Telemedicine, AI and robotic process automation: How NewYork-Presbyterian is equalizing access to care

NewYork-Presbyterian has successfully implemented telemedicine, artificial intelligence and robotic process automation into the health system's operational workflows to improve access to care and the patient experience.

Here, CIO Daniel Barchi describes the system's key initiatives to add health IT that enhances the care delivery process without placing more stress on physicians and care teams.

Question: What is the best technology investment NewYork-Presbyterian has made in the past year?

Daniel Barchi: We are investing in telemedicine, artificial intelligence and robotic process automation because we feel these technologies offer great opportunities to reach a larger number of patients and provide equal access to high quality care. We are using technology to make our current processes faster and reach a broader patient population.

NewYork-Presbyterian serves one of the largest populations of underserved people in New York. We use telemedicine to reach all of the patients that need our care. It's wonderful that they can also have access to world-class care at Columbia University and Weill Cornell Physicians, but if it’s difficult for them to take half a day off work to visit a physical practice location for follow up appointments, then this is an instance when telemedicine can help. We ultimately need to find more ways to leverage telemedicine to break down those barriers that might prevent patients and whole communities from gaining access to quality healthcare.

Q: How are you using AI today and where do you see the most useful applications in the future?

DB: NewYork-Presbyterian is using artificial intelligence in the clinical space as well as in the operational and back office space. In the back office, we use artificial intelligence and robotics process automation to speed up our process for bill pay and claims follow-up. We have a talented team of financial experts, but a lot of the work they have to do is manual. We are using the robotic process automation to standardize the workflow and allow bots to scan through the bills and applicable records from the patient encounter and do the appropriate follow-up with payers. In that way, we can expect to drive down costs for the back office services.

On the front end, we are using AI to identify risk in a couple of ways. We are using artificial intelligence to alert physicians the day before a patient is scheduled to go home, so the physician can check to make sure the right consults and reports are ordered. The computer looks at thousands of patient encounters and sees where there are roadblocks, so it can then make recommendations to the physicians on which tests to order. We feel like we have world-class physicians and nurses, but our physicians and nurses plus technology are more capable.

Q: Beyond the robotic process automation for the revenue cycle, how else is NewYork-Presbyterian using robotic technology to make operational workflow more efficient?

DB: The other big areas for robotics use are environmental services, delivery and food services. We are looking for opportunities for robots to perform basic tasks so our staff can focus on higher-level tasks. We see robots that have been run by the same people who used to do the cleaning, allowing those individuals to spend more time on their area to affect the environment.

For example, where there used to be people delivering linen and food trays from the centralized location up to the floor, now there are autonomous robots to make the transport. The robots are deployed to carry food from the kitchen up to the patient floors so the cooks can focus on food preparation. Then the employees on the floor receive the food and take it to the patients. The patients still interact with the dining associate stationed on their floor, but this eliminates the extra steps for humans.

Q: Could you tell me a bit more about your clinical operations center? What makes the concept unique and how well is it working?

DB: NewYork-Presbyterian wanted to standardize best practices across its 10 hospital campuses to improve quality. We have standardized and centralized phone operators, and we were able to have them do basics of answering the phone, as well as managing telemedicine visits and helping physicians implement new technology. The individuals working at this centralized location can help make sure the physician has the right pharmacy refills called in, and also support remote patient monitoring efforts.

As a result, we have been able to increase the speed with which we can refill patient pharmacy requests, lowering the time to refill from a day to about two hours. This is better for patient satisfaction and reduces the amount of duplicate equipment on each floor. We have also been able to save 21,000 hours of nurse time, including the time it takes to adjust the room temperature, freezers for medications and more. This has really been a game changer.

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