RPA Use Case: Prep Bots

Imagine your business had a 25% failure rate. Chances are, you’d want to improve. And for healthcare professionals, prep bots powered by robotic process automation (RPA) offer you the opportunity to do so. 

A colonoscopy is the procedure of choice for screening and preventing colorectal cancer (CRC). Patients should undergo routine colonoscopy every ten years if they are 50 or older and at average risk for developing CRC. To prepare for a colonoscopy, patients must complete a prep process to ensure their colon is empty, allowing the physician to clearly evaluate the bowel walls.

Unfortunately, inadequate or suboptimal preparation occurs in 20-30% of patients undergoing colonoscopy. Incomplete colonoscopies generally lead to reduced compensation for medical practices. These failures are compounded, leading to increased costs due to rescheduling, wasted resources, longer procedure times, and a higher risk of procedural complications. Most importantly, inadequate preparation can lead to decreased adenoma detection rates (ADR) and missed CRCs. In short, a significant amount of colonoscopies are unsuccessful, representing an opportunity for improvement.

In most cases, practices provide patients with a written copy of prep instructions when a procedure has been scheduled. Though patients are told how important preparation is, little is done to encourage adherence. If the patient fails to prepare thoroughly, provider insurance payments will be reduced, and the procedure will need to be rescheduled. 

Robotic process automation (RPA) offers a unique opportunity for providers to assist patients in their preparation for diagnostic medical procedures. This use case will examine how to guide patients through their prep using RPA.

Prep Problems

No one looks forward to colonoscopy prep. By its very nature, it is unpleasant at best. Several controllable factors may contribute to inadequate preparation, including inadequate adherence to procedures and insufficient intake of preparation medication.

Patient Understanding

To adequately prepare for their colonoscopy, patients must clearly understand the need and the steps required for proper prep. Studies confirm how important this is. A Frontiers in Medicine study found that patients adequately armed with prep completion strategies and procedural knowledge showed a significantly higher quality of preparation and willingness to take the prep. Even so, packets and PDFs do little if the patient doesn’t use them at the right time.

Timing is Everything

Due to dietary restrictions and ingestion of laxatives, many patients feel that colonoscopy prep is the most challenging part of the procedure. In general, prep consists of several phases:

  • One to two days before the procedure, patients are told to restrict their diets to clear, light foods such as clear broths, gelatin, and fruit juices.
  • At the same time, patients must increase their fluid intake to avoid dehydration. 
  • Several hours before the scheduled procedure, patients must take strong laxatives to empty their bowels. 
    • Often, patients must ingest two or more medications at specific time intervals. 
    • Patients are also asked to consume specific amounts of fluids along with their medications. 
  • Finally, after the last doses of medicine are taken, patients must stop drinking and take nothing by mouth within 2-3 hours of their colonoscopy. 

Patients must follow their provider’s instructions strictly. Omitting steps or altering amounts of medications or fluids may result in insufficient prep, an inconclusive examination, or an errant result.

Encouragement and Support

The Internet is filled with articles, blogs, discussion boards, and even first-hand news reporter experiences documenting the colonoscopy process from preparation to procedure. Those who seek information will find it. 

That said, one must consider the validity of the facts found online. Medical procedures and preparations vary by patient, so information is not one-size-all. Encouragement and support would best come from providers – but how can instructions best be delivered to each patient?

A Better Solution: RPA Prep Bots

When patients do not adequately prepare for their colonoscopies, providers receive reduced payments, and the patients must reschedule their test within an insurance provider’s limited time window. In short, incomplete procedures:

  • Reduce provider earnings
  • Back up provider schedules
  • Delay patient care

Acknowledging the complexity of pre-colonoscopy prep, how could robotic process automation improve patient experience and prep results? Let’s examine how RPA prep bots can foster the preparation process.

Streamlined Scheduling and Support

As mentioned, the type and quality of patient prep instructions can vary significantly. However, providers who utilize RPA technology can rely upon the automatic and timely delivery of information to each patient. 

Bots continually review a provider’s schedule and route messages and instructions to each patient based on their prescribed procedure’s timing. A patient who called to inquire about a colonoscopy would receive an appointment with the office screener, and the bot would send out an appointment reminder. Later, when the same patient begins prep, he would receive personalized, timely reminders of proper procedures along with encouragement to hydrate and stick with the process.

Such programs have already been proven to be successful. In one study, a single phone call reminder the day before the procedure improved success rates from 82 to 97%! Another study yielded similar results. Though communication in the day prior has been statistically proven to be effective, the adoption of such practice still isn’t commonplace.

According to a study referenced in Gastroenterology & Endoscopy News, electronic reminders about proper bowel preparation greatly “improves the quality of their prep and avoids cancellations.” This particular study, yielded better results in preparation, fewer cancellations and also improved patient satisfaction. 

The study also explains the key change within the practice that allowed this program to be successful:

“Staff originally had to manually input data from the electronic health record to Medumo for each patient, but that process is now automated from the time of scheduling.”

RPA technology can provide to-the-minute messaging to synchronize a patient’s prep steps according to his appointment time, thus reducing patient error by eliminating confusion about when to complete each prep step. 

Prep Bots: Beyond Colonoscopies

Just as prep bots stand to improve the colonoscopy preparation experience significantly, reducing provider costs and decreasing sub-par or abandoned procedures, they have implications elsewhere in healthcare. RPA technology could remind patients of upcoming fasting blood work and dental procedures. In fact, bots can provide frustration-sparing, cost-saving reminders. Wherever patient preparation has been identified as a cause for procedures to fail could be a potential use case.

Though each bot requires customization, most prep bots are comparable. Fill out the form for immediate access to a step-by-step guide to prep bots.


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