Robotic Process Automation as an EHR Reliability Layer for Inpatient Care Gaps: Automating Virtual Huddles Using Secure Chat

Objectives: This case report describes the implementation and outcomes of robotic process automation (RPA) interventions used as an electronic health record (EHR)-based reliability layer for 2 inpatient quality initiatives: First Contact Provider (FCP) assignment and admission medication reconciliation (AMR) within 24 hours. Methods: RPA bots were created to support 2 inpatient quality initiatives by monitoring EHR patient lists for predefined care gaps: missing FCP assignment and incomplete AMR. When a gap was identified, the bot opened the patient chart, initiated a secure-message conversation with frontline clinicians and quality improvement champions, and generated operational reports to support follow-up. Chi-square tests compared FCP before (September 1, 2022–February 28, 2023) versus after implementation (March 1–August 31, 2023), and AMR before (December 1, 2022–May 31, 2023) versus after implementation (June 1–November 30, 2023). Results: For FCP, the bot identified 9,361 encounters without an assignment across 118 hospital units and generated 14,984 secure-message conversations linking 17 quality improvement champions with 2,336 providers. FCP assignment improved from 81.2% (5,096,966/6,269,754 patient-hours) to 88.5% (5,858,442/6,619,047; p < 0.001). For AMR, the bot identified 10,680 incomplete reconciliations across 131 hospital units and generated 21,502 secure-message conversations linking 208 quality improvement champions with 3,234 unique providers. Timely completion improved from 86% (33,886/39,489 encounters) to 96% (39,790/41,624; p < 0.001). Conclusions: Implementation of RPA was associated with substantial improvement in FCP assignment and timely AMR completion. Initiating a bot-enabled secure-chat “virtual safety huddle” may provide a practical EHR reliability layer for rule-based inpatient care gaps.