How Agentic Automation Replaced Manual Multi-IDN Coordination in Weeks

Many operational leaders have built entire teams around the assumption that the administrative work that happens after an exam—retrieving studies, validating and normalizing data and routing exams into clinical workflows—requires human judgment. It doesn’t. Agentic AI can execute that entire coordination workflow autonomously, at a scale no staffing model can match.

For two of the country’s largest IDNs, that distinction went from theory to production in a matter of weeks. Today, the manual coordination across systems that once required daily staff effort now runs autonomously, reliably and at scale—enabling staff capacity to be redeployed towards higher-value work.

The Challenge

Manual multi-IDN image coordination blocked scalability, delayed priors access, and drained FTE capacity.

When patients of one major IDN receive imaging services at a partner network, both organizations share a clear clinical objective: ensure every relevant record flows back to the originating system quickly and reliably—without adding work for already stretched teams.

At the scale of two large IDNs, that objective met real complexity. The work spanned across distinct EMR, PACS and legacy image exchange environments, each with its own conventions, identifiers and operational standards. The exchange pathway between the two organizations existed, but the execution depended on people.

In practice, that meant:

• Staff logging into image exchange portals to identify and retrieve incoming studies
• Manual patient matching and normalization before ingestion
• Inconsistent visibility into transfer status and audit trails
• Operational effort that scaled linearly with volume

The bottleneck wasn’t clinical interpretation. It was the coordination between systems. And at the volume these two organizations operate, that coordination was consuming a significant amount of staff time every day. The cost wasn’t just operational. Once an exam is complete, the originating IDN needs timely access so clinicians can review priors before making care decisions, avoid duplicate scans, and maintain a continuous view of the patient’s health record. Every hour of manual coordination was an hour of clinical visibility that didn’t exist yet.

What this required wasn’t a faster version of the same manual process. It required a system that could interpret context, make routing decisions and act—without human intervention at every step. Leadership alignment was clear: move from human coordination to automated orchestration—and move quickly.

The Solution

PocketHealth delivered a scalable, cost-effective agentic automation system that fully automates cross-network imaging coordination into PACS.

PocketHealth worked with both organizations to design and deploy a purpose-built agentic solution—live in production within five weeks. This solution automates the exact workflow staff were already performing: logging into legacy image exchanges, pulling studies, matching patients in the EMR and normalizing studies and importing them into the PACS. The same steps, but without human intervention:

1. When a patient from the originating IDN is imaged at the partner facility, that partner facility sends the completed study through their existing image exchange—exactly as they always have. Nothing changes on their end.
2. At the originating IDN, PocketHealth monitors these spokes, detects the incoming study, matches the patient in the EMR and finds or creates the appropriate outside imaging order. It then normalizes the DICOM headers to match local conventions and pushes the study into PACS—automatically, in sequence, without staff involvement.
3. From the moment the exam is complete to the moment it appears in the clinician’s worklist, no staff member touches it. That clinician gets the access they need—to review priors, avoid duplicate scans and maintain a continuous view of the patient’s imaging history—without waiting on a manual process to catch up.
4. If anything doesn’t align, such as an uncertain patient match or missing data, the case is flagged to a human review worklist rather than silently failing. Once staff have resolved that case, the study moves seamlessly back into the automated workflow.

Importantly for both organizations, every step of this process is logged, creating consistent visibility, traceability and accountability.

The Results

After implementing PocketHealth, two of the nation’s largest IDNs now route hundreds of cross-network studies daily with zero manual coordination, faster access to priors and staff capacity redeployed to higher-value care.

PocketHealth didn’t execute a fixed script. It deployed a dynamic, multi-step coordination system across distinct organizational environments. Although the initiative began as a targeted improvement on manual coordination, it quickly evolved into a broader operational transformation:

• Staff at the originating organization no longer log into different image exchanges to monitor incoming studies. They also no longer manually rename and import studies. Instead, clean, matched studies move seamlessly and quickly into their PACS. Staff capacity that was previously absorbed by cross-network handoffs is now deployed on direct patient care.
• For the partner organization, nothing needed to change on their end. They were able to retain their existing processes, resulting in zero change management required.
• For both organizations, the relationship shifted from ongoing human coordination to a repeatable, governed and scalable agentic system. The system has now been operating autonomously for months without manual intervention.

Equally important: speed. In environments this complex—spanning multiple states, facilities, and EMR, PACS and image exchange systems—standing up new operational infrastructure can often take months. This deployment took five weeks.

This implementation demonstrates what’s possible when healthcare organizations invest in operational agentic AI: expanded capacity, improved speed-of-care and a foundation for extending agentic automation into additional workflows across the enterprise.

About PocketHealth

PocketHealth is the AI-enabled workflow automation platform transforming health system operations. With three interconnected solutions—Conductor, Image Exchange and Patient Connect—PocketHealth automates all manual, non-clinical tasks across the patient journey, from requisition processing to inbound call management to seamless image sharing and patient engagement. As a result, providers can redeploy staff, expand margins and deliver safer, more seamless care, while patients gain the knowledge and guidance they need so follow-ups don’t fall through the cracks. PocketHealth is SOC2- and HIPAA-compliant, and is trusted by more than 900 hospitals and imaging centers across North America, serving over 2 million patients. Request a demo today.