Agentic Pipelines

We’ve all felt it, whether as patients, clinicians, or administrators: the frustrating friction within our healthcare systems. Missed appointments, lost referrals, endless forms, chasing results – these aren’t just minor inconveniences; they are symptoms of a deeper, systemic issue. A recent insightful analysis by The King’s Fund, titled “Lost in the system: the need for better admin” (Cream et al, 2025), casts a stark light on the scale and impact of administrative inefficiencies, particularly within the NHS, but with lessons applicable far beyond. It paints a picture of dedicated professionals hampered by outdated processes, fragmented systems, and a lack of investment in the very infrastructure meant to support care delivery.

The report highlights a reality many experience daily: a complex web of administrative tasks, often performed manually, consuming valuable time and resources that could be directed towards patient care. It’s a story of clinicians bogged down by paperwork instead of patients, administrators battling incompatible software, and patients left bewildered, repeating information, and facing delays that can impact their health outcomes.

But acknowledging the problem, however vividly described, is only the first step. The crucial question is: how do we begin to unravel this complexity and build a more efficient, effective, and humane administrative backbone for our healthcare services? The answer lies not in piecemeal fixes, but in a strategic, diagnostic approach: a comprehensive efficiency audit. This isn’t just about finding fault; it’s about mapping the terrain, understanding the bottlenecks, and identifying the opportunities where modern solutions like automation, streamlined pipelines, and intelligent agentic processes can make a transformative difference.

The Crippling Cost of Clunky Admin: Insights from the Frontline

The King’s Fund report underscores several critical areas where administrative failings exact a heavy toll:

1. Outdated Technology and Fragmented Systems: The persistence of pagers, fax machines, and non-interoperable digital systems creates information silos. Data doesn’t flow smoothly between departments, hospitals, or primary and secondary care. This necessitates manual workarounds, re-keying of information (introducing errors), and significant delays in accessing crucial patient data. Imagine a referral needing to be faxed, then manually entered, potentially delayed or lost – a common scenario highlighted in the analysis.
2. Manual, Repetitive Tasks: A vast amount of staff time – both clinical and administrative – is spent on tasks that are fundamentally repetitive: appointment scheduling, sending reminders, processing standard forms, chasing up missing information, manually transcribing notes. This isn’t just inefficient; it’s demoralising. Clinicians trained for years to provide care find themselves acting as clerks, while skilled administrators are tied up with low-value tasks that machines could handle flawlessly.
3. Poor Communication and Coordination: The lack of integrated systems directly impacts communication. Patients get conflicting information, test results aren’t communicated promptly to the right person, and care transitions (like hospital discharge) become fraught with potential errors and delays because different parts of the system aren’t talking to each other effectively. The report details the frustration and anxiety this causes for patients navigating their care journey.
4. Impact on Patient Experience: The ultimate cost is borne by patients. Delays in diagnosis or treatment due to lost referrals or slow administrative processes, the stress of navigating a confusing system, the need to repeatedly provide the same information – these significantly detract from the quality and timeliness of care.
5. Impact on Staff Morale and Retention: Constant battles with inefficient systems contribute significantly to staff burnout and frustration. When professionals feel hampered rather than supported by the tools and processes they use daily, it erodes morale and can drive talented individuals away from the healthcare sector – a sector already facing workforce challenges.
6. Wasted Resources: Every hour spent on unnecessary manual admin, every delayed appointment slot, every duplicated test due to lost results represents a tangible waste of precious healthcare funding and resources.

The King’s Fund analysis makes it clear: the administrative systems underpinning healthcare are not just passive background elements; they are active determinants of efficiency, patient safety, staff well-being, and overall system sustainability. Ignoring the need for administrative reform is no longer viable.

The Starting Point: A Comprehensive Efficiency Audit

Simply throwing new technology at the problem isn’t the answer. Without understanding the specific workflows, bottlenecks, and pain points, investments can be misplaced, and new systems can even add complexity if not implemented thoughtfully. This is where the efficiency audit becomes indispensable.

An efficiency audit, in this context, involves a deep dive into existing administrative processes:

• Process Mapping: Documenting how tasks are actually performed, step-by-step, from patient referral to discharge, including all communication loops, data entry points, and decision gates.
• Bottleneck Identification: Pinpointing where delays occur, where information gets stuck, and which steps consume disproportionate amounts of time or resources.
• Quantifying Waste: Measuring the time spent on manual tasks, the frequency of errors, the cost of delays, and the impact of poor communication.
• Technology Assessment: Evaluating the suitability and integration (or lack thereof) of existing tools and systems.
• User Experience Analysis: Gathering feedback from staff (clinical and admin) and patients about their frustrations and suggestions.

This audit provides the crucial diagnostic data – the evidence base needed to design targeted interventions. It moves beyond anecdotal frustration to create a clear, data-driven picture of where and why the system is failing. It’s the foundation upon which effective solutions can be built.

Building the Solution: Automation, Pipelines, and Agentic Processes

Once the audit has illuminated the specific problems, we can deploy a powerful toolkit of modern solutions designed to streamline workflows, reduce manual burden, and enhance communication:

1. Automation (Robotic Process Automation – RPA & Scripting): Many of the repetitive, rules-based tasks highlighted by the King’s Fund report are prime candidates for automation.
   • What it does: Software “bots” can be programmed to mimic human actions like logging into systems, copying and pasting data, filling out forms, sending standard notifications (like appointment reminders), and managing basic data entry.
   • Impact: Frees up staff from tedious tasks, allowing them to focus on more complex, value-added activities and patient interaction. Reduces errors associated with manual data entry. Operates 24/7, speeding up processes significantly. Imagine automating the transcription of referral information between incompatible systems or automatically sending discharge summaries to GPs.
2. Process Pipelines (Workflow Orchestration): Fragmented processes, like patient pathways involving multiple departments or organisations, require seamless coordination.
   • What it does: Digital pipelines define and manage the flow of tasks and information through a multi-step process. They ensure that when one step is completed, the next step is automatically triggered, and the right information is passed to the right person or system at the right time.
   • Impact: Creates end-to-end visibility and control over complex workflows like referrals, diagnostic pathways, or discharge planning. Reduces the chance of steps being missed or delayed. Improves communication by ensuring everyone involved has access to the current status and necessary data. This directly addresses the communication gaps and coordination issues identified in the report.
3. Agentic Processes (AI-Powered Agents): For more complex tasks involving decision-making, interaction, and coordination, AI agents offer a leap forward.
   • What it does: These are sophisticated AI systems designed to perform specific roles or manage complex workflows autonomously. They can understand context, interact using natural language, make decisions based on predefined rules or learned patterns, and coordinate with other systems or even humans.
   • Impact: Can manage complex scheduling across multiple constraints (clinician availability, room booking, equipment needs), proactively communicate with patients (e.g., pre-operative instructions, follow-up checks), triage administrative requests, identify potential issues in a patient pathway (e.g., conflicting appointments, missing results), and even help optimise resource allocation. They represent the next level of intelligent automation, capable of handling dynamic situations that go beyond simple RPA.

Why This Approach is the Right Path Forward

Starting with an efficiency audit and then strategically implementing automation, pipelines, and agentic processes offers a multitude of benefits that directly counter the problems outlined by The King’s Fund:

• Improved Patient Care: Faster access to appointments, quicker turnaround for results, smoother transitions between services, and less chance of administrative errors contribute directly to better, safer patient experiences and outcomes.
• Reduced Staff Burden: Automating mundane tasks and streamlining workflows alleviates pressure on both clinical and administrative staff, reducing frustration, mitigating burnout, and allowing them to utilise their skills more effectively.
• Significant Cost Savings: Reducing manual effort, minimising errors, optimising resource use, and preventing delays translates into substantial financial savings over time.
• Enhanced Data Quality and Insights: Automated processes and integrated pipelines generate cleaner, more consistent data, providing valuable insights for service improvement, operational management, and population health initiatives.
• Scalability and Resilience: Well-designed digital workflows are easier to scale and adapt than manual processes, making the system more resilient to fluctuations in demand.

Conclusion: From Diagnosis to Cure

The King’s Fund report compellingly diagnoses the chronic condition of administrative inefficiency plaguing our healthcare systems. It details the symptoms – frustration, delays, errors, waste – and highlights the urgent need for treatment.

Continuing with the status quo is unsustainable. Incremental tweaks are insufficient. What’s needed is a clear-eyed, systematic approach to understanding the root causes and deploying modern solutions effectively.

An efficiency audit provides that essential diagnostic clarity. It maps the labyrinth, identifies the blockages, and quantifies the cost of inaction. It is the crucial first step, laying the groundwork for targeted interventions. Following this diagnosis, the strategic application of automations to handle repetitive tasks, pipelines to orchestrate complex workflows, and agentic processes to manage dynamic coordination offers a powerful cure.

This isn’t about replacing humans; it’s about augmenting their capabilities, freeing them from the drudgery of inefficient processes, and enabling them to focus on the core mission of healthcare: providing timely, effective, and compassionate care. By embracing a data-driven audit and leveraging the power of modern process technologies, we can move from being “lost in the system” to designing administrative functions that actively support, rather than hinder, the delivery of excellent healthcare for all.

The time for that audit, and the transformation it enables, is now.

References

Cream, J., Wellings, D., Wenzel, L., Lant, J. and Pett, W. (2025). Lost in the system: the need for better admin. Available at: https://www.kingsfund.org.uk/insight-and-analysis/long-reads/lost-in-system-need-for-better-admin (Accessed: 5 May 2025).