Build around the administrative work that slows a care team: missing referral information, payer documentation and unresolved handoffs. Start with one queue, its responsible owner and the records staff already use. Clinical decisions remain with qualified professionals.
The workflow designs below are starting points for scoping. Review our published work and its implementation status, then evaluate your own records, operating constraints and acceptance criteria.
Referral records arrive through different channels, leaving staff to reconcile missing or conflicting details.
A packet can look complete while relying on the wrong payer rule or unsupported information.
A case moves between teams without a visible owner for its next administrative action.
Use approved EHR exports or interfaces, referral documents and the scheduling queue. Extract requested fields with links to the original pages; flag missing or conflicting information for intake staff. An incomplete referral stays in an exception queue until a person verifies it. The system can draft a request for missing records, while staff approve external messages and scheduling changes.
Acceptance: Compare record completeness, rework and elapsed time to an agreed baseline. Test duplicate patients, outdated referrals and conflicting identifiers; an uncertain patient match must stop the workflow.
Connect the approved payer requirements, administrative case records and supporting documents. Produce a checklist and draft packet with provenance for each entry. Staff verify the payer rule version and evidence before submission. A model must not invent a diagnosis, procedure justification or supporting document.
Acceptance: Measure packet completeness and staff correction effort. Keep payer response time separate from preparation time, and retain a record of who approved the packet.
Map patient information through documents, prompts, logs, backups and support access. Your privacy, security and clinical owners approve the data boundary and intended use before deployment. HHS guidance treats risk analysis as a review of electronic protected health information risks and safeguards; hosting location alone does not establish compliance.
Review the applicable safeguards with your team using HHS guidance on risk analysis.
Review the deployment security questions and private AI operating options.
A recurring task with varied documents may need a custom AI application. A fixed reconciliation rule may fit existing software. Map integration and permission requirements before selecting either approach. Keep the accepted source records available to the reviewer.
Assign an owner for source quality, access reviews, alerts and change approval. Agree how staff continue work when a connected system or model is unavailable. Test the fallback as part of acceptance, rather than assuming a person can reconstruct the process during an incident.
Use these questions to prepare a project conversation:
Include a redacted example of a normal case and an exception, the current process owner and the system of record. Request a project review when you can describe the decision the system needs to support.
Establish the current completion time, correction effort and quality from actual records. Agree a representative evaluation set, including exceptions and prohibited actions. Compare the candidate workflow with the existing process and simpler software or rule changes.
Accept deployment only after the responsible users can verify the evidence, permissions and fallback. Identify who monitors performance, handles incidents and approves source or model changes. Read our delivery approach and review ownership and operating responsibilities.
Optional Google Analytics stays off until you choose Accept analytics.