The situation
The bottleneck was the inbox, not the clinicians.
Referrals arrived as faxes, PDFs and emails in every format imaginable. Administrative staff opened each one, keyed the details into the patient administration system and passed it on for clinical triage.
On a busy week the backlog reached two days before a clinician saw a referral. Nobody wanted a model making clinical decisions; everybody wanted the keying to go away.
What the agent may and may not do
| Action | Agent | Person |
|---|---|---|
| Read the referral | Yes | Yes |
| Extract patient and referrer details | Drafts | Confirms |
| Suggest a specialty queue | Suggests | Decides |
| Assign clinical urgency | Never | Clinician only |
| Contact the patient | Never | Yes |
Guardrails the clinical governance committee asked for
Rule 1
Nothing is decided by the agent
It prepares; a person confirms every field and a clinician sets every urgency.
Rule 2
Uncertainty is visible
Fields the agent is unsure of are flagged, not guessed.
Rule 3
Everything is logged
Each extraction keeps the source page and the reviewer who confirmed it.
