Deploying RPA in the HSE

Ciarán Galway speaks with Kevin Kelly, RPA Lead with HSE Shared Services and Philip McGrath, Public Service Innovation Policy Lead with the Reform and Innovation Division at the Department of Public Expenditure and Reform (DPER) about the rollout of robotic process automation (RPA) across the Health Service Executive (HSE).

What are the key drivers of RPA deployment in the HSE?

Philip McGrath

The key drivers of RPA in the HSE are the same as the drivers of RPA in any of our public service bodies; we need to automate processes that are time consuming and laborious to make organisations more efficient. These processes follow a particular pattern; they generally involve several different systems, and they involve rules. RPA frees up staff to be transferred to do more value-added work and undertake more cerebral tasks, while simultaneously speeding up processes. Moreover, RPA assists in performing a type of audit on an organisation’s processes. It helps to identify areas where processes really aren’t contributing to desired outcomes, other processes that lean methodology can be applied to, as well as processes that might not need to be undertaken at all. This improves the service delivered to citizens, making it better, easier to use and quicker.

Kevin Kelly

In many of the areas where we have deployed RPA, it has enabled those already stretched teams to absorb more work with the same headcount. Although traditionally a good fit in the areas of administration and particularly within HR and finance, we are observing interest from both administrative and frontline areas and through the conversations we are having right across the health sector, use cases are emerging that positively impact frontline services directly. For instance, nurses who have been relieved of administrative tasks through RPA and surveillance scientists who have handed over their administrative tasks to a robot or virtual worker, thereby allowing them to analyse infectious disease data rather than having to process it first.

What are the advantages of the HSE/DPER collaboration on RPA?

Kevin Kelly

Having DPER’s stamp of approval on this technology and on the approach that we were taking has been invaluable. From the HSE’s perspective, DPER came on board at an early opportunity and supported us to identify suitable areas to conduct a number of pilots. Since then, the decisions we have taken to invest in the establishment of our Centre of Excellence and in the operating and delivery model we have subsequently adopted have been validated by DPER. This instilled a high degree of confidence that our approach is correctly aligned with broader public sector policy.

Philip McGrath

DPER has been involved in research, testing, piloting, and growing RPA since the end of 2016. Our collaboration with the HSE has confirmed that RPA can be gamechanger in terms of how we administer our services to the citizen. The health sector is the largest and, arguably, the most complex component of the public sector and we know that there are several systems that would be prohibitively expensive and difficult to integrate using conventional automation methods. That’s why driving RPA’s success in this particular sector will pave the way for other centres of excellence to embed RPA across government.

While we have centres of excellence in Revenue, the National Shared Services Office and the Department of Social Protection is working through its options at the moment, what the HSE has done is showcase how RPA can be successful in terms of changing how we do work. This ranges from the back office and the work done in relation to Garda vetting to the Mater Hospital, where nurses have been assisted in their administrative duties, and to the work on positive Covid test cases in the Health Protection Surveillance Centre. It has confirmed and validated DPER’s planned direction of travel and it has shown the enormous savings that can be made if people commit at a strategic level. The Centre of Excellence that Kevin is building is very much strategically focused and incorporates the virtual worker into the future of the health service. Overall, the collaboration acts as a blueprint for us in moving forward across government.

What are the most significant challenges on this journey?

Kevin Kelly

While the deployment of RPA within the HSE was a year or two in the making, it suddenly became an overnight success because we were fortunate to land RPA technology into the right areas at the right time in the very early stages of the Covid-19 response and it made a significant difference. However, the challenge that presents now is the expectation to keep delivering, while simultaneously building an enterprise technology platform and embedding an appropriate delivery methodology and support structure. So, it is a balancing act at the moment between doing this correctly while simultaneously meeting demand.

“People are genuinely excited about what they hear about RPA and when we present the evidence from within the HSE, there is a clamour for this technology to be applied.”

Kevin Kelly, Health Business Services

Another challenge that we have encountered is a skills deficit. RPA is a relatively new and niche technology, so we’re cognisant of the challenge of attracting appropriately skilled people who are in high demand. For that reason, we’re keen to upskill our own staff to become proficient in RPA technology so we have developed staff training opportunities through our Digital Academy and are exploring other initiatives that will create a pipeline of talent through apprenticeships and internships that we will then tap into.

Philip McGrath

The most significant challenge since we began embedding the pilots was the Covid-19 pandemic and the associated challenges that working remotely has presented. However, this has also acted as a catalyst. Organisations will now very quickly move to digital inputs which then more easily enable the deployment of RPA. In terms of the challenge, projects across the HSE have, out of necessity, been required to take a backseat while our health service staff focus on protecting the public and the vaccination programme. As much as we would love to be pursuing every single pipeline of processes, there are other priorities for Kevin and his team. While the deployment of RPA is very important in terms of the future of the health service and ensuring the most efficient service possible, it is clear that the health and wellbeing of the citizen takes precedence.

Kevin Kelly

That’s correct. Many of my team have been involved in the Covid-19 response to some degree over the last 12 months, firstly in contact tracing and more recently the vaccination programme. Simultaneously, however, the HSE has undergone a rate of digitalisation during that timeframe that might otherwise have taken years. As such, staff have become more aware of new and innovative ways of working than they were perhaps 12 or 18 months ago. They are scanning for more efficient approaches to work and can now envisage how automation might occur in their respective part of the health service. The crisis has brought about an opportunity for us in that digital transformation has accelerated. But we’re in the early stages of our RPA journey and there is a substantial volume of work ahead of us to firmly establish the Centre of Excellence and embed a federated model of local delivery and self-sufficiency across the organisation.

Philip McGrath

We found it particularly difficult to identify projects over a number of years, in part at least due to a misunderstanding about what RPA is and how it can be applied. Covid has inadvertently put processes under a microscope and enabled people to understand that what they previously thought were subjective decisions were in fact a series of rules-based decisions, usually bundled together. There has been something of a cultural shift as a result of the Covid-19 pandemic.

How has the application of RPA supported the health service’s Covid-19 response?

Kevin Kelly

This is where the RPA has already proven its worth for the HSE. One of the areas in which we had piloted RPA was a process around Garda vetting and fortunately, we had it automated by the end of February 2020 just prior to the first positive Covid-19 cases in Ireland. That particular Garda vetting process previously took over three weeks for a team in Dublin to complete and the implementation of RPA reduced that time to six hours. As such, a process that was occurring monthly could now be completed weekly. In the context of the Covid emergency, at a time when we were hiring new interns and nursing graduates at pace, the streamlining and automation of this process meant that these new health service staff had their HR records updated with their vetting outcomes more rapidly enabling them to be deployed into frontline posts more quickly.

In March 2020, we then engaged with the Director of the Health Protection Surveillance Centre and, over the past year, we have implemented an RPA solution which has effectively reduced a previously manual process from 26 minutes to just over three minutes. In effect, for every 100 positive Covid cases, we are now saving public health staff 38 hours of administrative workload. When you consider the context of hundreds, or at times thousands of positive daily cases, that’s a significant number of hours of manual data entry being saved each day. By early December, we had scaled the solution by cloning our RPA virtual agents to manage up to 10,000 cases per day based on predicted models. HSE data scientists have been instilled with such confidence that they are now discussing the automation of additional processes relating to vaccination data, genome sequencing and antigen testing notifications. We would simply not have been capable of managing the workload that was emerging from the daily positive Covid figures, so it is a good news story.

“I’d love to see the Centre of Excellence that Kevin and the team have developed being available to all the bodies in the health sector and potentially making this platform accessible to other public service bodies in the future.”

Philip McGrath, Department of Public Expenditure and Reform

Philip McGrath

I was almost shocked by the level of support that RPA provided to the Health Protection Surveillance Centre. It was a very proud moment for the people who had been working on RPA when we saw how much assistance this provided during a national crisis and how it enabled our medical scientists to do what they do best; protect public health. RPA, in this instance has really validated itself and has shown that we can have a future where our human workforce is supported by virtual or robot workforce.

What is your vision for the future of RPA across the health service?

Kevin Kelly

Our plan is to develop a high degree of self-sufficiency in RPA skillsets, right across the organisation. We will do this by establishing a central technology platform, a governance structure and a series of methodologies which will support and encourage all elements of the health sector to adopt virtual workers into their respective areas to perform repetitive, mechanical tasks, and ultimately free up our staff to focus on delivering better health outcomes for our service users.

For now, we’re focused on driving RPA based automation across this very large organisation, but we are keeping our finger on the pulse on new developments, such as chatbot technology or other cognitive AI technologies, which can then knit into what we’re already doing.

Philip McGrath

I’d love to see the Centre of Excellence that Kevin and the team have developed being available to all the bodies in the health sector and potentially making this platform accessible to other public service bodies in the future. If that is possible from a technical, logistical and governance perspective, that would be very welcome. There is a lot of valuable time, whether in clinician, data management or back office, being spent on processes which are not adding value. As Kevin said, what we need to do is find ways to return that time to the frontline, rendering our services better, cheaper, and faster for the user. We can do that by investing in our people who can then automate their own processes and become self-sufficient in automation. We can then look at incorporating additional intelligent automation platforms and move into more advanced areas, such as cognitive computing and artificial intelligence.

Kevin Kelly

One of the most pleasing and surprising aspects of this is the manner in which our colleagues have been so eager to embrace RPA. We haven’t met any resistance and people have recognised the benefit to them, the work they do and the service they deliver to their service users. It has been a positive experience for us in exploring the opportunities which exist with every section we have engaged with. People are genuinely excited about what they hear about RPA and when we present the evidence from within the HSE, there is a clamour for this technology to be applied.

Philip McGrath

That sentiment has been mirrored elsewhere. Previously, when we rolled out RPA within the National Shared Services Office, there was initially a lot of suspicion around RPA. However, when people saw that it worked and removed challenging processes that staff had to spend hours each day working on, they sought to improve their processes to get them to the point whereby they could be automated. While they can offload much of the mundane, repetitive, and time-consuming aspects of their work to a virtual worker, staff retain ownership of the processes, and that is important.