when appropriate to a nurse if there were concerns about their results, which allowed our nurses to first and foremost focus on direct patient care.”

This trial by fire opened the door to even more opportunities for automation, says LaFeir Fry. “We’ve started focusing on other very cool mechanisms that automation can do to give time back to staff,” she says. “Places where nurses are already overburdened, to help in areas like chart auditing and documentation.”

A direct impact

Geisinger’s employees found it gratifying to see the direct impact of their work as they reacted quickly to the unfolding events of the pandemic. “I was interacting directly with frontline staff, making changes across our whole digital transformation footprint. It was very gratifying to be able to help,” says LaFeir Fry.

Automation can be a boon for time and efficiency in many non-emergency areas, she says. “Think about some of those manual things you have to do every day. They’re not at the top of your license, not what you trained for, and to have those go away and give you time to critically or strategically think about what’s involved in patient care—it’s almost calming,” says LaFeir Fry. “We work in such a fast-paced environment. To have that time back can be so helpful for patients, too.”

Some of the best feel-good stories come from direct patient care, but LaFeir Fry notes that it’s important to recognize the back office staff’s work as well. “Claims processing, for example. That impacts patients and members directly,” she says. “The quicker we can do those things, the better turnaround we have for billing transparency.” Leveraging automation for tasks like claims processing frees up the back office teams to focus on items that the bots flag for additional review or involvement, allowing them to put more time into the non-routine needs of the job.

“There’s so many things that have a direct impact on patient care—shift changes, shift leader handoffs—where you don’t want information to get lost,” she says. “We’re diving into all those areas.”

The future of automation

The pandemic forced changes in the provision of care, but it also allowed team members to appreciate the necessity of digital interfaces that help patients, says LaFeir Fry. Automation really shone in areas like telemedicine.

Seeing the results in real time helped foster acceptance of automation. “In the beginning, it was important to remember that it takes a while for people to understand what the tech can do and how it can help you with your patients,” says LaFeir Fry. “Everyone got a quick download of information when COVID hit, and now these are primary tools.”

Being a clinician carries a certain level of administrative burden, LaFeir Fry says. While clinicians’ primary focus will always be patient care, operational tasks like reporting, billing, and regulatory requirements will continually demand chunks of their time.

“How can we focus on reducing those burdens and allow you to focus your time on direct patient care?” she says. “I want automation to never take away the human interaction that is so critical for patient care. But how do I help make that interaction more meaningful and allow [clinicians] the time to do that longer because they’re now not worried about other some other administrative burden? We’re on that path now.”

Six-stage creation process

The bots used at the Steele Institute have a six-stage creation process:

1: Discovery. The automation team meets with internal teams, discussing workflows and identifying opportunities where automation could help.

2: Design. Their team’s technical and process architects collaborate to develop a blueprint for the new bot.

3: Development and testing. The bot is coded and built, and then tested to ensure it’s working as intended.

4: Pre-deployment. The bot is ready to be tested by the team who requested it.

5: Initial deployment. The bot is released, but the team continues to monitor it for issues or opportunities for improvement.

6: Production. The bot is officially launched, with daily monitoring.

Matt Phillion is a freelance writer covering healthcare, cybersecurity, and more. He can be reached at matthew.phillion@gmail.com.