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Case study · Healthcare · Conversational AI

38% call containment in 90 days for a regional healthcare provider — healthcare-safe conversational AI

A regional healthcare provider needed to contain rising call volume for scheduling, refills and pre-visit intake without adding agents. pronix.ai deployed Kore.ai Agent Platform virtual agents on voice and chat with Epic integration, PHI guardrails and HITL escalation — 38% containment in 90 days with CSAT flat.

Client
Regional healthcare provider, 42 clinics
Industry
Healthcare Providers
Platform
Kore.ai Agent Platform · Epic · Amazon Connect
By pronix.ai CX Engineering8 min readQ1 2026
38%
Tier-1 call containment
-24%
Average handle time on transferred calls
+0.3pt
Patient CSAT
0
healthcare audit findings

*Representative outcome; results vary by client, scope and platform configuration.

The challenge

Call volume was up 34% year over year, driven by appointment scheduling, medication refills and pre-visit intake. Hiring couldn't keep pace and abandon rates were climbing. Any AI rollout had to stay inside healthcare guardrails, integrate with Epic and never mis-triage a clinical symptom.

Our approach

Step 01

Bounded intents, clinical guardrails

Shortlisted three intents — scheduling, refills, pre-visit intake — and put a symptom-triage classifier in front that hard-routed anything clinical to a human within two seconds.

Step 02

Epic-native tool layer

Nine idempotent tool calls into Epic for appointment slots, medication lists and demographics. Every write journaled to Epic audit for compliance.

Step 03

Voice + chat from day one

Same Agent Platform bot flow deployed to Amazon Connect voice and the patient portal chat — one authoring surface, two channels live together.

Step 04

PHI guardrails and HITL

PII/PHI masking on every prompt, topic-scope firewall, and a warm handoff pattern that shipped the full transcript context to the agent — no repetition.

Our access center finally has room to breathe — and patients are getting appointments booked at 11pm on a Sunday.

VP Patient Access
For VP Patient AccessFor CIOFor Chief Digital Officer

Illustrative case study. Scenarios, metrics, quotes and client details are representative composites based on Pronix engagements and industry benchmarks unless a named client is shown with written consent. Outcomes vary by client, scope, data quality and platform configuration. Nothing on this page is a guarantee, warranty or professional advice. See our Terms of Use for the full disclaimer.

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