Debunking some of the misconceptions surrounding operational improvement technology

Revenue cycle management is a great place for operational improvement technologies. These technologies can leverage process and task mining to give leaders a bird’s-eye view of their teams’ workflows.

But according to Todd Doze, CEO of Janus Health, a revenue cycle management technology company and a 20-year healthcare veteran, there are three common myths about operational improvement technologies:

  1. Operational improvement systems replace human actions, even though they are designed to help people make better decisions.
  2. Operational improvement technologies lack the granularity needed to make decisions, even though they provide a detailed, workflow-level view that the human eye cannot comprehend.
  3. Operational improvement systems take time that a team doesn’t have, even though many organizations find that these technologies help redistribute resources in low-risk, high-reward ways that allow team members to perform at their best.

Healthcare IT News spoke with tech CEO Doze to dig deeper into the myths he describes and the realities he believes and his experience with the technologies exist that he wants more people to understand.

Q. You say there are three common myths associated with operational improvement technology. Let’s get to the bottom of them. Your first myth: operational improvement systems replace the human touch. Explain why you believe this is not true.

A. To fully unpack this, let’s start by outlining what operational improvement technology is. At its core, this technology is designed to help organizations achieve maximum return with the least amount of effort.

It’s no secret that hospitals are understaffed, and not just on the clinician side. Back-end billing offices also face staffing shortages and limited hours in the day to process, track, and collect claims that overwhelm their systems. These challenges combined with a difficult payer mix can make workflows extremely labor-intensive and inefficient, resulting in delays. The most critical delay is late payments, which directly impact a hospital or health system’s bottom line.

The idea that operational improvement technologies will eliminate human connection is simply unwarranted. In reality, the goal of this technology is to leverage process and task mining to help people make better decisions, not replace them.

One third of today’s excessive health care spending is spent on administrative tasks, and the billing/revenue cycle folks are no strangers to this dilemma. Operational improvement technology, often using automation but not always, can provide data and contextual clues to help teams make the next right decision.

Sometimes that decision is knowing what and where to automate, and other times it’s realizing that process refinement and staff retraining are needed to keep moving forward. Change management is possible with tools like these because it gets right to the heart of “how your people work” and “what your people work on.”

It is up to you and your leadership team what you do with the answers and how and what you want to optimize.

Q. Your second myth: Operational improvement technologies lack the granularity needed to make decisions. Why a myth?

A. While people like to believe that we can capture everything (and that nothing will escape us), the truth is that we all make mistakes in one form or another. For example, for years, healthcare systems have relied on internal process improvement teams or outside consultants to examine workflows and identify areas that need improvement.

Despite their best efforts, human observation of other people at work is the equivalent of looking through a limited lens. There are many reasons for this, the biggest being that individuals behave differently when being monitored. This impairs understanding of the overall workflow, ultimately hampering optimization efforts.

The idea that operational improvement systems can provide a granular view of workflows that the human eye can’t comprehend should be music to the ears of revenue cycle professionals. With the ability to zero in on individual day-to-day workflows at the team, payer, or individual level, cracks in the foundation can be quickly identified and teams are better equipped to make adjustments when necessary.

For example, perhaps there is a particular individual who is having difficulty moving forward with claim resolutions. There could be multiple reasons for this, including but not limited to a difficult payer mix, too many steps required, too few steps taken, and so on.

The beauty of early detection of these issues is that it provides a multitude of positive outcomes for the healthcare system or hospital. For example, less inefficiency, better performance, identification of processes that are broken or no longer useful to the organization, analysis of quality differences that are expensive to maintain from a time and financial perspective, and last but not least, prevention of refusals.

Q. And finally, your third myth: Operational improvement systems require time that a team doesn’t have. They don’t?

A. There’s no doubt that assessing the data that operational improvement technology can provide takes time and effort – like anything worth doing, there’s an investment required. However, I can say with certainty that the chances are that time is dwarfed by the time your team is wasting on inefficient, outdated workflows.

If you’ve ever thought to yourself, Isn’t there a better way to increase our margins, or What are my teams really working on? Then operational improvement technology is worth a conversation.

In a recent report from the AHAfound that labor accounts for the largest percentage of hospital costs. That’s a whopping $893 billion spent on labor, far outpacing other expenses like medications and supplies.

Operational improvement technology offers a low-risk, high-reward way to ensure your workforce is performing at its peak. We all know the challenges of managing hourly workers, and it’s even more challenging when we don’t have a clear picture of how they’re spending their time.

Operational improvement technology takes the guesswork out of managing and gives leaders the certainty they need to lead their teams.

Knowledge is power. Leaders owe it to themselves and their teams to have the right data to make decisions that are in everyone’s best interest. The sooner you can dive into that data and make decisions, the sooner you free up more time – which ultimately creates more margin at the company level.

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