Applying Robotic Process Automation to Monitor Business Processes in Hospital Information Systems: Mixed Method Approach

Background: Electronic medical records (EMRs) have undergone significant changes due to advancements in technology, including artificial intelligence, the Internet of Things, and cloud services. The increasing complexity within health care systems necessitates enhanced process reengineering and system monitoring approaches. Robotic process automation (RPA) provides a user-centric approach to monitoring system complexity by mimicking end user interactions, thus presenting potential improvements in system performance and monitoring. Objective: This study aimed to explore the application of RPA in monitoring the complexities of EMR systems within a hospital environment, focusing on RPA's ability to perform end-to-end performance monitoring that closely reflects real-time user experiences. Methods: The research was conducted at Seoul National University Bundang Hospital using a mixed methods approach. It included the iterative development and integration of RPA bots programmed to simulate and monitor typical user interactions with the hospital's EMR system. Quantitative data from RPA process outputs and qualitative insights from interviews with system engineers and managers were used to evaluate the effectiveness of RPA in system monitoring. Results: RPA bots effectively identified and reported system inefficiencies and failures, providing a bridge between end user experiences and engineering assessments. The bots were particularly useful in detecting delays and errors immediately following system updates or interactions with external services. Over 3 years, RPA monitoring highlighted discrepancies between user-reported experiences and traditional engineering metrics, with the bots frequently identifying critical system issues that were not evident from standard component-level monitoring. Conclusions:RPA enhances system monitoring by providing insights that reflect true end user experiences, which are often overlooked by traditional monitoring methods. The study confirms the potential of RPA to act as a comprehensive monitoring tool within complex health care systems, suggesting that RPA can significantly contribute to the maintenance and improvement of EMR systems by providing a more accurate and timely reflection of system performance and user satisfaction. (JMIR MedInform2025;13:e59801)doi: 10.2196/59801