Healthcare & business ops workflows

Healthcare ops call triage workflow with safety caveats

Front-desk calls mix appointment requests, billing questions, and urgent symptoms — and untrained routing risks safety.

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Audience
Healthcare & business ops workflows
Problem
Front-desk calls mix appointment requests, billing questions, and urgent symptoms — and untrained routing risks safety.
Outcome
Non-urgent calls are routed and logged quickly; anything that smells urgent goes immediately to a human clinician — never to AI.
Tools used
  • Your phone / IVR system
  • A reviewed routing tree
  • Audit log
  • Your clinical lead's approval
Time required
1 week to draft, 4 weeks to validate before any live use
Difficulty
Hard (clinical safety required)

Steps

  1. Have a clinician define a 'never automate' list: chest pain, suicidal ideation, pregnancy bleeding, pediatric fever, allergic reaction, anything emergency-coded by your jurisdiction.
  2. Build a routing tree that only handles 3-4 known non-clinical categories: appointment scheduling, billing, hours, directions.
  3. Anything outside the tree, including any of the 'never automate' phrases, must immediately transfer to a human.
  4. Run a shadow mode where AI suggests routing but a human approves every decision for 4 weeks.
  5. Publish a public disclosure that AI assists with non-clinical routing only and that members can opt out of AI handling.

Example output

Caller says 'I want to reschedule Tuesday' → AI routes to scheduling. Caller says 'I'm having trouble breathing' → AI immediately transfers to human + flags audit log.

Human-review point. A clinician must own this workflow. AI cannot triage symptoms, give medical advice, or override the 'never automate' list. All AI decisions are auditable.
Privacy notes. PHI must never be sent to a third-party LLM without a signed BAA. Do not log call audio without explicit consent. Comply with your jurisdiction's privacy law.

Fork and remix ideas

  • Adapt for legal-aid call triage with similar 'never automate' lists.
  • Adapt for school front-desk calls about safety incidents.
  • Use the same 'never automate' pattern for any safety-critical inbox.
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