01The systems in the way
A hospital or clinical group typically runs an EHR that speaks HL7 but not REST, a lab system the vendor will not open, imaging on DICOM, and a scheduling client written for a desktop that has not changed in a decade. Around those sit payer portals — dozens of them, each with its own login, its own form layout and no interface beyond a browser. Staff bridge those gaps by hand, and that manual bridging is where the working day goes.
| System | What it gives you |
|---|---|
| EHR | HL7 / no REST |
| Lab system | vendor only |
| Imaging | DICOM |
| Payer portal | web only |
| Scheduling | legacy client |
| Pharmacy | fax + PDF |
02Why the usual approaches stall
Integration engines solve part of it and stop at the perimeter: they cannot log into a payer portal on your behalf. RPA scripts can, until the portal moves a button and the script fails silently for three weeks. And any approach that ships patient data to a hosted model is a non-starter before the clinical governance conversation even begins.
If a human can do it in a browser or a terminal, an agent can do it — at volume, with an audit trail. That is the whole basis of how we approach healthcare: we treat the systems you already run as the integration surface, rather than waiting for an API that is never going to ship.
03What an agent actually does here
Worked example
A prior-authorisation agent assembles the clinical packet from the EHR, submits it through each payer’s own web form, polls for status, and escalates denials to a named person with the reason and the evidence attached. Nothing about that requires a payer API, and nothing about it requires patient data to leave the clinical network.
This is a reference design drawn from the problems we are asked about most often in healthcare — not a case study of delivered client work. Where we have shipped a build, we say so plainly and put you in touch with the client.
04Constraints we design to
- Patient data can be kept entirely inside the clinical network — local weights, no outbound calls, no hosted model
- Every action is written to an append-only trace: what was read, what was submitted, what was returned
- Denials and ambiguous cases route to a human rather than being auto-resolved
- Designed towards HIPAA technical safeguards and the DPDP Act; certification and any BAA is reviewed with counsel, not assumed
Tell us which system is the problem
Describe the workflow that is done by hand today and the system that blocks it. We will come back within one working day with an initial read on feasibility — including if the honest answer is that an agent is the wrong tool.
Scope your agent →