AI and Automation in Healthcare: Insights from RCM leaders at HFMA Las Vegas 2024

Here at Revedy, we’re focused on best practices around automated coding and the use of AI. At the HFMA conference, leaders from Mayo Clinic, Kaiser Permanente, and Amazon Health Services (One Medical) shared their experiences with AI automation in healthcare revenue management. Their insights covered both progress and hurdles and reinforced the Revedy focus on quality, explainability, and workflow integration.

What We Learned from Revenue Cycle Leaders

It’s Not Simple 

Implementing AI and automation in healthcare is a complex process. Mayo Clinic’s journey illustrates this complexity: they created 34 virtual workers, automating millions of actions and saving significant time and money. Yet, this achievement required meticulous planning and system integration. Kaiser Permanente faced similar challenges, juggling multiple systems and a vast number of patient encounters. One Medical’s experience further underscores the focus required, as they grappled with integrating new solutions into existing systems and navigating AI model approval processes.

Governance, Customization, and Workflow Integration 

Success in this field demands robust management and tailored approaches. Mayo Clinic exemplifies this with their structured process for introducing automation, from conception to implementation. They’ve even empowered staff to create custom automations for specific tasks. Kaiser Permanente’s strategy involves careful planning and prioritization of automation efforts. One Medical spent significant time and effort customizing their coding solution to address specific needs and seamlessly integrating it with their EMR.

It Really Needs to Work: Quality is Key

The bottom line? Automations must deliver tangible results. Mayo Clinic rigorously tracks their automations to demonstrate value. One Medical set ambitious goals for their coding solution and exceeded them, achieving a 91.2% success rate and improving coding accuracy. These outcomes underscore the importance of setting clear objectives and measuring performance.

Explainable, Inspectable, and Trusted 

Transparency and reliability are non-negotiable in healthcare automation. Mayo Clinic ensures this through thorough testing before deployment. One Medical uses performance agreements to set clear expectations, focusing on coding accuracy and automation rates. Kaiser Permanente  emphasizes data use planning and backup solutions to ensure their systems can be verified and trusted.

It’s Important and It’s Happening 

Despite the challenges, healthcare organizations are making significant strides in AI automation. Mayo Clinic has trained dozens of staff to create automations. One Medical anticipates major improvements in coding efficiency and is exploring new features for better documentation. Kaiser Permanente strategically applies automation where it can have the most impact. These varied approaches demonstrate the industry’s commitment to advancing AI automation.

While AI automation in healthcare presents significant challenges, it’s progressing steadily. Organizations are focusing on careful management, customization, and system reliability. Their efforts are yielding improvements in efficiency, accuracy, and cost savings. As these technologies evolve, they’re poised to play an increasingly crucial role in healthcare financial management.

Learn more about Revedy’s approach to automated coding: https://revedy.io

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