Agentic AI in Healthcare: Moving from Automation to Autonomous Care Delivery

Healthcare is at a pivotal crossroads. As organizations face rising operational complexity, workforce shortages, and mounting administrative burdens, the need for transformative solutions has never been greater. Enter agentic AI—a new generation of artificial intelligence that moves beyond traditional automation and generative AI, ushering in an era where autonomous systems can execute multi-step clinical and administrative processes with minimal human intervention. This evolution is not just a technological leap; it’s a strategic imperative for healthcare leaders seeking to reduce costs, improve care delivery, and future-proof their organizations.

From Generative to Agentic AI: What’s the Difference?

To appreciate the significance of agentic AI, it’s important to distinguish it from generative AI. Generative AI, such as large language models, excels at creating new content—summarizing information, drafting documentation, or generating images—based on patterns learned from vast datasets. These tools have already found a home in healthcare, supporting tasks like transcribing clinical notes, summarizing patient histories, and enhancing patient communication. However, generative AI typically requires human oversight to act on its outputs.

Agentic AI, by contrast, is designed to act. These systems autonomously pursue complex goals, make decisions, and execute end-to-end processes across disparate systems. In healthcare, this means moving beyond generating a discharge summary or a prior authorization letter to actually submitting forms, updating records, coordinating with payers, and triggering follow-up actions—all without waiting for a human to push the next button. Agentic AI combines the creative and analytical power of generative models with decision engines, workflow orchestration, and deep integration into clinical and administrative systems.

Real-World Use Cases: Transforming Healthcare Operations

Early pilots and deployments of agentic AI in healthcare are already demonstrating measurable impact across several high-value workflows:

1. Automated Patient Intake

Agentic AI can extract information from unstructured documents, verify insurance eligibility, and initiate claims—all while ensuring compliance with privacy regulations. By integrating with electronic health records (EHRs) and payer systems, these agents accelerate onboarding, reduce manual data entry, and minimize errors.

2. Prior Authorization and Claims Management

Traditionally, prior authorization is a labor-intensive process requiring staff to gather documentation, fill out forms, and communicate with payers. Agentic AI can automate the entire workflow: extracting relevant data from EHRs, validating medical necessity, auto-filling forms, submitting requests, and tracking responses. This not only reduces administrative burden but also accelerates patient access to care and speeds up claims resolution.

3. Discharge Planning and Care Coordination

Discharge planning involves coordinating multiple stakeholders—physicians, nurses, social workers, and payers—to ensure safe transitions from hospital to home or another care setting. Agentic AI can orchestrate this process by identifying discharge criteria, scheduling follow-up appointments, arranging transportation, and ensuring that all necessary documentation is completed and communicated to the right parties.

4. Clinical Workflow Orchestration

Agentic AI can assist clinicians by summarizing patient histories, flagging potential risks, and coordinating care across departments. For example, an AI agent could monitor EHR data, identify patients at risk of readmission, and trigger follow-up actions automatically, supporting proactive, data-driven care.

Integration, Compliance, and Governance: Unique Challenges in Healthcare

The promise of agentic AI is immense, but so are the challenges—especially in healthcare, where data privacy, interoperability, and regulatory compliance are paramount. Unlike generative AI, which can often be deployed as a standalone tool, agentic AI requires deep integration with a patchwork of legacy systems, EHRs, payer platforms, and regulatory databases. Key challenges include:

The Human-in-the-Loop Imperative

Despite their autonomy, agentic AI systems are not designed to operate in a vacuum. Human oversight remains essential—especially in high-stakes environments like healthcare. The "human-in-the-loop" model ensures that clinicians, administrators, and compliance officers can review, validate, and override AI-driven decisions when necessary. This collaborative approach balances efficiency with accountability, allowing organizations to harness the speed and scalability of AI while maintaining control over critical decisions.

Regulatory and Ethical Considerations

As agentic AI takes on more responsibility in care delivery, regulatory scrutiny will intensify. Healthcare organizations must navigate a complex landscape of evolving guidelines, from digital health initiatives to emerging standards for AI transparency, explainability, and risk management. Ethical considerations—such as bias mitigation, patient consent, and liability in the event of errors—must be addressed proactively. Building robust governance frameworks, clear audit trails, and transparent decision-making processes will be essential to earning the trust of patients, providers, and regulators alike.

Measurable Impact: Efficiency, Cost Reduction, and Better Outcomes

By automating the "back office" of healthcare, agentic AI enables organizations to do more with less, improving both efficiency and care quality.

Roadmap for Healthcare Leaders: From Pilot to Scale

Why Publicis Sapient?

With decades of digital transformation expertise and a proven track record in regulated, data-intensive environments, Publicis Sapient partners with healthcare organizations to design, build, and scale agentic AI solutions tailored to the sector’s unique needs. Our proprietary platforms accelerate system integration and workflow automation, while our human-centered approach ensures that technology augments—not replaces—human brilliance.

Ready to explore how agentic AI can transform your healthcare organization? Connect with Publicis Sapient to start your journey toward autonomous, efficient, and patient-centered care.