Episode 66 of HIPAA Critical features an interview with Hoala Greevy on the growing need for workflow automation in the healthcare industry.
Hannah Trum: I'm Hannah Trum and this is HIPAA Critical, a podcast from Paubox where we discuss security, technology, and compliance news with healthcare industry leaders. A new year brings with it, new cybersecurity risks, an increasingly tight labor market, and, of course, new innovations. But one thing remains the same: human error continues to be the leading cause of data breaches. Updating passwords, ongoing training, and modernizing infosec policies are all valuable human cybersecurity best practices. How do we take the technology we use the most, like email or voicemail, and make it work for humans to help prevent error? Workflow automation is one of those things. And as a hot topic, it appears in several interviews of HIPAA Critical. You can read blogs and published articles about it on the Paubox website and if you attend a social mixer you can even ask a question about it. How email and workflow automation operate in tandem for the healthcare industry is specifically something I’ve chatted about with today’s guest, Hoala Greevy, before. As Founder CEO of Paubox, it’s Hoala’s job to stay ahead of the curve and figure out how to take the ease of email and optimize the workday. Not only for those who work at Paubox but the customers they serve. Hi, Hoala. How are you? Thank you so much for joining me on HIPAA Critical today. I want to jump right into our main topic, which is workflow automation. This is something that you and I have talked about before, but I specifically want to talk about how workflow automation can streamline time-consuming tasks that both employees and employers hate. Things like intake form, data entry, a signature, those kind of things. But it's added more upfront costs than simply just hiring someone to input that data on a part-time basis. How do you approach or how would you approach a VP of technology about the pros and cons of automation, especially the cost versus the cost of just hiring someone?
Hoala Greevy: Sure. Well, the value proposition for workflow automation in US healthcare, to me starts with a few questions. We can begin by asking that VP of technology, if they're having issues hiring enough staff, both in the IT department and throughout their organization.
So for example, according to the US Census Bureau, 76% of healthcare workers are women. And in our society, it's often women that have left the workforce to provide childcare during the pandemic. In addition, burnout, fear of getting sick and early retirement are also decreasing the available workforce in US healthcare.
And then to exacerbate this trend. We still have 10,000 Baby Boomers retiring every day in the United States, which of course causes demand for healthcare employees to grow by double-digit rates.
Now that we can see with absolute certainty that every health care organization, say with over 100 employees is struggling to hire, we can then ask if they're interested in workflow automation via email, and why I included the term email is due to something I recently learned about, and it's called the human endpoint.
This is when a company has people whose jobs consist of taking directions from a machine or acting as a bridge between two or more incompatible machines. So in other words, by humans acting as duct tape between two systems that can't talk to each other, and during the pandemic, we have noticed email usage has surged, while other forms of communication, like printing and paper-based faxes, have gone down.
In fact, nearly everything that happens in a healthcare org, whether it's the patient intake, esignatures, accounts payable, accounts receivable, etc, now takes place via email. Many of these incoming emails involve human endpoints.
So efaxes for example, or fax the email prime examples for any effects arriving in a healthcare organization. We know a certainty, there are one or more people monitoring the mailbox it arrives to, opening the email, and its PDF attachment, and manually entering the data in that effect somewhere else, right. So this could be an EMR system, a CRM system or a billing system, for example.
Then our proposition then becomes, hey, we already see this stuff flowing through your enterprise, because we're providing email security for incoming email, why don't we automate some of that workflow for it for you in a compliant, secure manner.
Customer feedback so far from this idea, this solution is indicative of a large unmet need in the market.
Hannah: So for you, it's not even about how it can automate and make employees lives easier. It's about really the cost question of, are you gonna hire people to do these tasks that other people hate? Are you going to pay upfront to have it automated so you can hire the people, to hire the women, who have left the workforce who have better skills than just data entry?
Hoala: Yeah. And what we found out is these folks hate doing the work anyway. It's rote, repetitive, error-prone, soul-crushing. We've talked to these human endpoints in person during the pandemic.
The first thing I'll say is, hey, you know, Paubox is not here to take you out of a job. And the response has been, you know what, I hate that work anyway. I want to do more human work.
Hannah: Yeah, I read that provider, can they spend five minutes five to 10 minutes on data entry per patient, that's two to four hours a day that they're spending, just putting in data, instead of actually seeing patients and doing revenue generating activities. It's crazy.
Hoala: We've met some folks who have master's degrees and above spending 30 to 40% of their day on data entry into the EHR. That's it's astounding,
Hannah: That is astounding. Who goes and gets into all of that debt just to spend 30 hours or 30% of their time inputting data. For non-providers or people who work in and around health care, those tedious tasks can really be the difference between staying at a job and finding a new job. So do you agree with me when I say that workflow automation is also an attractive recruiting and retention tool for organizations?
Hoala: Yeah, I think in concept that sounds pretty valid.
As for me personally, I guess it depends on the organization. Is the leadership invested in the idea of workflow automation? Or are they still getting their toes wet? How pervasive is it, how high is the adoption?
I think within US healthcare, it's still too early to tell. I still think we're in the very beginning of workflow automation, due to compliance and regulation and HIPAA compliance issues. You know, they can't just choose any old vendor off the block for workflow automation have to be selective and diligent in who they have to automate these tasks. So, you know, there's a level of compliance that has to be met for any vendor you do business within this.
Hannah: Do you feel HIPAA violations, HIPAA rules, and HIPAA laws will have to change as workflow automation in the cybersecurity landscape in healthcare changes?
Hoala: I would love one of the HIPAA laws to be slightly amended to where eFax faxes are still acceptable, but HHS strongly recommends the use of secure email. Having that guidance within the HIPAA Privacy and HIPAA security laws would go a long way to to encourage the adoption of workflow automation because paper-based faxes are soul-crushing.
Hannah: Definitely. And you said earlier that workflow automation is not here to replace jobs, it's actually here to enhance people's jobs. I read a survey that said 96% of workers surveyed by Zapier say that automation benefits their workday. You are the CEO of a company that is very pro workflow automation, how do you see it affecting Paubox employees?
Hoala: Yeah, for sure. So it's less repetitive work, which then leads to less human errors, higher efficiency, both for our internal, you know, sales, efficiency metrics, and, and just ideally, just higher morale within the organization.
We're in the very beginning, and it just seems like a very pragmatic idea that's worth spending time and attention on.
Hannah: How do you see workflow automation affecting companies that are trying to scale?
Hoala: I would say, a company's ability to scale is directly correlated to its ability to automate business processes and workflows. I think it's one-to-one.
Hannah: Can you elaborate a little more on how you think it's one to one?
Hoala: Well, in scale, you're depending more on software to achieve greater penetration in the market, whether that's signing up customers, marketing, tech, marketing automation, etc. You simply can't hire enough humans to properly scale out as the business is growing.
And it's also very expensive.
So the ability to scale processes and workflows is the very concept that allows a business to scale, especially a software business.
Hannah: Because workflow automation can benefit many departments as you said, marketing automation, IT automation, what other added benefits do you think there are?
Hoala: Oh, definitely in accounting and finance, especially if you have a business that has a lot of small payments coming through, so automating and reconciling those payments within an accounting system. And, you know, all this is happening in email.
If your payment processor is Stripe, for example, you get an email every time you get paid from a customer using a credit card that's using Stripe. You get the inbound email, so and so paid you. We take that email, parse the data, and reconcile that payment to their accounting system, such as QuickBooks. So as the business scales, automation becomes very key.
Hannah: Okay, I'd like to go back and talk just a second about the time-consuming tasks that employers and employees both hate doing. Things like patient intake forms and eSignature capabilities. Could you kind of walk us through how either one of that workflow automation would work from a high level?
Hoala: Yeah, sure. So what we've seen with our customers is, for certain types of workflow within a business, a healthcare business, certain activities generate billable events that they can show to the insurance carrier. Some of these things require some type of confirmation from the patient. Something is going to happen, and they agree to that plan.
That involves an e-signature. It doesn't have to be top-of-line DocuSign documentation, but some kind of e-signature, acknowledging the plan, attaching that e-signature into the EMR system, for auditing and record keeping purposes.
And then once a signature is in there, our customers can then use that as a billable event for reimbursement. To automate all that, keep records so that that e-signature/PDF/whatever it is, is attached to the client or patient's record in their EHR system.
That's something that's happening 20, even 50 times a day in certain organizations. So right now all that's manual. Just automating that one workflow creates an instant ROI for the business, and really helps them stay lean, during the pandemic when it's super tough to hire people anyway.
Hannah: Definitely, if they're doing that 50 times a day, I can't imagine how long that would take me to do, probably a whole day's worth of work. That's saving an entire person's day of work so that they can go and do something more beneficial.
Hoala: Yes, for sure.
And, again, a lot of burnout during COVID. So it's just very hard to hire people right now anyway. Then compare the cost of an employee for doing soul-crushing work, when you factor in unemployment, taxes, insurance, etc, HR training equipment.
It's a very easy math calculation for the accounting department to see how workflow automation software really benefits the customer and the patient as well.
Hannah: Right now, it might be cheaper to hire a part time person every six months. But in the long run, how long are you going to want to keep doing that?
Hoala: Training? Burnout? Mistakes? Errors? Yep.
We've talked to customers, when they have a person at the front desk of a hospital, doing patient intake, and just miss entering some kind of insurance data. Whether it's a birthday, or the last name, incorrectly into the EMR system, it creates this cascading event of costly edits and corrections they need to make. Because the wrong person gets billed and it's just really hard to unwind.
Hannah: That's also really annoying for a patient. I've definitely had my information and put it wrong. And then I have to call and say no, this is my actual birthday. Here's my birth certificate, all of these things. And it's just one tiny mistake, and it is so tedious for both providers and patients. Do you have any other thoughts, questions, comments, we want to talk about with workflow automation today?
Hoala: We're still in the beginning. Security and compliance will remain a very important aspect of this new area we're getting into.
We know our customers. They want security, reliability and ease of use. So we'll continue to build solutions that achieve all three and workflow automation.
To me, it's just a no-brainer, but the thing we're doing differently is looking at it from an email perspective. There's just a ton of opportunity there, both for us as a company and for the customers that we can provide value to you.
Hannah: I agree. I work in Marketing, as you know, and there's so much that you can learn from people's email behavior from a marketing standpoint. So I can't even imagine from an automation, an IT, or security dev standpoint, what you can automate of the data points that your email system collects on all of your users.
Hoala: That's exciting stuff, forefront.
Hannah: Yeah, definitely. Well, thank you so much for joining me today. I really appreciate it and I can't wait to have you on again.
Hoala: Thanks. Great to catch up.
Hannah : Need more information about workflow automation? Head to paubox.com/blog or paubox.com/blog/press for the latest from Paubox. You can listen to every episode of HIPAA Critical on paubox.com or subscribe via Apple Podcasts , Spotify , iHeartRadio , Stitcher , Amazon Music , or wherever you listen. Thank you for tuning into another episode of HIPAA Critical; I’m your host, Hannah Trum, signing off.