In the healthcare industry, efficiency and precision are paramount. When a medical equipment solutions provider realized that its outdated, time-consuming manual payment processing system was resulting in unacceptably high error rates, the need to automate was clear. Once the gears were in motion, an in-house implementation team managed to deploy a new platform within just one year. This case study explores the challenges faced, the steps taken to gain user buy-in for the automated system, and the substantial benefits realized from this technological advancement.
The subject of this study is a Lagos-based company that imports, installs, repairs, and maintains medical equipment and supplies medical consumables. Its clients include medical centers, teaching hospitals, private hospitals, clinics, and other facilities throughout Nigeria and extending into neighboring countries.
By 2021, the organization had grown to approximately 150 employees and plans were underway to expand further in the region. Its leaders were focused on streamlining and scaling up business processes, and they recognized that having staff fill out paper forms to make payments to vendors and original equipment manufacturers (OEMs) was no longer serving them.
They decided to automate the process, and to help achieve that goal, they hired a new business assurance manager, Oyeleye Yussuf, with the intention of leveraging his prior experience carrying out a similar project at another organization.
Manual Payment Processing Pain Point
When Yussuf joined the company, he found that approximately two-thirds of the staff had a hands-on role to play in the journey of a payment request from receipt to posting. Everything was conducted manually using paper forms.
The first line manager could approve requests for payments of less than 100,000 naira (approximately US$67.15). A second line manager would have to approve requests for payments exceeding 100,000 naira but less than 200,000 naira, while a member of the executive team would have to review and approve any request for more than 200,000 naira.
Next, upon approval, a request would be delivered to the budget control unit in the finance department for confirmation that funds were budgeted for the item. Once it cleared that hurdle, the request would be taken to the business assurance department for review against company policy. Upon determination that the documentation was in order and the payment was confirmed as wholly, reasonably, exclusively, and necessarily incurred, the request would finally land in the company’s treasury unit for payment processing and posting on the enterprise resource planning (ERP) system.
At the time of Yussuf’s initial review of the system, approximately 350 payment requests were processed manually, and the error rate was alarming—higher than 20%. There were multiple problems with the payment processing method. At the top of the list was the error rate, but that was compounded by several other issues:
- The length of time it took for a request to go through the approval and payment cycle (often exacerbated by approval bottlenecks)
- Difficulties with storage and retrieval of transaction documents
- Lack of a clear audit trail when documents went missing
- Increasing stationery and printing costs
Delays in processing payments to vendors could be very serious, according to Yussuf. “There were also issues of wrong payments to vendors, such as overpayments, duplicated payments, or incorrect tax calculations,” he said. These errors resulted in both reputational damage and financial losses.
In addition to the goal of eliminating those problems, the executive team wanted to take advantage of the potential of an automated system for compiling and analyzing data in service of the company’s overall strategic business goals.
Finding the Right Solution
The first step for the in-house implementation team, consisting of Yussuf and four collaborators from key business units, was to identify the right IT consultant and solution for the job. They were looking for a system that could automate their payment processes, reduce human intervention and error, protect against cyberattacks, and ensure easy generation of data and analytics for decision making.
The team considered Microsoft 365, Microsoft Dynamics 365, and Microsoft Power Apps. They soon realized that Microsoft 365 did not have the transaction flow capability they needed, because it did not have a mobile application. Microsoft 365 would not be able to automatically send a transaction that initiated in the field to the appropriate person for review and approval, for example.
Microsoft Dynamics offered appealing capabilities, but it was outside the budgeted amount for the new platform. “It was very, very good,” Yussuf said, “but we were unable to commit that amount of money to the project.”
The best choice for the company was Power Apps, which the team found functionally equal to Dynamics in many key respects. A bonus was that Power Apps could easily scale to Dynamics, which could suit the organization down the road. Executives approved the recommendation and authorized the team to proceed with the Power Apps implementation.
Embedding Custom Controls
In deploying Power Apps, Yussuf’s responsibilities included ensuring the complete gathering of user requirements and the embedding of controls through approvals and authorizations. It was important to establish segregation of duties. “You want to be sure that one person does not start and finish the processing of a payment request,” he pointed out. The same person should not be capable of initiating a transaction, approving it, and processing it. Approval limits were put in place to address that issue.
With the old manual processes, sometimes a payment request of more than 300,000 naira would be approved by only one person, violating company policy. With controls embedded in the automated process system, that type of error cannot occur. The system automatically notifies the next line of approval according to the limits set.
The automated process also speeds up the time from initial request to payment by means of multiple notifications. “We designed this in such a way that every 30 minutes the approver gets a reminder—a notification that a request is pending,” Yussuf said. “It is expected that the request will be approved or rejected within 30 minutes. The approver keeps getting notifications until the request is attended to.”
The frequent notifications have the desired effect, noted Yussuf. “Approvers do not want their admin boxes clogged with notifications, because that can actually count against them, showing excessive turnaround time in attending to requests.”
The team was able to establish custom controls to detect and resolve problems much earlier in the transaction process. “At every point in time, the initiator gets notified of the stage of the request,” Yussuf explained. “If an approver rejects a request, the initiator gets a notification that shows the reason for the rejection. After correcting the error, the initiator can resubmit the request.”
Preliminary User Testing
One of the first challenges Yussuf encountered was reluctance on the part of users to shift to the automated system. “Users were comfortable with the old way of processing requests and did not see any need for a change,” he recalled. Some staff members worried they might have to work after normal business hours to review and approve requests.
To allay those fears, the in-house implementation organized a session, with the approval of the executives, to describe how the process would work and explain its importance to the business.
During the user acceptance testing (UAT) phase, staff initiated requests in a test environment to see how the automated process would work when migrated to the live environment. Different real-life scenarios were created—for example, rejecting requests, returning requests to initiators for correction, and holding requests pending approval.
The implementation team examined the effectiveness of controls embedded in the system. It tested whether staff were prevented from approving requests for payments that were above their approval limits. The team also checked to see if segregation of duties was embedded in the system.
After all issues raised during the UAT phase were resolved, the team carried out the following steps:
- Sensitization emails were sent out at regular intervals to inform staff of the new process, the rollout date, and the date for the discontinuation of the manual process.
- A day before the cutover date, the new process was migrated to the live environment.
- On the cutover date, emails were sent to inform staff of the discontinuation of the manual process and launch of the new automated process.
- The email instructed staff to meet with members of the implementation team if they encountered any issues with the new process.
- The email also informed staff that any functionality challenges should be brought to the attention of the in-house implementation team for escalation as needed.
Overcoming Resistance
Despite the steps taken to prepare the way for rollout of the automated process, Yussuf observed that many staff members continued to demonstrate reluctance to adopt the new approach. The lack of user buy-in slowed down transaction processing, impeded service delivery, delayed payment to vendors, negatively affected the organization’s brand perception, and reduced profitability. Training sessions were organized but attendance was unsatisfactory. Some staff chose not to attend because they were resistant to the new technology. Others, particularly engineers, were working in the field and could not attend the training at the appointed times. To address the lag in training, the team developed a “train the trainer” model. “We went to different departments to teach people how to train their colleagues and staff," Yussuf recalled.
To further encourage buy-in, the implementation team went from desk to desk, teaching staff members one-on-one how to use the system. “I think they thought it was going to be a challenging system to use, but they found out it was user-friendly.” In retrospect, Yussuf believes that sensitizing the staff earlier and more often on the importance of the new process to the organization would likely have encouraged earlier user buy-in. This could be especially helpful for larger or fully remote organizations, where one-on-one training may not be feasible.
User attitudes shifted substantially, from reluctance and resistance to enthusiasm.Still, users gradually saw how easy it was to use the process, and adoption improved. In fact, user attitudes shifted substantially, from reluctance and resistance to enthusiasm. They appreciated how easy it was to track their requests for follow-up, for example.
In response to a recent poll on the effectiveness and efficiency of the new system, more than 98% of staff said it made request processing easy.
Business Benefits
As of today, 100% of all payment requests are raised on the platform. The company processes an average of 700 requests monthly, with an error rate of less than 1%.
The company’s executives appreciate the platform’s ease of transaction approval. A Power BI dashboard showing the number of payment requests raised, the amount paid within a period, the outstanding amount to be paid, the age analysis of the outstanding amount, and the value of accounts payable per period is embedded in the automation process to monitor payments.
“A click of the button, and you have all your reports at a glance,” Yussuf said.
By conducting age analysis, for example, the Power BI platform can provide a clear picture of how long a debt has been owed to ensure that payments are made in a timely manner to comply with the payment terms in vendor contracts.
The Power BI platform can also perform data visualization to support decisions related to budget preparation and cash flow analysis. “You know the outstanding amount you owe to vendors, so you know how much you need to commit to payment,” said Yussuf. “You know what outflows you need to make, so you can do your cash flow projection, your cash flow analysis. You can do all of that from the data generated on the Power BI platform.”
Conclusion
The transition from manual to automated payment processing marked a significant milestone for the Lagos-based medical equipment solutions provider. Through careful planning and persistent user engagement, the company’s implementation team successfully overcame initial user resistance to establish a robust and efficient automated system. The new platform, powered by Microsoft Power Apps embedded with Power BI, has not only eliminated the errors and delays associated with manual processes but also provided valuable data insights to support strategic decision making. This case study underscores the transformative impact of automating business processes, highlighting the critical role of technology in driving efficiency and supporting growth in the healthcare sector.
MICK BRADY
Is a freelance technology communicator with more than 20 years of experience editing and writing for technology focused publications.