How Automation Technology is Helping Members Get the Care They Need, Faster

Amy Barczy

| 4 min read

Amy Barczy is a former brand journalist who authored...

If you’re managing a complex health condition, navigating appointments, prescriptions and tests can feel overwhelming. That’s why Blue Cross Blue Shield of Michigan has a care management team of trained professionals – including registered nurses – that proactively reach out to high-risk patients to help them coordinate their health care. These care management nurses connect with members to help them through their health care journey, making sure they avoid unnecessary services and are able to effectively manage their day-to-day health.
These nurses offer a high level of personalized customer service to Blue Cross members. Thanks to a recent Blue Cross Information Technology project, those nurses can now help hundreds more members each month – leading to better health outcomes, and ultimately save both members and the health care system money. 
This project is just one of the ways the Blue Cross IT team helps makes a difference in the lives of members by supporting every aspect of the business.
“Blue Cross is not an IT company. But we are a very IT-dependent company, making sure our members have access to health care at the right time and at the right place,” said Brian Armstrong, vice president and chief information officer of Health Plan Business at Blue Cross. “We have a culture of service in IT as we support the parts of our business that directly help our members live better lives.”

How they did it

The Blue Cross IT team took the nurses’ existing care management software program and re-engineered it to work better and faster. Using RPA – or robotic process automation – the IT team taught the software program to pull together data about each member. RPA is a technology that improves efficiency by using software robots to automatically complete tasks and processes.
The IT team used attended bots to manage repetitive actions in the software system to eliminate the need for the nurse team to spend time collating information and completing mundane tasks. Now, the nurse team can quickly access the information they need to get each member help and to document progress on each case.
As a result of this software improvement from the IT Team, the care management nurses can reach 34% more patients – driving an estimated $4.5 million in value.
“If you’re a nurse that’s focused on helping people, you want to get down to business,” Armstrong said. “We improved the effectiveness of the nurses so they can engage more members in more programs – so they can focus on things that matter both to our members, and to their careers.”

Advancing health care delivery through IT

Blue Cross plans to build upon the successes of applying RPA technology to help the care management nurse team. Using this project as a pilot test, the Blue Cross IT team plans to extend the use of this technology to other parts of the business after analyzing the initial program results. Projects like these often lead to tangible improvements in health care and patient outcomes.
Applying technology like RPA and automated bots is just one of the ways Blue Cross IT leverages cutting edge tools to help members live healthier lives by advancing health care delivery.
Blue Cross is deploying advanced analytics to help members improve their overall health by using targeted education and prevention measures. The added benefit of improved health outcomes is decreased health care costs for members and the system. The data models produced by the team can be used to implement vendor solutions or can be used to craft new strategies and approaches.
From in-home health care to engaging members, the IT department strives to use customer data to improve the overall member experience. A goal of the Blue Cross IT department is focused on how to leverage technology that makes every interaction with our users an easier experience. We have invested over $1 billion in new business capabilities the past five years, and every aspect of our technology investments includes new models, enablers and partners.
MI Blues Perspectives is sponsored by Blue Cross Blue Shield of Michigan, a nonprofit, independent licensee of the Blue Cross Blue Shield Association