Angie Stewart: Hello and welcome to Healthcare Insider, a sponsored content podcast series from Modern Healthcare Custom Media. I'm your host, Angie Stewart. This episode is sponsored by TruBridge. Its industry-leading HFMA peer-reviewed suite of revenue cycle management offerings combines visibility and transparency to enhance productivity and support the financial health of healthcare organizations across all care settings. TruBridge supports efficient patient care with EHR product offerings that successfully integrate data between care settings clearing the way for care. On today's podcast, we're thrilled to have Wes Cronkite, Chief Technology and Innovation Officer at TruBridge. Wes brings extensive technology leadership experience to TruBridge having joined the leadership team in 2021. He previously held roles at nThrive, IBM and BrightSpring Health Services, driving innovation and digital transformation. Wes, thank you so much for being here today.
Wes Cronkite: Thank you and excited to be here.
Angie Stewart: To get started, let's talk a bit about your role as a technology expert and innovator. This role is more critical than ever as healthcare continues to refine its digital capabilities. Can you tell me about some of the biggest challenges you face in your position or the aspects of your work that you find the most rewarding?
Wes Cronkite: Absolutely. So yeah, again, thanks for having me, and healthcare is definitely a passion of mine. So of the time I've spent in my career, 18 of the 21 years has been in the healthcare space. I left for a bit and came back primarily because I do see a need for deeper technology assets and capabilities, especially on the provider side of healthcare to effectively deliver care to the population that needs it. And it is an industry that's a laggard. We know that it's behind in terms of keeping pace with other industries, but I am excited and was excited as well kind of stepping into the role of TruBridge at how fast things are now starting to move as standards are starting to get set and adoption of those standards are happening. And just the focus that big tech and technology in general has put on the healthcare industry is like I've never seen before, which is very exciting to see unfolding and a bit of the passion that keeps me after it on behalf of our customers that are trying to provide care to communities in need.
Angie Stewart: Yeah, certainly an exciting time to be in healthcare and healthcare technology. Specifically, let's get into more detail about the technology aspect for healthcare providers. Can you tell us about the current state of technology in revenue cycle management and how is it shaping operations for hospitals and healthcare providers?
Wes Cronkite: Yeah, so I think the current state landscape of technology that supports the revenue cycle is still fragmented, although I think it's gotten better in kind of a combination of things that the EHR practice management system can do on its own and then all the bolt-ons that kind of make it more efficient and drive for that efficiency and the wins that technology can bring to the table. I do think that the state of the union right now is that CEOs, CIOs, CTOs that I speak to at provider organizations, they're looking for one answer. They don't want to deal with the multitude of different systems and platforms and how they integrate. And we all know technology integrations have a very high likelihood to start to fail as you try to tie too much into it. So trying to build one core platform, and I do see that as very needed out there.
But then you've got this other kind of wave of AI that's out in the industry and a lot of newer companies and newer startups coming to the table with their new technology. And that balance is very difficult for the CTO, the CIO to understand do I wait for my host system, my core system to come up with the answer, or do I take the bet on one of these really shiny objects that sound great from the AI perspective of a new company and how do we bring that in? And then just on top of all of that, there's a little bit of an unfair advantage from my perspective that the payers have of the investments they're making kind of in their core platforms that are making this more difficult for the revenue cycle talent to keep up and to keep that fair playing field between the provider side and the payers side.
Angie Stewart: This is just a follow-up question to dig in a little more to what you just said. What do you think are some of the payer investments that are making this imbalance exist for healthcare providers?
Wes Cronkite: I think that some of it's been publicized. I think some of it's still behind the curtain, but there have been investments made specifically around prior authorizations in that process of on the payer side, ensuring that the process of requesting those authorizations and putting that out and into the provider space is more less human driven and more using more advanced automation and AI to uncover the risk profile on their side, which is a fair part of the game, but also kind dropping a lot on the payer's shoulders. I mean the provider's shoulders that they're just not prepared to handle and don't have the technology or the systems and are trying to throw people at it. So that's something that we at TruBridge are very aware of and trying to solve for on a breadth of different opportunities to keep pace. But it is, from my perspective and opinion, a little easier for the payer to unlock that technology because they aren't dealing with the smorgasbord of different applications that some of our providers unfortunately have to deal with.
Angie Stewart: Thank you for clarifying what that challenge is for healthcare providers in keeping pace with these technological changes. Let's talk a little bit about what automation in AI and revenue cycle management means for providers. Can you break down what those look like for providers in practical terms in revenue cycle management?
Wes Cronkite: Yeah, sure. I'll take a little bit of a trip down memory lane to talk about. The first time I really saw automation in action, it was at actually UPMC they had built out and they were very proud to showcase to us a bit of the first stab at RPA in a simple way and just being able to go out to payer websites and get deeper and more relevant and more accurate information around the status of a claim that's been submitted. And being able to do that in a lighter technical lift than was expected and seen in the industry. And as I saw that, I kind of had this aha moment of, wow, that would be really powerful to put in the hands of our technology teams and see what we can do to get that going. Since then, there's been some big tech companies that have spun up with an RPA focus.
There's been a lot of outside investment, but I think that that is the starting gate to me to really an AI or automation strategy is just making sure you've got at least the competency and a handle around how to do robotic process automation, which at its core is fairly simple. It's hitting record on your computer, watching all the steps you take, and then having that playback at high speed and high quality to gain efficiencies. So I think that's kind of the initial stage from there and where the balls being pushed now is let's start to let these bots that have been out there doing transactional tasks start to be more intelligent, start to make, I wouldn't call it full on decisions, but at least know and prioritize what they're working on, understand where humans need to be intervened and also bring them closer to the humans.
The concept is kind of having a human in the loop to push through better and faster efficiency. So I think that's, from my perspective, that's the stage the general healthcare industry is in now is trying to get more of the intelligence into these agents or bots that are out there. But I think that the next stage and where a lot of investment and there's been a lot of push around is to start getting to ai, which I would consider when actual decisions are being made by the technology. And that's scary. I think it's a little less scary on the financial side of healthcare than it is the clinical clinical. It's very, very scary. But it's putting trust in being able to make the right decisions of how to handle a claim based on all of the data surrounding it, historical information on the pathways that it's taken, and ultimately driving for the fastest path to the claim getting paid and the revenue coming in the door for the provider. So I don't think we're there yet. I think that there's a lot of desire and a lot of pipe around getting it there. And I do think, again, the technology has advanced itself where that's not as heavy as a lift, but I do think we're probably two to three to five years out of having a real answer around the AI that can do the full on decision making and work of a process from start to finish.
Angie Stewart: So with Robotic Process Automation, RPA and AI, these are some of the pieces of technology that are currently being implemented in healthcare systems, and then some further down the line of having AI handle some of the decision-making. You mentioned some of the considerations to have with those things. What are some of the benefits that revenue cycle leaders might expect to see from this ongoing evolution?
Wes Cronkite: Yeah, I think the benefits, I'd say it's like a triple threat, and we've seen this as well at TruBridge as we've lit up. We've got a pretty strong RPA holding here that we put forth on behalf of our customers within that ecosystem of different platforms that we need to run through. The first that everyone thinks of, and this is kind of the CFO mindset, is cost, right? So there is a benefit to running a bot that doesn't go on vacation and take sick days and runs 24 hours a day, seven days a week. There is a cost benefit to that. However, I think thinking beyond that, because that runs out pretty quickly, we do see as well revenue velocity improvements. So with the transactional manual, non-critical thinking, you don't really need a medical billing background to do these tasks that are the reality of healthcare and the systems, and that's tangled web that's there to be able to clear that clears the way for more revenue to come in the door and be able to be recognizing that as a provider.
So we do see revenue velocity and then the one that people don't really think about, but I've also seen unfold in my career, his happier employees, and that's a weird one, right? Because you kind of think of automation, you think, oh, this is scary. I'm going to lose my job. It's going to get taken away. Where seeing it really successful is the employees don't really wake up excited and fired up about doing that transactional thing for the first hour of their day that they just have to do because the systems don't do it and it doesn't work. So if you clear that pain off of their plates and they spend their time really working on the things that they've been trained up on and their experts in driving for resolution of complex claims and handling all they need to get the bill out the door clean and get back a very rapid claim payment, that's what they went to school for.
That's what they're here for. That's what they're fired up about. It's not handling all that transactional, systematic stuff that just piles on top and creates that pain. So again, it's a little unique in a value prop because no one thinks of, wow, I deployed automation and we've seen happier employees, but we've seen that success and have seen that our employees have had a very positive reaction to our bots. And when we threaten to slow them down or take them away, they're very quick to say, no, no, no, no, no, don't touch. Don't touch our bot there. So there's a bit of an interesting digital and human employee bond that's happened. That's interesting to see.
Angie Stewart: That is really interesting. Do you think this is significant in making those teams a little bit more resistant to turnover and things like that?
Wes Cronkite: I think it helps in that light clearly. I think that staffing challenge is still out there though, to be candid. I don't think it's gotten much better due to the benefits of automation. But I do think that walking into an organization as a new team member and having the support of bots that are surrounding you to take some of the painful work off I do think creates an environment where there'll be longer tenure and less of a Oh God moment, what did I just step into? Which happens sometimes when you have organizations that don't have automation, don't have great systems. Being trained on a platform that was built several decades ago is just not what the younger generation is expecting as they walk into a new role and a new job.
Angie Stewart: Still a long way to go, but lots to consider in terms of the benefits of AI and automation and RCM. What would be your advice, Wes, for leaders who might be hesitant about making this investment in RCM automation?
Wes Cronkite: Yeah, so I mentioned it earlier, and I am a believer that you should be looking at your core EHR PM system first and seeing what their roadmap looks like, where their investments are heading before falling for what I'd call the shiny object syndrome. There are a lot of new digital health companies and startups that are surrounding this ai. I wouldn't say a lot of them are in the RCM space, but they're coming along and I would be cautious to ensure that you've got the right level of integration and don't add one more system to the mix that you now have to manage all of the pain that comes along with adding a new system. I would suggest that I would also suggest the discussion we just had around, it's not just about costs. Don't get too hung up in that cost ROI upfront and trying to prove out the ROI of this entire solution over its lifetime.
I kind of think of, I use an analogy of sending a child to college. You don't show up at the registrar's desk of the college on day one and say, I hope I need you to guarantee that if I send my child to college, they're going to have $150,000 a year job that's stable for the next 10 years after they graduate. You kind of have to believe a little bit in the concept of automation and what it can bring to the table and where it's looking ahead and know that it's good for your organization. Know that it's the right move to make, and then see that there is a lot of success to be seen there. So I would also suggest that that advice to anyone who's on the cusp of thinking about should I go after automation or not? But again, I think it's about leaning into the tech you already have, leaning into any services groups that are supporting you in the revenue cycle side. Look there first, and then if that's not fitting it, see what else is out there.
Angie Stewart: That's great advice. Wes, before we wrap up today, do you have any words of wisdom to kind of, quell some of the fears or anxieties around tech innovation out there?
Wes Cronkite: Yeah, we touched on it a little bit, but I would say that don't think of this technology automation, ai, what's coming as the grim reaper of your employees positions. That would be my primary message that I'd like to deliver to the audience that this is here to help. It's a copilot, an agent and assistant similar to the technology that's come before it. The goal here is to adopt it and leverage it for your benefit, and I really want to press on the audience to not think of it as something to be fearful of and make sure, of course, that you're leveraging it in a safe and compliant way. That's always key. But don't be afraid that this is the thing that comes in and takes away all of the jobs. There's plenty of work to do in healthcare that work will not stop. And the best we can to lean into this technology to help us drive efficiency is what my suggestion would be.
Angie Stewart: Yeah, that's definitely reassuring to think of this technology as a copilot or an assistant rather than something that's going to replace the jobs that we need humans to do as well in healthcare. So thank you, Wes, for taking the time to discuss this important topic. And thank you again to TruBridge for their collaboration on this sponsored episode of Healthcare Insider. For more information, please visit TruBridge.com. That's TRUBridge.com. To our audience, thanks for tuning in today. To listen to more episodes of Healthcare Insider, go to the multimedia section on ModernHealthcare.com or subscribe at your preferred podcaster. I'm your host, Angie Stewart. Thanks for listening.
