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Use cases

Real workflows. Specific reasons they stall.

These are the healthcare AI workflows we take to production. Each one works in a demo. Each one has a concrete reason it doesn't go live - and a concrete fix.

01Fax and document intake

Health plans, TPAs and benefits administrators

The workflow

Faxes, PDFs and scanned forms arrive all day. A model classifies each one, pulls the key fields and routes it to the right queue, replacing manual sorting.

Why it stalls

  • Documents come from outside parties, and any of them can contain text the model treats as instructions.
  • Extracted fields feed downstream systems, so a wrong member ID or date is a real error, not a typo.
  • The OCR, model and storage vendors each touch PHI, and the BAA chain has gaps.
Document intake flowControl we add
  1. Fax / PDF
  2. OCR
  3. Injection filter
  4. Model: classify + extract
  5. Confidence check
  6. Queue or human review

What we do

  • Build an evaluation set from a sample of your real documents, scored field by field
  • Test prompt injection through the documents themselves, then add input filtering and output checks
  • Set confidence thresholds that send uncertain documents to a person
  • Map every vendor in the path and close BAA and retention gaps

What you walk away with

  • Field-level accuracy on your documents, not a vendor benchmark
  • Routing rules your operations lead can read and change
  • Injection test results your security team can review

02Medical record summarization

Workers' comp, legal-medical review and independent review

The workflow

Reviewers read hundreds of pages of medical records per claim. A model drafts a chronology and summary, so the reviewer starts from a draft instead of a stack.

Why it stalls

  • A summary that misses a prior injury or invents a date can change a claim decision.
  • Reviewers won't trust a summary they can't check against the source.
  • Whole records go to a model vendor, often with more PHI than the task needs.
Record summarization flowControl we add
  1. Medical records
  2. PHI minimization
  3. Model: chronology + summary
  4. Citation check
  5. Reviewer sign-off

What we do

  • Require every statement in the summary to cite its source page
  • Measure omissions and unsupported statements on records your reviewers already closed
  • Strip identifiers the summary doesn't need before the model call
  • Design the review step so reviewers can check any statement against its source

What you walk away with

  • Measured rates for omissions and unsupported statements
  • A review step your reviewers helped design
  • Documentation of what PHI goes where, and why

03Prior authorization intake

Health plans and utilization management teams

The workflow

Prior authorization requests arrive incomplete and in every format. A model assembles the packet - request, clinical notes, the matching criteria - so the clinical reviewer starts with everything in one place.

Why it stalls

  • Anything near a coverage decision draws scrutiny from regulators, auditors and your own medical director.
  • Reviewers need to see why the model pulled what it pulled.
  • Rules on automated decision support and nondiscrimination apply, and nobody has mapped them to this workflow.
Prior authorization flowControl we add
  1. Request + clinical notes
  2. Model: assemble packet
  3. Retrieval log
  4. Clinician decides
  5. Determination

What we do

  • Keep the model to assembly and highlighting; the coverage decision stays with a clinician
  • Log what the model retrieved and showed for every request
  • Test packet completeness and accuracy on past requests
  • Map the workflow against nondiscrimination and decision-support requirements

What you walk away with

  • A written line between what the model does and what the clinician decides
  • An audit trail for every request
  • Completeness and accuracy results on your past requests

04AI vendor security review

AI companies selling to health plans, hospitals and life sciences

The workflow

Your buyer's security team sends a long questionnaire and asks for your SOC 2 report. More of the questions are about AI every quarter, and the answers live in Slack threads and a few engineers' heads.

Why it stalls

  • Questions about model providers, training on customer data and PHI in prompts have no written answers.
  • There is no SOC 2 report yet, or the report doesn't cover the AI features.
  • Engineers lose days to each questionnaire instead of shipping.
Security review flowControl we add
  1. Buyer questionnaire
  2. Answer library
  3. PHI data-flow doc
  4. Evidence binder
  5. Approved vendor

What we do

  • Document how PHI moves through your product, end to end, including model providers
  • Write a reusable answer library for the AI questions buyers ask
  • Map your controls to SOC 2 and HITRUST and close the gaps
  • Organize the evidence your assessor will ask for, before they ask

What you walk away with

  • Questionnaire answers your sales team can send without an engineer
  • A data-flow document you can share with buyers under NDA
  • A readiness plan and evidence binder for your assessor

Have a pilot stuck in review?

Tell us what you built and where it's blocked. We'll tell you honestly whether we can help.