How automation is fueling the shift to person-focused health

The potential of automation, AI and emerging technologies to enable more patient-centered healthcare

Whether it's a chatbot on a doctor's website or SMS updates on an insurance claim, emerging technologies like AI and automation are integral to how we experience healthcare today. But rather than de-personalizing the healthcare experience, these innovations are moving providers and payers closer to patients more than ever. They're taking over rote back-office tasks, using health data to uncover fresh insights, and freeing providers to focus on what they do best: caring for patients.

I spoke with John George, director of CGI's Health Payer Practice, to learn more about emerging technology in the health industry. In this Q&A, John offers great insight into the potential of automation, AI and machine learning to enable more patient-centered healthcare.

You recently attended the 2023 Health Information and Management Systems Society (HIMSS) global conference. What's top of mind for health industry leaders right now?

One of the biggest themes this year was speed. Patient needs are evolving quickly, and payers and providers are under pressure to cut costs while delivering innovations that outpace the competition. So there was a lot of discussion around how to accelerate speed to market, speed to value and speed to impact for their products, services and innovations.

Another hot topic was around the continuum of care- how to ensure smooth coordination of services and providers for a more seamless healthcare experience. The HITECH Act in 2009 dramatically accelerated the adoption of electronic medical records -- obviously a good thing! But the industry continues to face challenges in aggregating data from so many separate systems to create a holistic health picture.

How does automation in particular help address these challenges?

It's a game changer, with vast potential that we've only begun to capture. Automation can take over and speed up routine tasks like data entry and documentation with fewer errors. That gives time back to administrative staff to focus on higher-value work. A great example here is prior authorization, which is traditionally a time-consuming task. Let’s face it, prior authorizations can be onerous for both a provider and a payer. To gain authorization from an insurer on any given procedure or treatment, providers need to gather and share all sorts of information. Requirements vary, but they often include medical records, diagnosis codes, treatment plans and other information. What if you could apply automation on both sides of this process -- data gathering on the provider side, review and authorization on the payer side? How many hours could be saved and instead spent on patient care?

Even more exciting is automation's potential to drive better health outcomes. With a more seamless exchange of data between disparate systems, providers get a clearer picture of a patient's entire health journey, starting with wellness. AI-assisted analysis of that data can reveal patterns, predict outcomes, and even identify related risks, such as a patient's access to food and reliable transportation to get to their appointments. This all helps providers and payers make smarter decisions and deliver better end-to-end care.

What are some common challenges healthcare providers and payers face when implementing automation?

From my perspective, the biggest challenge is the lack of a high-level technology strategy. We often see a lot of one-off solutions developed to solve a specific problem. Over time, you end up with duplicative solutions that don't "talk" to each other and don't have a support model in place. You need an executive sponsor who understands these technologies and has a strategic roadmap for implementing them thoughtfully.

How can CGI help our healthcare clients unlock automation's potential?

First, we bring that high-level strategic vision that I just talked about. We have a solid methodology and extensive industry expertise, so we're able to take a more holistic approach to implementation. We can look at an organization's needs and any pilot solutions they've developed and then identify opportunities to consolidate or amplify that work.

Second, our managed services, like CGI Accel360 powered by UiPath, help organizations speed up their adoption of automation without taking on a lot of overhead or managing the platform. Because it's a subscription-based service, it accelerates setup, increases security, and allows our clients to realize the benefits of intelligent automation much faster.

What role do you see automation playing in the health industry 10 years from now?

Automation, AI and machine learning will move beyond back-office processes and into all corners of operations and the patient experience. For example, supply chains will be better managed because providers will be able to spot potential supply and equipment shortages before they happen. 

On the patient side, we'll continue to gain more exposure to things like generative AI, robotic-assisted surgeries, telemedicine, personal health monitoring via wearable devices, and so on. Technology will become commonplace across all aspects of our healthcare experience. That said, nothing will ever fully replace the value of in-person, empathetic care from health professionals. The future of healthcare will be a combination of all these things, working in concert toward a common goal of delivering highly personalized, end-to-end patient care.

Learn more about CGI's services and solutions for health and automation with CGI Accel360.