By Andrew Williams, Health Industry Lead, Appian

Healthcare delivery is rapidly evolving beyond traditional hospital environments into patients' homes, community clinics and mobile health units. As hospital care moves outside of traditional hospital walls, healthcare providers face challenges in delivering consistent, high-quality services across fragmented environments.

Despite Australia's globally renowned healthcare system, significant challenges persist in delivering effective out-of-hospital (OOH) healthcare. These include inconsistent funding models across public and private services, fragmented information sharing and inadequate data management practices. Addressing these challenges in order to improve health equity, reduce clinical risk associated with suboptimal data management practices within a complex enterprise care setting, necessitates the use of Artificial Intelligence (AI) and process automation technologies.

Digital front doors to benefit patient and provider

A Digital Front Door (DFD) can only be effective when supported by an ecosystem of integrated technology components working in harmony to improve the patient experience and support more efficient care pathways. By digitising and automating patient triage and self-diagnostic processes, healthcare providers can efficiently allocate resources according to the urgency of a patient’s needs. McKinsey research indicates digitisation could potentially reduce Australia's healthcare spend by 8-16%, with around 10% savings directly achievable through eTriage and automated diagnostic tools.

A study of AI integration into Australian virtual front doors looked at Polish healthcare technology, Infermedica, as a case study to understand the benefits. It found the company’s AI-powered triage system had improved self-assessment completion rates by 71% (up from 49% to 84%). Successful triaging also diverted more than half of all ER calls to less acute settings, saving time and money for the relevant healthcare providers and workers.

Similarly, the Virtual ED service operating in Victoria which undertakes approximately 600 consultations a day. The Virtual ED has helped 83% of patients avoid an unnecessary trip to the hospital – delivering urgent care in the comfort of their own home while taking pressure off frontline healthcare workers.

This approach not only reduces pressure on primary care facilities, but also ensures healthcare professionals can focus on critical patient interactions and care.

Digitising pre-visit workflows

Automation enhances pre-visit workflows and streamlines patient administration prior to in-person visits. Tasks such as consent documentation, identity verification and insurance eligibility checks can be completed digitally in advance, improving patient safety and quality as well as significantly reducing time spent on paperwork and enabling healthcare professionals to reduce waiting times and see more patients.

Process automation in out-of-hospital care

Leveraging process automation technologies like intelligent document processing, AI-driven predictive analytics and automated compliance checks, allows healthcare providers to deliver more efficient and safer care. For example, home-based care providers can benefit from digital consent and automated documentation, simplifying administrative tasks so that care givers can focus on patient outcomes.

Effective process automation assists with safe and effective transition of care between the physical hospital services and out-of-hospital care teams and allows organisations to monitor and refine processes over time.

Compliance on-the-move

As healthcare delivery increasingly shifts to mobile and decentralised environments, consistent adherence to clinical and privacy standards becomes more critical. The Australian Government’s National Digital Health Strategy 2023-2028 highlights that 69% of healthcare providers advocate for substantial improvements in technology infrastructure and compliance standards to facilitate effective digital transformation.

The strategy specifically recommends, "ensuring consistency in clinical standards and regulations across OOH services, including staff training, patient assessment and monitoring and robust communication standards between hospital-based and community-based providers."

Adhering to these standards ensures that patients and providers alike have confidence in the quality and safety of care delivered, regardless of the setting. Technologies such as AI-driven compliance monitoring and automated audits can help healthcare providers ensure clinical guidelines, privacy protocols and documentation standards are consistently upheld across dispersed care environments.

Case study: automating administration at Acclaim Autism

The most impactful applications of AI in healthcare today often target repetitive, administrative tasks, freeing healthcare professionals to prioritise care giving. This can also help mitigate workforce burnout and significantly boost staff morale.

Acclaim Autism aimed precisely for this improvement, partnering with Appian to tackle the challenge of processing complex onboarding documentation. Acclaim is a behavioural healthcare organisation offering high-quality, evidence-based therapy to families affected by Autism Spectrum Disorder (ASD).
Acclaim’s onboarding documents frequently include unstructured medical diagnosis forms dense with free text, leading to elevated manual data entry rates and repeated administrative rework.

The Appian team implemented Agent Studio and generative AI for document processing, seamlessly integrating AI into Acclaim’s existing intake workflow in just three weeks. The outcome was transformative, achieving up to 95% accuracy in data extraction from complex forms.

Crucially, this automation reduced Acclaim’s wait times dramatically – from 3-6 months down to just one month – providing faster access to essential support for families affected by ASD.

“This is a groundbreaking solution that significantly improves our data extraction accuracy while ensuring our intake staff and clinicians remain integral to the process. It’s the perfect blend of cutting-edge technology and human expertise, allowing us to deliver more precise and personalised care to our clients,” said Ryan Cox, Vice President of Acclaim Autism.

Once patients are successfully processed, however, the complexity of each case only continues. The scheduling and management of Applied Behaviour Analysis (ABA) comes with many variables and stakeholders, from diagnosing professionals, clinical supervisors and behaviour therapists, to the children and their parents.

Speaking at Appian World 2025, Cox explained how Acclaim is now working with Appian to enhance the future of these workflows to improve the lives of its patients and their caregivers.

“We collected all of these variables and put them into a prototype that provides the best care team possible,” he explained. “It’s designed from the clinical requirements, not from the admin side and it’s going to improve lives.”

Once a patient case is established, an efficient way to manage it must be developed. Previously, emails and SMS would become lost. Other communications such as verbal conversations with therapists or clinical supervisors would be forgotten, leaving patients and their caregivers frustrated. Services were either halted or completely interrupted and cancellation rates went up.

“Appian’s Agent Studio demonstrates how AI and low-code can combine to extend human capacity in ways that matter most: reaching families faster, reducing administrative friction, and enabling clinicians to focus on what they do best—care,” said Cox. “Agent Studio bridges the gap between business users and software engineers. By uploading our existing processes into the agent’s knowledge set, we quickly achieved reliable clinician-patient matches—a powerful result from a simple setup.”

Embracing AI and the automation advantage

The future of healthcare relies on effectively delivering high-quality care beyond traditional hospital settings. Embracing innovative technologies such as AI and process automation will be crucial in delivering seamless, high-quality care across diverse environments. The successful integration of these technologies not only addresses inefficiencies in healthcare settings, but also helps to provide more responsive, efficient and patient-focused healthcare outcomes.

Learn more about improving healthcare delivery through AI and process automation at appian.com.